The Transition Game – Week 7

Welcome back!

Since last week I have completed the workbook portion of “Who Are You?”, have kept up with my gratitude practice, completing 3 lifts a week plus lots of rollerblading and hiking with my pup, spent as much time in the sun as I can, and have been reaching out to lots of old friends. I am feeling great and have even been able to support a few friends going through hard times which has been very rewarding.

I loved this lesson in the workbook, it was fun to reflect on where I came from, what made me who I am and put pen to paper to lay it all out clearly. In the book it says most people draw a complete blank when you ask who they are, I immediately wrote a page about who I am with no hesitation. That felt great, I can’t wait to see what my facilitator has to say about that and what I wrote. It speaks to how much better I have been feeling, if you asked me that question a couple of months ago I probably would have said “I don’t know, who cares, why are you asking me that?!”

Here is what I wrote:

“I am a hard-nosed Calgary kid who built my own success out of the willingness to do what others would not and the refusal to be intimidated by anyone. I am an animal lover and crazy dog man. I love rap, rock, tattoos, guns, motorcycles, and violent sports but I am highly sensitive and soft on the inside just like the men in my family before me. I am intense but also the biggest goofball man child in the world once you gain my trust. I am an only child but was never lonely, I made my friends my siblings and my Dad always laughed and called me a social butterfly. I am unique, weird, quirky however you want to put it but I have always loved and embraced it with no fear of being judged.”

I’m not sure if I did that right, but either way, it felt good to write, it felt good to remind myself of all these things. After I meet with my facilitator I will likely rewrite it, there is another section at the back for a second draft. I look forward to that as well.

Another task in my homework that had a big impact on me was after some readings I wrote notes about all the ups and downs in my life. Then I had to ask myself “why am I doubting myself, why would I do that”. Which I was already asking myself before getting halfway done with my notes. For starters, my ups list is three times as long as my downs list. Looking at the ups, the times I defied the odds, the way I impacted people around me. When I had a clear picture of who I was and believed in myself, I reached every single goal I set for myself. Yet, here I am after spending 20 years that way, doubting myself every day in every way. Insane. That’s the only way to describe it, it makes no sense. This work has been so eye-opening, it all seems so simple yet I was completely stumped and lost. I guess I just wasn’t asking the right questions or any at all.

The quote at the start of the lesson sums it up best. “Most of the shadows of this life are caused by standing in one’s own sunshine.” – Ralph Waldo Emerson

Thanks for all the support, I hope through sharing my reflections you have been able to do some of your own!

Write you next week,

Esty

The Transition Game: Week 6

Welcome back!

What’s new this week? Well, I completed the new Attitude online section, have been way more consistent with my gratitude practice, am feeling better with my workouts and mixing in some new things like collecting road rash while rollerblading. Another plus is I have been much more productive during the week allowing me more free time on the weekends to recharge. The online section of Attitude gave me some of my favourite tools and perspectives yet.

The first thing that impacted me was journaling my daily attitude changes for a week, they went like this:

  1. Training/Workouts – I’m too tired, I don’t have time -> I will make time, it will give me more energy and help me sleep, plus I love it.
  2. Chores – Stupid, annoying, never-ending, better things to do -> Put on some music, have fun with it, get it done and reduce stress in the process.
  3. On day 3 I realized what would have the biggest impact on my life was changing my attitude about myself and doing some positive self-talk in the process, like Muhamad Ali and his poetic trash talking, it wasn’t to talk trash, it was to instill in his mind he was the greatest and so he was. I started with this. I am a fitness junkie, I will stick to my routines and let them drive my success.
  4. I am a smart and capable marketer
  5. The more I learn the more I earn $$$
  6. I am a social person with a good heart which makes for a great salesman
  7. A side hustle I’m passionate about and enjoy would be amazing, no need to worry about the hours it takes, just enjoy it and live!

Not a bad start, I’m sure my facilitator will have some ideas on how to tweak these further and what to focus on next but I’m feeling a lot better about myself and life in general already. The next strategy and the one that has impacted me most was finding three powerful positive words to say in my head when I feel my attitude shift negatively. The words have to create very clear pictures in your mind of times where you had an excellent attitude that created positive emotions and results. It took me some time to work it out and find the pictures in my mind that could snap me out of these negative attitude shifts. I ended up with gains, goals, and gratitude. 

Yes, you can laugh at me for picking gains as my number one, I laugh at myself for being “that guy” all the time but I couldn’t discard it because of the picture it creates in my mind. I’m at the gym, it’s a beautiful summer day, I’m working my ass off to the point my training partners are starting to wonder if I’m a psychopath, my trainer is grinning at the monster he has created. I’m building myself up, I’m ten feet tall and bulletproof, but I’m not just training my body, I’m learning to harness the power of my mind, building mental resilience and discipline. My confidence is unwavering and everyone around me feels my energy when I walk into the room.

Goals, it’s a beautiful summer day again. I’m outside with friends or in my Jeep with the windows down and music blasting, I know exactly where I want to go and how to get there. Everything is coming together in my life and I bring a smile with me everywhere I go. I’m constantly given positive feedback for being so driven and disciplined. “Everyone wants to be like Esty”, I can hear my old trainer say it clear as day as the younger athletes watch me train. My direction and path are clear and in front of me, I visualize my dream with ease and know in my heart I will make it come true.

Gratitude, yeah it’s a beautiful summer day again. I love the sun and I loved the offseason just as much as I loved being in season and playing the game. If I’m being honest, during my five-year college career I loved the offseason training far more than I loved the game. When I think of gratitude I flash to being on my couch after a long training day, 1.5 hours of weights and an hour of cardio in the books plus a solid hour on the ice. Lots of stretching, rolling, and refuelling in between. I can relax now, I’m happy with what I did, I feel great even though I’m sore head to toe and I know I’ll need a forklift to get out of bed the next day and do it all over again. I put on an action movie as the sun starts to go down and I’m completely content, at peace, and happy. I am grateful to be able to live this lifestyle and to have the support and admiration of my friends and family. LIFE IS GOOD!

