M.I.A.W. Day 5: Depression

Depressed man sitting on steps in dark corridor

To finish off Mental Illness Awareness Week, we will be talking about depression. Contrary to what some people believe, depression is a real medical condition that requires treatment and attention. It is not simply a downturn in a person’s mood, and it is certainly not a sign of weakness.

Also known as clinical or major depression, it is a disorder that causes people to feel extremely sad or hopeless over a long period of time. It has a wide variety of symptoms, which include feelings of worthlessness, loss of interest or pleasure in favourite activities, and suicidal thoughts, among others.

It can also affect a person’s physical health, as it can cause a decline in a person’s energy, psychomotor impairment (such as slowed speech and body movements), physical aches and pains, insomnia, and changes in weight. Furthermore, it can decrease appetite as well as hinder thinking and decision-making skills.

Like many other mental illnesses, the causes of depression remain unclear, though it is widely believed that both biological and environmental factors play a role. For example, chemical imbalances in the brain of substances such as norepinephrine have been linked to depression. However, the death of a loved one, social isolation, or an oppressive upbringing can also lead to depressive thoughts.

Certain groups of people are considered to be at higher risk of experiencing depression. They include:

  • Youth (particularly those who identify as lesbian, gay, bisexual, or transgender)
  • Older adults: resulting from the loss of a partner or a dwindling social circle, also from dementia or being confined in care homes
  • Women: twice as likely to be diagnosed with depression as men, largely because of life-cycle changes, hormonal changes, higher rates of childhood abuse or relationship violence, and social pressures
  • People with substance abuse issues: some substances like alcohol, heroin and prescription sleeping pills lower brain activity, increasing the risk of depression
  • People with chronic illness: resulting from a decline in quality of life
  • People from different cultures: different cultures have different ways of dealing with depression

Other types of depression include seasonal affective disorder (SAD), also known as seasonal depression, which is associated with lack of daylight. This type of depression is particularly common in the wintertime, and is believed to affect between 3% and 5% of Canadian adults.

Postpartum depression is another type, which mostly affects women who have recently given birth. It is often linked to rapid hormonal changes, though other factors, such as sleep deprivation, personality, and family history, can also influence symptoms. Postpartum depression can also be experienced by men who have recently become fathers as well as new adoptive parents.

Treatment tends to take the form of counseling and medication. In turn, counseling can be delivered through cognitive-behavioural therapy (CBT), which involves coaching to break the negative thinking and action patterns caused be depression; or interpersonal therapy (IPT), which addresses social interaction when personal relationships have suffered as a result of a person’s depressive state.

The best way to get treatment if you feel like you are experiencing depression is by approaching your doctor. The Centre for Addiction and Mental Health (CAMH) offers a Mood and Anxiety Program, with both outpatient and inpatient options, for persons who have been referred by health specialists. In addition, Ontario’s Mental Health Helpline can be reached at 1-866-531-2600, and its website also offers chat and email services.

Please feel free to share your story with us by commenting on this blog post (anonymously if you wish) or on its related Facebook post. Your story could make a difference to someone.

Sources: Canadian Mental Health Association (B.C. Division), DepressionHurts.ca.


M.I.A.W. Day 4: Eating Disorders

Eating disorders are mental illnesses that are characterized by abnormal eating behaviours. According to the Canadian Mental Health Association (CMHA), the three most common types are anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Anorexia nervosa happens when a person becomes heavily invested in keeping their body weight extremely low. This is done by restricting their food intake and/or exercising obsessively. They may feel overweight even if they are seriously underweight, which exacerbates the problem. Restricting food can have severe consequences on a person’s body, as it can cause “heart and kidney problems, low blood iron, bone loss, digestive problems, low heart rate, low blood pressure, and fertility problems in women.”

Bulimia nervosa consists of periods of excessive eating followed by periods of purging (eliminating ingested food through methods such as vomiting and using laxatives). Like people affected by anorexia, people with bulimia may feel overweight regardless of their actual weight. It can cause health problems such as kidney problems, dehydration, and digestive problems, while vomiting can damage a person’s teeth, mouth, and throat.


Binge-eating disorder involves periods of over-eating. People who are affected by this disorder may feel like they can’t control how much they eat, and feel distressed, depressed, or guilty after bingeing. For these reasons, many often keep their bingeing habits a secret. Bingeing often has a comforting effect on those who engage in it, and it can sometimes develop following dieting periods. In turn, some people turn to dieting or fasting after binge-eating episodes or periods. It can increase the risk of Type 2 diabetes as well as cause high blood pressure and weight problems.