After doing that exercise I started using the strategy that day and it works. Very well, I’ve used it in various situations now and it snaps me out of my bad attitude very quickly. I highly recommend everyone finds their three powerful positive words and just repeat them over and over and over again. I promise your shitty attitude won’t stand a chance.

Write you next week!

Esty

The Transition Game: Week 5

Welcome back!

Since I last wrote I have had another facilitator meeting, finished “Attitude Determines your Altitude” in my workbook and began some of the homework that comes with the lesson. I have been procrastinating less but still have a long way to go, I’m working out more consistently and have worked my gratitude practice into my warm-ups which puts me in an even better headspace than training alone already did. Using my scheduler remains to be a huge challenge, I always have a plan in my mind and I need to just prioritize putting it down on paper when I first sit down to start my workday. I know it will benefit me and I have to remind myself of that each morning to get it done.

As always, this most recent lesson has been an opportunity to look myself in the mirror, analyze my past, and help shape my future. In my workbook, the first thing that struck me was I was asked to indicate whether my thoughts were positive or negative when it came to school, my sport, myself, and home life. It was hard to have to circle negative on each, but a needed wake-up call. Especially once realizing that the results I am getting or have gotten in those areas are not the results I want. Immediately I flashback to my hockey career and remember the years I had the most success, I would have circled positive for all but school (I don’t think there has ever been a time in my life where I would circle positive for school). I was very fortunate to have some great coaches when I first entered the elite levels of hockey, one coach made it mandatory for us to send him positive self-talk emails on game days, if you didn’t, you did not play. Many guys thought this was just plain stupid, they refused and were punished, or they didn’t commit and never saw the full benefits. With a nudge from my parents backed by the fact that the coach had a very successful professional hockey career himself, I committed to it. The impact it had on my on-ice performance and overall confidence blew my 13-year-old mind.

I tried to find the old emails but had no luck. From what I remember they went something like this:

“I am a physically dominant shut down defenseman, I am a solid skater and excellent positional player. I am a leader and will not allow my teammates to be intimated or taken advantage of.” We then would set goals for that specific game, mine were usually something like this. “I will have 20 hits with impact, 5 hard shots on net with potential for tips or rebounds, 5 blocked shots, and will be a +2 with 1 assist”. I was amazed to see that when I consistently did this, I not only truly began to believe it, but I reached those goals more times than not and it took me from barely making the team to being a sought after defenseman every year that routinely wore a letter on my jersey.

Somewhere along the line, I forgot about all of this, and by the time I achieved my dream of earning a hockey scholarship I had allowed it to be completely washed away thanks to my ego. I did not have the success in college I had dreamt of for the previous 8 years and thanks to my hindsight 20-20 vision I realize that was largely due to an unchecked negative shift in my attitude.

For my homework, I have to journal my daily changes in attitude for 1 week. Thus far I have gone from “I’m too tired to train today, I don’t have time” to “I will make time, working out will increase my overall energy and help improve my sleep”. Today I added “chores are stupid, annoying, never-ending, I have better things to do” and changed it to “Put on some music, have some fun with it, get it done and reduce my overall stress in the process”.

Thanks to everyone who has been keeping up with this blog, I’m truly enjoying writing it and It’s helping me more than you know!

Write you next week,

Esty

The Transition Game – Week 4

Welcome back!

Good news, since last week I have completed both the book and online lessons for Habits, got back on the workout train, have been much more productive, and have made progress in changing my bad habit of procrastinating tasks I dislike. My facilitator made it very clear to only focus on one habit at a time and I felt changing this one first would have the greatest impact on how I feel day to day. My gratitude practice is still really lacking and I need many reminders to do it daily, now that I am back to working out I have put a notepad and pen on my dumbbell rack and will incorporate my gratitude practice into my warmup ritual. Using my scheduler is another big challenge for me that I have yet to consistently integrate into my daily and weekly routines. I love having a plan, I hate having things planned down to the minute and that is my character strength score of 1 – which means I am very flexible as opposed to traditional. Often, I find myself completely disregarding everything I planned on paper which in turn causes me to think “well why the hell am I wasting time on this, I got way more done when I just winged it”. That is NOT a growth mindset and I will continue to work at using my scheduler consistently AND STICKING TO THE PLAN.

The Habits section of the Success Strategies program has been a great challenge but also my biggest opportunity for growth yet. I have realized how many poor habits I have which makes it difficult for me to not beat myself up. I have to constantly fight my utter disappointment in myself with each bad habit I recognize in my homework as well as when they pop up throughout my days. This is going to take years of hard work and dedication to break all these bad habits and replace them with good ones. I am very familiar with years of hard work and dedication however; I am not so used to it being on the mental side of things. Going back to the first blog post I wrote I talked about how during my Hockey career “I was the athlete equivalent of a Formula 1 racecar being driven by a gorilla”. This has rung true yet again, after writing down all of my habits both good and bad, all the good ones were physical (eating healthy, drinking lots of water, staying in great shape, staying very active even when working out is a challenge) and the bad ones were mental (stressful thinking, negative self-talk and self-doubt, mistrust of people, skepticism of all things society, procrastinating tasks I dislike or think are stupid, pushing my feelings down, putting up emotional walls).

I truly cannot wait to rid myself of the “gorilla” but I have to stay patient, focused, and increase my dedication to this work. Through the work that I have done so far here is what I’m noticing (on days I stay on top of it):

  • Decreased symptoms and feelings of depression
  • Increased self-awareness
  • Increased motivation
  • Better sleep (less dependant on cannabis)
  • Less autopilot and more present in the moment
  • Exhausted… but from the work, workouts, and mindfulness not for seemingly no reason
  • I’m starting to get excited about doing things again (rollerblading, walking, outdoor hangouts)
  • Looking for new hobbies instead of just letting myself rot, though this has been hard due to covid, at least I want to find something, I’m interested in trying Muay Thai and can’t wait for things to open up and to get vaccinated so I can dive in.

There is much work to be done, but for the first time in a while, that doesn’t bother me or stress me out.

Thanks for checking in, write you next week!

Esty

Finding Hope – 10 Tips for Reaching Mental Wellness and Practicing Self Care

We are so happy you chose to join us for our Finding Hope webinar. If you have found your way to this page and did not attend the webinar, you haven’t missed out! 

We want to thank you for your support and highlighted some action steps mentioned during the event that you can start taking right away! There are also some additional resources linked at the bottom of the page.

10 Tips for Reaching Mental Wellness and Practicing Self Care

Raeanne Woycenko

 
Self Care by definition is to take action to preserve or improve one’s health.
 
We have been taught and conditioned from a young age to be kind, help others, and be selfless, however, in today’s hectic world we are doing a disservice to ourselves and our loved ones when we don’t take time to care for ourselves first.
 
Think of the safety message we hear each time before we takeoff on a flight. The flight attendant announces, ‘In the event the cabin loses pressure we are to first place our own oxygen mask on before we help others’. This is so that we can in fact help others. This same type of safety message needs to be at the forefront of our minds each day as we go through life. We need to provide self-care to ourselves each day so that in turn we are strong and able to show up for our loved ones as the very best version of ourselves. Help yourself so that you may help others, it’s also an excellent practice to role-model for those around us.
 
When we recognize we aren’t feeling mentally or emotionally healthy, we need to take steps to get ourselves back on track. 
 
Here are some coping strategies and tips that were discussed in our Finding Hope webinar. We hope you will introduce some of them into your daily routine.
 
1.  Give thanks. It is important to express gratitude for even the smallest of life’s wonders. Even something we may normally take for granted, “like a tiny snowflake landing on your cheek” suggested Registered Nurse Gerri Harris, during the webinar.
   
Gratitude also helps us to recognize that we are part of something larger in life.
 
2.  Try new things. Find joy in learning about something new. Perhaps take up a new hobby, craft, or activity like snowshoeing where you can learn to appreciate and find joy in a season many of us dread. Trying something new allows us to focus for a period of time on something present rather than dwelling on something in the past or worrying about something in the future.
 
3.  Move your body. Start with a short walk around your block and add half a block each time you go out. If that sounds too daunting, even adding a few steps and walking to your kitchen from your bedroom, and then maybe to your living room the next day, and to the mailbox at your front door the day after. Each step doesn’t have to be large, it just needs to be forward motion, a little progress made each time. Not only does the sense of accomplishment feel good, but as you move your body you will get stronger, reduce stress hormones and produce endorphins – the feel-good neurotransmitters.
 
4.  Grounding Exercise shared by IGM Mental Health Clinician, Shawn O’Grady 
When you are feeling anxious and overwhelmed, slow down and ground yourself by using this 5-4-3-2-1 method. Place your hands on your thighs or rub your hands together, now look around you and notice 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. Share this technique with a trusted friend or family member so they can help you when they notice you are stressed or anxious. They can help by saying “I think it would be a good idea to do some grounding. Describe the top you’re wearing to me, tell me about what I’m wearing, what is the texture of the chair you’re sitting on?”
 
5.  “Don’t do it alone” was the piece of advice offered by Kelly Hrudey. Speak with a trusted friend or relative. Have those connections. Share your feelings. When you share with someone it helps you to feel mental and emotional relief. 
 
If you have a difficult time sharing with those close to you, schedule a time to meet with a mental health professional. “Unload your backpack” or “Drop your pack!” as IGM facilitator and former US Marine Derek Hines described it. “Talk about it and then let it go”.
 
6.  “Pick your hard” as I Got Mind’s Caitlyn Watters suggested. “Is it harder to do the work (to better your mental health), or is it harder to stay where you are?” Don’t be afraid to reach out for professional help. I Got Mind can help to connect you with a Professional through our partners at Hull Services.
 
7.  Keep a consistent routine and don’t over-schedule yourself. When we are running from task to task or activity to activity it causes us overload and stress. Slow down, allow extra time to alleviate the stress of running behind and keep balance in your life through offsetting some of your ‘busy’ activities with calmness from reading positive affirmations, meditating, or going for a walk.
 
Try to go to sleep and wake at a regular time each day, and do your best to get up, shower and dress. You will feel better.
 
8.  Breathing exercises help us to regulate our breathing rhythm. When we are stressed and anxious we tend to take quick, shallow breaths that come from our chests. This chest breathing can cause us to feel more stressed and anxious as it causes an upset in the balance of oxygen and carbon dioxide in our body which results in feeling dizzy, having tension in our muscles, and an increased heart rate. When this happens our blood is not receiving proper oxygen and can cause a stress response that contributes to anxiety.
 
9.  Learn to love yourself! Practice self-care daily. Remember, as stated above; before you can give more to others, you have to give more to yourself first. Schedule some ‘me’ time into your day. Investing in your wellness is the best investment you can make.
 
10.  Be Proactive. Seek out information about how to stay ahead of the mental health curve. Learn about why we feel the way we do, what we can do to change things, learn new skills and develop healthy habits.
 
We are here to help! At I Got Mind we offer affordable and accessible online courses for individuals (you, your family), sport organizations, business, and schools.
 
Whether the need is big or small, we have solutions for you.

Resources and Learning Opportunities

IGM Mental Health Checklist

I Got Mind Professional Counselling Services. In house psychologists, individual or group sessions. Please contact [email protected]

I Got Mind Referral for Hull ServicesPlease contact [email protected]

Distress Centre – CALL 403.266.HELP(4357) If you need immediate help.

Centre for Suicide Prevention

IGM Introducing Stress Course – Gain a deeper understanding of the thing that can both destroy and create.