It must be noted that eating disorders can affect anyone, regardless of age, gender, ethnicity, sexuality, or any other kind of personal identifier. Having said that, people who experience lower self-esteem or poor body image, perfectionism, or difficulties dealing with stress may be more likely to experience an eating disorder.

Though weight loss and gain are commonly associated with these disorders, they are not the only signs to look out for. Many people who experience an eating disorder may feel unwilling to speak out about their problems for fear of having to gain weight. Others may be afraid to stop binge-eating as it helps them cope with other aspects of their lives. It is therefore very important to observe people who might give away certain signs of having an eating disorder. After all, they are treatable and affected people can recover through counselling and—if necessary—medication to treat mood instability that sometimes come with eating disorders.

When approaching someone with an eating disorder in an effort to help them, remember to focus on supporting and understanding rather than controlling their eating habits and behaviour. The CMHA lists the following helpful tips:

  • Remember that eating disorders are a sign of much bigger problems. Avoid focusing on food or eating habits alone.
  • Be mindful of your own attitudes and behaviours around food and body image.
  • Never force someone to change their eating habits or trick someone into changing.
  • Avoid reacting to a loved one’s body image talk or trying to reason with statements that seem unrealistic to you.
  • If your loved one is an adult, remember that supporting help-seeking is a balance between your own concerns and their right to privacy.
  • If your loved one’s experiences are affecting other family members, family counselling may be helpful
  • Don’t be afraid to set boundaries and seek support for yourself.

Canada’s National Eating Disorder Information Centre (NEDIC) serves as a portal to a number of resources across the country for people who experience eating disorders. They also staff a toll-free helpline at 1-866-633-4220 (416-340-4156 in Toronto/GTA).

If you would like to share your story with eating disorders, feel free to leave a comment on this blog post (anonymously if you wish) or on its related Facebook post!

M.I.A.W. Day 3: Bipolar Disorder


Bipolar disorder.

Also called manic-depressive illness, bipolar disorder is defined by the United States’ National Institute of Mental Health as a mental disease that “causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.” The Public Health Agency of Canada specifies that it is a bio-chemical condition that provokes intense mood swings. These can last for “days, weeks or even months” and can range from mild to severe.

bipolar disorder mental illness awareness week 2014 miaw

Symptoms of bipolar disorder (U.S. National Institute of Mental Health).

These distinct emotional states are called mood episodes. The “overly joyful” or manic state is called called a manic episode, while the “extremely sad or hopeless state” is called a depressive episode. A mixed state is one that includes both manic and depressive symptoms.

While the disorder typically lasts a person’s whole life, the episodes can be spaced out by a long time during which the affected person experiences no symptoms. Furthermore, mood is not the only thing affecteda person’s energy levels, sleep pattern, and behaviour can also see drastic changes.

Some people can inadvertently experience a milder form of mania, known as hypomania. Hypomanic episodes can make you feel very good and productive, and may be easily confused with just having a “good day.” However, if these episodes go unchecked, hypomania can eventually lead to more severe manic and depressive episodes.

Mixed states are characterized by the experience of mania and depression at the same time. This can cause someone to feel agitated, have trouble sleeping, go through major changes in appetite, and have suicidal thoughts.

More severe manic or depressive episodes can lead to psychotic symptoms as well, like hallucinations and delusions, in keeping with their extreme emotional state. For this reason, bipolar disorder is sometimes confused with schizophrenia.

For example, if you are having psychotic symptoms during a manic episode, you may believe you are a famous person, have a lot of money, or have special powers. If you are having psychotic symptoms during a depressive episode, you may believe you are ruined and penniless, or you have committed a crime.”

Like other mental illnesses, bipolar disorder tends to run in families, but environmental factors are also believed to come into play. One MRI study found that the brain’s prefrontal cortex in people with bipolar disorder tends to be smaller and function differently when compared to  those of adults who don’t have the disorder. Having said that, scientists are still discovering how the regions of the brain are interconnected. More research is needed in both genetics and neurological connections to pinpoint an exact cause.

Diagnosis usually follows a physical exam, an interview, and lab tests, and typically falls into one of these four categories:

  1. Bipolar I Disorder—manic or mixed episodes that last at least seven days, or severe manic symptoms that require immediate hospital care; depressive episodes can occur as well, lasting at least 2 weeks.
  2. Bipolar II Disorder—pattern of depressive episodes and hypomanic episodes, but no full-blown manic or mixed episodes.
  3. Bipolar Disorder Not Otherwise Specified (BP-NOS)—symptoms of the illness exist but do not meet diagnostic criteria for either bipolar I or II.
  4. Cyclothymic Disorder, or Cyclothymia—a mild form of bipolar disorder that includes hypomanic and mild-depressive symptoms.

A severe form of the disorder is called Rapid-cycling Bipolar Disorder, which occurs when four or more episodes all happen within a year. It seems to be more common among younger people and women, and can come and go.

Treatment usually takes the form of medication (mood stabilizers), and sometimes antidepressants. These can be combined with psychotherapy, which provides support, education, and guidance to those affected and their families.

The Centre for Addiction and Mental Health (CAMH) is a great resource if you need help with bipolar disorder. It offers a Mood and Anxiety Program that provides a variety of services, including excellent inpatient care.

As always, if you would like to share your story with us, you can do so by commenting on this blog post (anonymously if you wish) or on its related Facebook post!

M.I.A.W. Day 2: Autism

Autism, or Autism Spectrum Disorder (ASD), is defined by the Autism Canada Foundation as “a complex neurobiological condition that can affect the normal function of the gastrointestinal, immune, hepatic, endocrine and nervous systems.” It affects normal brain development, causing communication problems, difficulty with handling social interactions, and a tendency to repeat “specific patterns of behaviour” (such as rocking, biting, self-hitting, etc.).


Given that it is a spectrum disorder, the symptoms and their severity can vary. Autistic disorder is the most extreme form, lying on one end of the spectrum, while Asperger syndrome and other autism-related disorders are milder.

According to the United States’ National Institute of Neurological Disorders and Stroke, early signs of autism in children include unresponsiveness to people, focusing on one item intently, avoiding eye contact, and not responding to their names. As they grow older, they may have a hard time picking up on social cues, such as tone of voice or facial expressions, and may lack empathy. They also tend to start speaking later than other children, and their topics of conversation can remain very limited as they grow. Maintaining their own order and a set routine is very important for many, and disrupting a child with ASD’s routine can cause severe stress and behaviour issues (such as tantrums, self-harm, aggression, among others).

While milder forms of ASD may go unnoticed throughout a person’s entire life, screening for ASD is usually made by having the person fill out questionnaire and/or use some kind of screening instrument. If the screening indicates the person might be affected, a comprehensive evaluation for diagnosis may follow, involving a team of psychologists, neurologists, psychiatrists, speech therapists, and other professionals.

As for the cause of ASD, scientists are not really sure. It is likely that ASD is triggered by a combination of genetics and environment, as well as certain irregularities in the brain (see image). Interestingly, if one identical twin has ASD, there is a 90 percent chance the other twin will be affected as well. In addition, boys are more commonly affected than girls, being four times more likely to develop ASD.

For most children, symptoms improve with age and treatment. This can involve educational/behavioural interventions with therapists and counseling that includes the family in the child’s development. Treatment can also take the form of medication to alleviate symptoms and autism-related conditions like anxiety, depression, obsessive-compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD).

It’s worth mentioning that children with language problems are more prone to developing epilepsy later in life. Furthermore, during adolescence many experience depression or behavioural problems that will require a modified treatment. Nevertheless, many people with ASD are able to work successfully and live independently in their adult life.

If you or someone you know needs help dealing with ASD, you can find resources through the Autism Canada Foundation, the Autism Resource Centre, and Autism Ontario.

Also, if you would like to share your story with us, you can leave a comment on this blog post (anonymously if you wish) or on its related Facebook post!

M.I.A.W. Day 1: Dementia

The United States’ Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life.” Contrary to what some  of us may believe, it is not a single specific disease, but rather an umbrella term that applies to a wide range of symptoms.


Prevalence of types of dementia in the United States.

The most common type of dementia is Alzheimer’s disease, accounting for 60 to 80 percent of cases. The second most common type is vascular dementia, which occurs after a stroke.

It must be highlighted that the idea that severe mental decline comes with old age (often under names such as “senility” or “senile dementia”) is a misconception. Dementia is an illness, not a part of natural aging, and must therefore be treated as such.

As for the symptoms, they can vary depending on the specific illness, but at least two of the following mental functions must be severely impaired in order for it to be considered dementia:

  • Memory
  • Communication and language
  • Ability to focus and pay attention
  • Reasoning and judgement
  • Visual perception

These symptoms often get progressively worse–they start slowly and worsen more quickly as time goes by. Detecting them early is key to ensuring proper treatment if possible and preparing for future care if and when it becomes necessary.

Conquering Alzheimer's - New Hopes

A healthy brain vs. a brain with advanced Alzheimer’s disease.

The cause of dementia is damage to brain cells, which prevents them from communicating with each other. In the case of Alzheimer’s disease, the first region of the brain whose cells are affected is usually the hippocampus, which is responsible for learning and memory. This explains why memory loss is among the earliest symptoms of Alzheimer’s disease.