IGM Preparing to Adapt Course – Created to aid people during the first Covid 19 lockdown.

IGM Success Strategies Program – The signature program for clients, this WILL change your life.

Research Roundup – January 2021

Post credit, our friends at: The Centre for Suicide Prevention

This is a summary of the latest significant Canadian (🇨🇦) and international suicide research we collected in the past month:

🇨🇦 Canadian Patient Safety Institute & Mental Health Commission of Canada. (2021). Suicide risk assessment toolkit: A resource for healthcare workers and organizations.
We typically do not include items from the grey literature, but we thought this new resource was deserving of attention. It is an accessible compilation of selected risk assessment tools. Accompanying text include current best practices culled from the research for risk assessment use. This is a major overhaul of a previous edition (2011).

Hvidkjaer, K., et al. (2020). People exposed to suicide attempts: Frequency, impact, and the support received. Suicide and Life-Threatening Behavior. 1–11. DOI: 10.1111/sltb.12720. A Danish population-based online survey suggesting that suicide attempts affect those exposed to them in more significant ways than previously thought.

Abstract – Objective: Little is known about people who have been exposed to a suicide attempt by someone they know. The purpose of this study was to examine how many people have been exposed to a suicide attempt by someone they knew and whether the exposure was associated with general well‐being and suicidal ideation. Method: A population‐based online survey was conducted during 2019 in Denmark (n = 6,191). The associations between exposures to suicide attempt and general well‐being (WHO‐5) and suicidal ideation (Suicidal Ideation Attributes Scale) were examined using linear regression analyses. Results: Overall, 24.6% reported having experienced a suicide attempt by someone they knew. Of those, 46.5% had experienced a suicide attempt of a close relation and this group reported having been more affected by the event. Those exposed scored lower on general well‐being (b: −3.0; 95% CI: −4.2 to −1.8; p > 0.001) and higher on suicidal ideation (b: 1.6; 95% CI: 1.3 – 1.9; p = 0.001) than those not exposed. Half of the exposed reported not having received sufficient support after the event. Conclusion: Suicide attempt affects a substantial share of the population, and it might be relevant to ensure that support is available for those exposed perceived to be in need of support.

🇨🇦 Leenaars, A., Dieserud, G., & Wenckstern, S. (2020). The mask of suicideArchives of Suicide Research. DOI: 10.1080/13811118.2020.1851832
Veteran Canadian sucidologist Antoon Leenaars uses tools of the Psychological Autopsy (PA) to investigate the prevalence of dissembling or “masking” among suicidal decedents. This was a study of 120 survivors/informants in Norway.

Abstract – Although it has been stated that the majority of suicidal people give definite warnings of their suicidal intention, a percentage of suicidal people may dissemble (or mask), possibly 20%. The aim of this psychological autopsy (PA) study was to explore the mask of suicide, examining age and sex of the decedent, and survivors’ relationship to the deceased. A PA study in Norway, with 120 survivors/informants, was undertaken. Overall, 80% of informants reported manifest and/or latent content of deception (dissembling); well above the 20% suggested. Three main themes emerged from the interviews of the 95 survivors that were related to the mask. In the opinion of the bereaved, reasons for the mask were due to: 1) Inability to adjust/ impairment; 2) Relational problems; and 3) Weakened resilience. Differences in masking or (self) deception were found in the age of the decedent, but not in sex, nor in the survivors’ closeness of the relationship. Older deceased people were perceived to exhibit more dissembling, associated to the suicide. Limitations are noted in this beginning study into the mask of suicide, and it is concluded that much greater research is needed to unmask the dangerous dissembling, maybe in some, self-deception.

🇨🇦 Zortea, T., et al. (2020). The impact of infectious disease-related public health emergencies on suicide, suicidal behavior, and suicidal thoughts: A systematic review. Crisis. DOI: 10.1027/0227-5910/a000753
A Canadian comprehensive systematic review analyzing the impacts of epidemics on suicide-related outcomes. 8 studies, published between 1992 and 2017, were identified and investigated.

Abstract – Background: Infectious disease-related public health emergencies (epidemics) may increase suicide risk, and high-quality evidence is needed to guide an international response. Aims: We investigated the potential impacts of epidemics on suicide-related outcomes. Method: We searched MEDLINE, EMBASE, PsycInfo, CINAHL, Scopus, Web of Science, PsyArXiv, medRxiv, and bioRxiv from inception to May 13–16, 2020. Inclusion criteria: primary studies, reviews, and meta-analyses; reporting the impact of epidemics; with a primary outcome of suicide, suicidal behavior, suicidal ideation, and/or self-harm. Exclusion criteria: not concerned with suicide-related outcomes; not suitable for data extraction. PROSPERO registration: #CRD42020187013. Results: Eight primary papers were included, examining the effects of five epidemics on suicide-related outcomes. There was evidence of increased suicide rates among older adults during SARS and in the year following the epidemic (possibly motivated by social disconnectedness, fears of virus infection, and concern about burdening others) and associations between SARS/ Ebola exposure and increased suicide attempts. A preprint study reported associations between COVID-19 distress and past-month suicidal ideation. Limitations: Few studies have investigated the topic; these are of relatively low methodological quality. Conclusion: Findings support an association between previous epidemics and increased risk of suicide-related outcomes. Research is needed to investigate the impact of COVID-19 on suicide outcomes.

Too, L.S., & Spittal, M.J. (2020). Suicide clusters among top 10 high-risk occupations: A study from 2001 to 2016 in Australia. The Journal of Nervous and Mental Disease, 208(12), 942-946. DOI: 10.1097/NMD.0000000000001234
An Australian study looks at the potential role suicide clusters may have on rates of suicide for at-risk occupational groups.

Abstract – A number of studies have demonstrated elevated risk of suicide in certain occupational groups. We seek to understand a possible new risk factor: suicide contagion, as demonstrated through a suicide cluster analysis. National-level coronial data and census population data were used for the study. We calculated suicide rates to identify “risky” occupations. SaTScan .1 was used to perform Poisson discrete scan statistic. Suicides occurring in arts and media professionals, construction, manufacturing, and skilled animal and horticultural workers seemed to cluster in time and/or space. Those working in construction settings were at risk of being in both time and space clusters.

🇨🇦 Grzeda-Isenberg, E., et al. (2020). Suicide attempt after determination of ineligibility for assisted death: A case series. Journal of Pain Symptom Management, 60(1), 158-163. DOI: 10.1016/j.jpainsymman.2020.02.016
Three case studies are presented of patients who attempted suicide after being deemed ineligible for Medical Assistance in Dying (MAID) in Canada. None met the current requirements of having a serious illness, experiencing intolerable suffering, and having a reasonably foreseeable natural death. The authors foresee this period of MAID ineligibility as an emerging category of vulnerability to suicide.

Abstract – Medical assistance in dying (MAID) and similar right-to-die laws are becoming increasingly common in jurisdictions across North America and elsewhere. To be eligible for MAID in Canada, requesters must have a serious illness, intolerable suffering, and a reasonably foreseeable natural death. They must also undergo two assessments to confirm eligibility. Although a growing body of literature now exists to help clinicians understand and support patients around requests for assisted death, a dearth of literature exists on how best to support those patients who are deemed ineligible. Here, we report on a case series of three patients who attempted suicide after being found ineligible for MAID. Two patients were ineligible because they did not appear to have reasonably foreseeable natural death. The third patient was ineligible because of concerns around decisional capacity. All three cases had previous diagnoses of depressive disorders and mild cognitive impairment, and two cases had histories of suicide attempts. In at-risk patients, we speculate that the period surrounding a finding of MAID ineligibility may represent a period of particular vulnerability. Clinicians must be vigilant and prepared for the possibility of heightened risk, including risk of self-harm, after a finding of ineligibility for assisted death.

🇨🇦 El-Magd, R.M.A., et al. (2020). Family members’ perspectives on family and social support available to suicidal patients, and health systems’ interactions and responses to suicide cases in Alberta: Protocol for a quantitative research study. Journal of Medical Internet Research Protocols, 9(11), e19112. DOI: 10.2196/19112. A Canadian protocol for a study of personal, familial, societal, and health systems factors that contribute to suicide deaths in Alberta. It will also look at the supports available for families who have lost members to suicide.

Abstract – Background: Suicide is a major cause of preventable death globally and a leading cause of death by injury in Canada. To support people who experience suicidal thoughts and behaviors and to ultimately prevent people from dying by suicide, it is important to understand individual and familial experiences with the health care system. Objective: We present the protocol for a study, the objective of which is to explore how people who died by suicide, and their family members, interacted with the health care system. Methods: This is a quantitative research study. Data will be collected through a self-administered paper-based or online survey of the family member of patients who died by suicide. The sample size was calculated to be 385 (margin of error ±3%). Results: Data collection will start in October 2020 and results will be available by March 2021. We expect the results to shed light on the experiences of individuals who died by suicide and their family members with the health care system. The study has received ethical clearance from the Health Ethics Research Board of the University of Alberta (Pro00096342). Conclusions: Our study may inform practice, policy, and future research. The findings may shape how members of the health care system respond to people who are at risk of suicide and their families.

Mak, J., et al. (2020). Suicide attempts among a cohort of transgender and gender diverse people. American Journal of Preventive Medicine, 59(4), 570-577. DOI: 10.1016/j.amepre.2020.03.026. Electronic medical records from an American dataset of individuals who are transgender or gender diverse were analyzed to gauge the prevalence of attempted suicide.

Abstract – Introduction: Transgender and gender diverse people often face discrimination and may experience disproportionate emotional distress that leads to suicide attempts. Therefore, it is essential to estimate the frequency and potential determinants of suicide attempts among transgender and gender diverse individuals. Methods: Longitudinal data on 6,327 transgender and gender diverse individuals enrolled in 3 integrated healthcare systems were analyzed to assess suicide attempt rates. Incidence was compared between transmasculine and transfeminine people by age and race/ethnicity and according to mental health status at baseline. Cox proportional hazards models examined rates and predictors of suicide attempts during follow-up. Data were collected in 2016, and analyses were conducted in 2019. Results: During follow-up, 4.8% of transmasculine and 3.0% of transfeminine patients had at least 1 suicide attempt. Suicide attempt rates were more than 7 times higher among patients aged <18 years than among those aged >45 years, more than 3 times higher among patients with previous history of suicide ideation or suicide attempts than among those with no such history, and 2–5 times higher among those with 1–2 mental health diagnoses and more than 2 mental health diagnoses at baseline than among those with none. Conclusions: Among transgender and gender diverse individuals, younger people, people with previous suicidal ideation or attempts, and people with multiple mental health diagnoses are at a higher risk for suicide attempts. Future research should examine the impact of gender-affirming healthcare use on the risk of suicide attempts and identify targets for suicide prevention interventions among transgender and gender diverse people in clinical settings.

Sharp, L., et al. (2020). Delivering the first internationally accessible Massive Online Open Course (MOOC) on suicide prevention: A case study and insights into best practice. Journal of Perspectives in Applied Academic Practice, 8(2), 72-80. The authors present guidelines of how best to deliver “sensitive and/or controversial topics,” such as suicide prevention, in the context of the Massive Online Open Course (MOOC).