Unfortunately, there is no single test that can help doctors diagnose dementia. Diagnoses are made following a careful look at a patient’s “medical history, a physical examination, laboratory tests, and the characteristic changes” in thinking and everyday function and behaviour.

alzheimer's in canada

Canadians living with dementia and its economic cost – 2011 vs. 2031 (Canadian Institutes of Health Research infographic).

In addition, most types of dementia, including Alzheimer’s, have no cure or treatment, many of them being a product of old age and genetics. Some drugs can temporarily alleviate certain symptoms, but more research is needed in the field to create a better solution. Enrolling in clinical trials to improve the medical community’s knowledge base could make a great difference for future generations.

And while there is no cure, maintaining a healthy diet and active physical lifestyle can lower a person’s chances of developing dementia. This is especially important as our population continues to age and dementia rates are expected to soar in the coming decades. The Globe and Mail recently reported that Canada is the only G7 nation “without a national dementia strategy” (though some provinces do have their own) and the World Health Organization has declared the disease “a growing public concern.”

If you or someone you know needs help dealing with Alzheimer’s or other types of dementia, Alzheimer Societies across Ontario offer the program called First Link, which “helps connect people with dementia and their caregivers to support and education so they can cope with changes associated with the disease.” For more information, please visit the Alzheimer Society website, or call their toll-free number at 1-800-879-4226.

If you would like to share your story as someone affected by dementia, either personally or indirectly, be sure to leave a comment on this post (anonymously if you wish) or on its related Facebook post!

Mental Illness Awareness Week

mental illness awareness week miaw list of mental health illnessesToday marks the beginning of Mental Illness Awareness Week. (Sounds like a bit of a mouthful, so we will refer to it as MIAW.)

The image above lists a wide range of mental illnesses that many people face all over the world. While we obviously won’t be able to cover all of them, our goal for this week is to publish a blog post that highlights one mental illness per day, providing a brief description of each one.

Our main mandate here at Crown Jewels is to raise awareness of mental health, and we believe that a key component of that is educating the public about the various illnesses and conditions that fall under the umbrella of mental health issues.

If you would like to share your story with any of these mental health issues, please feel free to leave a comment on this week’s blog posts (anonymously if you wish) or their related Facebook posts.

Mental Health in the Media: September

More young people wait for mental health treatment

Youth waiting for medical treatment for mental health issues are looking at wait times of up to a year. This is a worrying statistic because delay in treatment can escalate the severity of symptoms in youth. Doctors and health officials are concerned about the discrepancy between the message that youth should seek help for mental health related issues and the reality of insufficient funding for mental health treatment.

Source: http://ottawacitizen.com/news/local-news/more-young-people-wait-for-mental-health-treatment

Unusual drama school in Rome is set to expand

A drama school is Rome is offering a program for those with mental disabilities. The hope is that learning stagecraft could be used as a form of treatment. The program teaches the students how to express their feelings in a nonjudgmental environment and in doing so create a new culture for those with mental disorders. The school is working towards becoming a state-recognized university.

Source: http://www.nytimes.com/2014/09/04/theater/unusual-drama-school-in-rome-is-set-to-expand.html

Addressing youth mental health key to tackling suicide prevention

Suicide is the second leading cause of death among Canadian youth 15 to 25 years of age. Currently, Canada lacks a national suicide prevention policy unlike a number of countries around the world. Doctors say the issue is that suicide prevention needs to be look at in connection with mental health, not separate from it as it is now. The current services available are not sensitive to the needs of youth which makes them hesitant to ask for help.

Source: http://www.theglobeandmail.com/life/health-and-fitness/health-advisor/addressing-youth-mental-health-key-to-tackling-suicide-prevention/article20495150/

First blood test to diagnose depression in adults

The first blood test to diagnose major depression in adults has been developed, providing the first objective, scientific diagnosis for depression. The test also predicts who will benefit from cognitive behavioural therapy, offering the opportunity for more effective, individualized therapy. The test also showed the biological effects of the therapy, the first measurable, blood-based evidence of the therapy’s success and showed who is vulnerable to recurring episodes of depression.

Source: http://www.sciencedaily.com/releases/2014/09/140917121229.htm

The time has come to end stigma and fund mental health care in America

The World Health Organization (WHO) has launched a new campaign: No Health Without Mental Health. WHO wants to ensure that mental health is understood on a factual basis and has set out key facts. The organization has also set global targets that they wish to achieve by 2020. The biggest barrier to overcome for this campaign to be successful is stigma within society.

Source: http://www.huffingtonpost.com/ginger-lernerwren/the-time-has-come-to-end-_b_5832510.html