Abstract – To date, little guidance exists on how to design safe and effective online programming on sensitive and/or controversial topics. Massive online open courses (MOOCs) represent a unique opportunity for delivering inclusive and accessible teaching to international learner audiences. This paper provides an insight into designing and delivering the first internationally accessible MOOC on suicide prevention in the global context in 2019-highlighting insights into best practice as well as pertinent challenges. The results from two runs of this MOOC indicate that there appears to be a global demand for education on suicide prevention. Our practice suggests that new knowledge on extremely sensitive topics such as suicide can be safely and effectively delivered through a MOOC to an international community of learners. Learner safety needs to be carefully considered when developing and delivering online learning. Thorough and careful moderation is essential to ensure that learners engage safely and sensitively with the content and with one another. The involvement of diverse stakeholders, including people with lived experience, in the MOOC design is recommended to enhance the authenticity, inclusiveness and rigour of the curriculum.

🇨🇦 Sampasa-Kanyinga, H., et al. (2020). 24-hour movement guidelines and suicidality among adolescents. Journal of Affective Disorders, 274, 372-380. DOI: 10.1016/j.jad.2020.05.096. Data culled from the 2015-2017 Ontario Drug Use and Health Survey of student in grades 7-12 are used to determine if adherence to the 24-hour movement guidelines affects the frequency of suicidal ideation and suicide attempts.

Abstract – Background: The 24-hour movement guidelines for children and youth recommend ≥60 min/day of moderate-to-vigorous physical activity, ≤2 h/day of screen time, 9-11 h/night of sleep for 11-13 years and 8-10 h/night for 14-17 years. The objectives of this study were to examine the associations between meeting combinations of the recommendations contained within the 24-hour movement guidelines for children and youth and suicidal ideation and suicide attempts, and test whether age and gender moderate these associations. Methods: Data on 10,183 students were obtained from the 2015-2017 Ontario Student Drug Use and Health Survey, a representative cross-sectional survey of Ontario students in grades 7-12 (mean [SD] age, 15.2 [1.8] years). Results: Suicidal ideation and suicide attempts were reported by 13.1% and 3.3% of students, respectively. Meeting individual recommendations or combinations of recommendations were differentially associated with suicidal ideation and suicide attempts between adolescent boys and girls and younger and older (three-way interactions statistically significant for both outcomes). Meeting all 3 recommendations was associated with lower odds of suicidal ideation (OR: 0.24, 95% CI: 0.09 – 0.69) and suicide attempts (OR: 0.08, 95% CI: 0.02 – 0.41) among boys aged 15 to 20 years, but not those aged 11 to 14 years nor girls in both age groups. Limitations: The cross-sectional nature of the data precludes causal inferences and there is possibility of bias related to self-reports. Conclusions: These findings suggest that adherence to the 24-hour movement guidelines among adolescents is related to lower odds of suicidality in older boys.

Liu, R.T., et al. (2020). Sleep and suicide: A systematic review and meta-analysis of longitudinal studies. Clinical Psychology Review, 81. DOI: 10.1016/j.cpr.2020.101895. A review of 41 studies on the association between sleep disturbances and suicidal thoughts and behaviours.

Abstract – The current review provides a quantitative synthesis of the empirical literature on sleep disturbance as a risk factor for suicidal thoughts and behaviors (STBs). A systematic search of PsycINFO, MEDLINE, and the references of prior reviews resulted in 41 eligible studies included in this meta-analysis. Sleep disturbance, including insomnia, prospectively predicted STBs, yielding small-to-medium to medium effect sizes for these associations. Complicating interpretation of these findings, however, is that few studies of suicidal ideation and suicide attempts, as well as none of suicide deaths, assessed short-term risk (i.e., employed follow-up assessments of under a month). Such studies are needed to evaluate current conceptualizations of sleep dysregulation as being involved in acute risk for suicidal behavior. This want of short-term risk studies also suggests that current clinical recommendations to monitor sleep as a potential warning sign of suicide risk has a relatively modest empirical basis, being largely driven by cross-sectional or retrospective research. The current review ends with recommendations for generating future research on short-term risk and greater differentiation between acute and chronic aspects of sleep disturbance, and by providing a model of how sleep disturbance may confer risk for STBs through neuroinflammatory and stress processes and associated impairments in executive control.

Sandford, D.M., et al. (2020). The impact on mental health practitioners of the death of a patient by suicide: A systematic review. Clinical Psychology and Psychotherapy. DOI: 10.1002/cpp.251554 studies are analyzed in this systemic review. Quantitative and qualitative research is examined which focuses on the effects that losing a patient to suicide has on mental health professionals.

Abstract – There is a growing body of research investigating the impact on mental health professionals of losing a patient through suicide. However, the nature and extent of the impact is unclear. This systematic review synthesizes both quantitative and qualitative studies in the area. The aim was to review the literature on the impact of losing a patient through suicide with respect to both personal and professional practice responses as well as the support received. A search of the major psychological and medical databases was conducted, using keywords including suicide, patient, practitioner, and impact, which yielded 3,942 records. Fifty‐four studies were included in the final narrative synthesis. Most common personal reactions in qualitative studies included guilt, shock, sadness, anger, and blame. Impact on professional practice included self‐doubt and being more cautious and defensive in the management of suicide risk. As quantitative study methodologies were heterogeneous, it was difficult to make direct comparisons across studies. However, 13 studies (total n = 717 practitioners) utilized the Impact of Event Scale, finding that between 12% and 53% of practitioners recorded clinically significant scores. The need for training that is focused on the impact of suicides, and the value placed upon informal support was often cited. The experience of losing a patient through suicide can have a significant impact on mental health professionals, both in terms of their personal reactions and subsequent changes to professional practice. The negative impact, however, may be moderated by cultural and organisational factors and by the nature of support available.

🇨🇦 May, A.M., et al. (2020). Motivations for suicide: Converging evidence from clinical and community samples. Journal of Psychiatric Research, 123, 171-177. DOI: 10.1016/j.jpsychires.2020.02.010. This study looks at The Inventory of Motivations for Suicide Attempts, a self-report measure to assess potential motivations for suicide. Two distinct groups of people who had experienced a suicide attempt – adult psychiatric patients and community participants recruited online – were issued the tool and their responses were analyzed.

Abstract – Understanding what motivates suicidal behavior is critical to effective prevention and clinical intervention. The Inventory of Motivations for Suicide Attempts (IMSA) is a self-report measure developed to assess a wide variety of potential motivations for suicide. The purpose of this study is to examine the measure’s psychometric and descriptive properties in two distinct populations: 1) adult psychiatric inpatients (n = 59) with recent suicide attempts (median of 3 days prior) and 2) community participants assessed online (n = 222) who had attempted suicide a median of 5 years earlier. Findings were very similar across both samples and consistent with initial research on the IMSA in outpatients and undergraduates who had attempted suicide. First, the individual IMSA scales demonstrated good internal reliability and were well represented by a two factor superordinate structure: 1) Internal Motivations and 2) Communication Motivations. Second, in both samples unbearable mental pain and hopelessness were the most common and strongly endorsed motivations, while interpersonal influence was the least endorsed. Finally, motivations were similar in men and women — a pattern that previous work was not in a position to examine. Taken together with previous work, findings suggest that the nature, structure, and clinical correlates of suicide attempt motivations remain consistent across diverse individuals and situations. The IMSA may serve as a useful tool in both research and clinical contexts to quickly assess individual suicide attempt motivations.

Bantilan, N., et al. (2020). Just in time crisis response: suicide alert system for telemedicine psychotherapy settings. Psychotherapy Research. DOI: 10.1080/10503307.2020.1781952 . A Natural Language Processing (NLP) algorithm is developed to detect suicidal content in written communications from patients to their caregivers. Its utility and applicability in a telehealth context is addressed.

Abstract – Objective: To design a Natural Language Processing (NLP) algorithm capable of detecting suicide content from patients’ written communication to their therapists, to support rapid response and clinical decision making in telehealth settings. Method: A training dataset of therapy transcripts for 1,864 patients was established by detecting patient content endorsing suicidality using a proxy-model anchored on therapists’ suicide prevention interventions; human expert raters then assessed the level of suicide risk endorsed by patients identified by the proxy-model (i.e., no risk, risk factors, ideation, method, or plan). A bag-of-words classification model was then iteratively built using the annotations from the expert raters to detect suicide risk level in 85,216 labeled patients’ sentences from the training dataset. Results: The final NLP model identified risk-related content from non-risk content with good accuracy (AUC = 82.78). Conclusions: Risk for suicide could be reliably identified by the NLP algorithm. The risk detection model could assist telehealth clinicians in providing crisis resources in a timely manner. This modeling approach could also be applied to other psychotherapy research tasks to assist in the understanding of how the psychotherapy process unfolds for each patient and therapist.

Mental Health Checklist

This is to help you identify anything you might not have noticed. It is not a professional assessment. It is for your own use. It will allow you to start to have a conversation or to look for professional help.

☐ Recent mood swings
☐ Has become more withdrawn in the last 30-60 days
☐ Has become irritated with my requests in the last 30-60 days
☐ Is not eating
☐ Is not sleeping well
☐ Is not hanging out with friends as much in the last 30-60 days
☐ Has wanted to quit their passion recently
☐ Has become defiant and aggressive with me and others
☐ I have noticed bruises/cuts lately
☐ Does not want to communicate about anything
☐ Says “I’m Fine” all the time
☐ Says “Just leave me alone”

These are some things that you can start to be aware of and sit down and take a good look. If you are noticing any of these issues, it is critical to sit and have a conversation ASAP to address.

How to Have the Difficult Conversation

One of the hardest things to do is to try to start a conversation with someone who is in pain. In their minds they are alone and no one can relate or understand what they are going through. Self-Pity is one of the most damaging illnesses that can occur. It stops the person from dealing with reality and can take the Mind to a very dark place.

In the darkness it is difficult to make sound decisions. It is hard to breathe; it is hard to believe that there is a way out.

The first questions are critical to getting the conversation going. Here are some starters.

I have noticed a change in you recently, has something happened to you?

I attended a presentation recently that has made me aware of some things that I have done. I want to apologize if any of (insert what you became aware of) have caused you pain. I simply did not realize how my actions have caused issues for you.

• I have not been feeling myself lately and did some research and found that I have some things to learn. I have noticed your behaviour is similar, would you be open to learning some new things together?

I love you very much and my biggest fear is that I am not providing what you need, can you help me un•derstand what you are dealing with?

These are all great conversation starters and take the guilt and shame off of them and show you are trying to help. Walking the dog, shooting hoops, having a day together is a great way to begin the process in a less intensive way.

Once you have begun to gain their trust and they open up, then you can bring up finding someone to help. Avoid using the words a therapist, a psychologist, a doctor. Simply say let’s find someone that could help us and then research some options together. Layout some timelines to finding the right one. Creating this structure to become healthy allows them to organize it in a way that they can stay focused and positive throughout the process. 

Exploration: The Underrated Self Care Method

Post credit – Mandie

When we say the word exploration, what’s the first thing that comes to your mind? Do you picture a vast Canyon with an open sky? A lake so vast you can’t see the end? Or a field with nothing but flowers and sun. 

Whichever you imagine, how do those places make you feel? Does it bring happiness or comfort? Excitement or Danger? Exploring a new place can be all of those emotions and feelings, and it can be important to put yourself out into the world.

Why should I explore new places? You might be asking yourself this question, and you might say “What’s the point?” Oh my friend, there are many opportunities from the exploration of new places and removing ourselves from the chaos that is everyday life, the monotony of it all can be so oppressive that most of us don’t even realize it.

Stress Relief

Do you ever feel yourself overwhelmed or run down? Then I have great news. Traveling and the exploration of new places is an amazing stress reducer and happiness booster. You may feel your mind clouded by worries and we all know how much social media wears on our consciousness. 

There is also a science behind why exploration is a viable option for stress relief.

Exploration promotes happiness which leads to lower cortisol levels making us feel more calm and content. According to a 2013 study 80% of Americans who were surveyed noticed a drop of stress levels just after a day or two of traveling. When we explore safely, it can be one of the greatest self care acts out there.

Creativity Boost 

If you’re an esteemed artist or just a casual one, exploration can exponentially increase your creativity. Visiting an environment with some sort of local culture can bring new ideas, philosophies, and cognitive flexibility. 

We know it sucks to stare at a blank piece of paper and think “Why am I so blocked…” and that’s exactly why we should go to a new place or take a walk to reset our train of thought and inspire new ideas to come forth from visual stimulation.

Even Ernest Hemingway, for example, drew inspiration for much of his work from his time in Spain and France. Now I know not everyone can afford to travel across the world, but even going to a new remote hiking location or new town can promote health and creativity.

It Brings You Out of Your Comfort Zone

A lot of people in modern society have trouble with going out of their comfort zone, especially if it has to do with doing something new. Facing difficulties in an unfamiliar environment, among new people, forces you to learn and adapt to a life that’s out of your comfort zone. 

This makes you more flexible, patient and emotionally strong. Exploration of new places can be especially tricky for people who have social anxiety, or people who have agoraphobia or have agoraphobic tendencies. 

We’ve personally dealt with having that anxiety of leaving our house and going to a new place…your mind races and you might think “What if I die…What if I get lost…What if I witness something horrible? The number one thing we can tell you is, just do it.

We know how hard it can be, trust us, but every time we’ve left the house and went somewhere new, we’ve enjoyed it and learned many new things, not only about ourselves but about the world. We KNOW you can do it too, but here are some tips to help make you feel more secure when visiting a new place.

Helpful Tips

  • NEVER go alone in a new busy city, or dangerous area if you choose to go to places like that. Make sure you bring someone you trust with you to keep you safe, or know who to call if you’re ever in trouble. It also doesn’t hurt to learn basic self defense moves
  • If you have social anxiety, try going to a more remote, nature based location to ease your mind.
  • Keep a positive attitude and open mind. It’s so important for your self care and health in general to think on the bright side and be an open person. This helps expose yourself to new things and cultures. 

If something or someone seems a little weird or different from yourself, think of how they got that way or why they do what they do. Cultures can differ from place to place so you always want to be aware.

  • Be respectful. Like I said above, being in a new place can bring new things, so make sure when you do visit a new place, to try and be respectful of their cultures and traditions. 

In general, just follow the rules they have set there and you should be fine. Ex. In Japan people almost never wear shoes inside, and have personal indoor slippers for you to use. It’s not illegal to wear shoes inside, but people will consider it very rude and will most likely not let you enter the establishment without taking them off.

  • Let go and have fun! Exploring new places should be looked at with a sense of wonder and excitement. Make sure you do what you want to do while you’re in a new place and just have fun. It can hinder all the health benefits included by not letting yourself just be selfish and enjoy it.

Live Freely

Now that you’ve read this, pick a new destination twice a week for 2 weeks and go forth! Life is about freedom and adventure. Be okay with bracing the unknown and think about your health first. Get in touch with the world around us and be safe.

“Man cannot discover new oceans unless he has the courage to lose sight of the shore.”
– Andre Gide

Mandie

Resolution Requires Resolve: 5 Steps to Take

With the New Year comes new ideas, new hope and new resolutions. Every year our minds race with the thoughts and wishes for change in our lives. Out with the old and in with the new. The problem is and always has been that whenever we want to change, we often don’t know how to go about it. We know that we have to do things differently, but diving into the unknown is scary, like walking down a dark alley alone. We feel vulnerable, unsure and question our ability to do what we want to do.

There are some things that you must gain an understanding of to become the change that you desire. First and foremost is to understand that we are habitual creatures and the habit we are trying to change is something that we have done for a long time. Whether it is getting into shape, eating better, quitting smoking, or just living a more fulfilled life. The battle that you have chosen to fight requires commitment, or an even better word RESOLVE. The second thing we have to prepare for are those times where fear and doubt overtake us. We can start great, but resolutions are abandoned far too often within the first month. WHY? Because we are creatures of habit, this new endeavour requires a lot of thought, a lot of work and does not feel as good as we thought, or at least that is what we tell ourselves. Our MINDS are so powerful that we actually can feel helpless. Do you have what it takes to change that habit? Can you do this thing that you feel you need to do to improve yourself? The answer is YES, YOU CAN!

Here are some steps that will help you stay on track to make the change you feel will benefit you.

  1. We are very visual in our thinking. If we can’t see it, we feel we can’t do it. Create a picture board with words and images that help us attach to how it will feel when we are successful in making the change.
  2. Positive affirmations, create a sentence or two that you can repeat to yourself when you feel the fear and doubt creeping in. Something that when you repeat it to yourself makes you feel powerful.
  3. Try to find someone who can help you. Often we are making the change because of what someone has said to us. “You have to lose weight, don’t you want to feel better and be around longer?” Comments such as these make us aware but also create resentment and put our thoughts in a bad place. Find someone who will support you. Someone that will tell you that you are doing great. Encouragement empowers.
  4. Identify the things that could potentially stop you from being successful and decide how you will counter those thoughts with action. (If it is bad eating habits, then when you feel like eating a bag of chips, look at the picture board or repeat your affirmation and grab an apple or do sit-ups, take some deep breaths and focus on the new you.)
  5. BELIEVE! It is a simple case of MIND over Matter. If you don’t MIND, well, it won’t matter. THINK THINK THINK, keep good thoughts in your MIND.
    Gandhi said it best “be the change you want to see in the World”.

I know that you can do it, you have done it before and this time is no different. If you are not standing on the edge, you are taking up too much room. Push yourself and gain an understanding of the fact that you can do anything you put your MIND to.

Good luck to you all! I wish you a happy and successful 2021.

Bob Wilkie
President, I Got Mind Inc.