Mental Health: How to recognize depression and what to do about it

By Dr. Yvette Lu.

This week is Canadian Mental Health Week and it’s the perfect opportunity to talk about mental health and mental illness. Talking about mental illness normalizes and reduces shame around it, making it more likely that people will seek help if they experience symptoms.

Check out my video from Breakfast Television on Mental Health. In it, we discuss the signs of depression, what to do about it, why you need to seek help, and resources in BC (other provinces and areas should have similar resources). I will also discuss this information in more detail below.


This year, the theme of Mental Health Week is #GetLoud! During mental health week, we encourage people to reflect on their attitudes towards mental health. It’s important to reduce discrimination and stigma so that people don’t feel shame about mental illness and don’t wait to seek help.

People with mental health issues often feel like they need to suffer silently. Part of the illness is that you feel like your voice and feelings are not important, so if you have mental illness, find someone you feel safe talking to and share how you feel. If someone opens up to you about their feelings and mental health, do your best to listen without judgment and help in whatever way you can.

Most people know that symptoms of depression include feeling sad or having a low mood. However, there are other symptoms that you may not be aware of that can also be signs of depression. These include:

    • anhedonia – no interest or pleasure in doing things you usually like to do
    • irritability and anger
    • poor sleep or sleeping too much
    • poor appetite or overeating, weight gain or weight loss
    • fatigue or low energy
    • feelings of guilt, that you are a failure or that you have let yourself or others down
    • poor concentration or attention
    • feeling really restless or, the opposite, feeling sluggish and slow
    • feeling very sensitive to rejection, to the point that it affects relationships

If you notice these symptoms, you should seek help. You can talk to your family doctor, who can connect you to resources and services in the community, and who can make sure your symptoms aren’t caused by another medical condition, like thyroid disease. You can also contact your local mental health center if you don’t have a doctor. It’s best to seek help early as mental illness is easier to treat when it’s caught early. Parents, I recommend looking for these symptoms in your children and teens as well.

There are many online and community resources available. Many of them are free and don’t require a doctor’s referral:

      • Bounce back: a free, evidence based program for adults and youth who are experiencing mild to moderate depression/anxiety, low mood, or stress. You can do the course online or through a telephone coaching program. It’s available in English, French, Cantonese or Punjabi. The telephone coaching version of the course requires a referral from your family doctor.
      • Confident Parents, Thriving Kids: A family focused, telephone based service for parents and caregivers that helps reduce mild to moderate behavioural challenges and promotes healthy child development in children ages 3-12. The course requires a referral from your family doctor.
      • Living Life to the Full: A mental health promotion course designed to help people deal with low mood, anxiety, stress, and everyday life challenges.
      • MindShift App: A free app from AnxietyBC to help cope with anxiety, originally developed for teens and young adults. I recommend it to all ages.
      • BC Crisis Center: A free Mental Health Support Line: 310-6789 in BC (no area code). You can call for information on local services or if you need emotional support. Workers have advanced training in mental health issues and services. They also have a suicide hotline 1-800-SUICIDE (1-800-784-2433) and a Seniors Distress Line: 604-872-1234. As well, an online chat is available for youth and adults.
      • Kelty Mental Health: Provides peer support to children, youth and their families, and to people with eating disorders.
      • Here to Help BC: An online resource to help people manage mental health and substance use problems.

These are only a few of the resources available online. Please check out the sites listed above for more info.

For more info about mental health week, visit www.mentalhealthweek.ca.

On another note, a show about caregivers that I made is currently in a competition for funding! If we win, we can make five more episodes! Please vote for “Who Cares with Dr Yvette Lu” at www.storiesforcaregivers.com.

Thank you!!

 

 

What you need to know before you travel

by Dr. Yvette Lu.

With Spring Break and Easter Holidays this weekend, and summer holidays coming up, a lot of people are making travel plans. What are the health considerations that we need to think about before travelling? Check out my Breakfast Television chat and my tips below!

 


In my blog below, I will look at

  • what needs to be done before travel
  • what goes in a travel health kit
  • what precautions to take while travelling abroad
  • what to think about when travelling with children

 

What needs to be done before travel?

Here are some basic things to do and think about before you travel. Start thinking about these things early! I have so many people who come into my office a few days before their trip asking about whether or not they need vaccinations. Some of the vaccinations and medications that are required for travel require several weeks lead time before they start taking effect. I tell my patients, book an appointment in the office as soon as you book your plane tickets to discuss your vaccinations!

More “Before You Go” tips:

  • consult a health care provider or travel clinic, preferably at least six weeks before travel to review vaccinations
  • make sure your basic vaccinations up to date – eg. tetanus/diphtheria (every 10 years), measles, mumps, rubella, pertussis, varicella (chicken pox), polio.
  • For certain places, additional vaccinations may be recommended – eg. yellow fever, typhoid, traveller’s diarrhea, hepatitis A.
  • When travelling to warmer areas, you may need protection against malaria (it involves taking antimalarial medication).
  • Check the Health Canada and CDC websites for any travel alerts to the areas you will be visiting.
  • Consider registering your trip with the Registration of Canadians Abroad Service – a free service that allows the Government of Canada to notify you in case of an emergency abroad or a personal emergency at home. It also allows the traveller to receive information before or during a natural disaster or civil unrest. Americans have a similar service called the Smart Traveler Enrollment Program. Many people don’t know about these programs, so spread the word.
  • Buy travel insurance – highly recommended! Health care costs can add up VERY quickly in a foreign country. We are lucky here in Canada, because we have good health insurance, but that is not the case in other countries.
  • Prepare a travel health kit (see next section).

 

What should be in a travel health kit?

It’s important to carry a basic travel health kit with you. First aid supplies and medications may not be easily available in other countries or may be different from those available here. A good travel health kit contains supplies to prevent illness, handle minor injuries and illnesses, and manage pre-existing medical conditions.

Here’s what to put in your travel medical kit:

  • Basic first aid items: eg. bandages, adhesive tape, hand sanitizer, antiseptic wound cleanser, blister pads or moleskin, disposable gloves, gauze, safety pins and scissors, tensor bandage, thermometer, tweezers for removing ticks/splinters, oral rehydration salts.
  • Basic medications: allergy medication, antidiarrheal medication, medication for motion sickness, 1% hydrocortisone cream for minor skin irritation (bug bites, poison ivy), antibacterial and antifungal ointments, cold and flu medications (decongestants, cough suppressants, throat lozenges), pain and fever medication, stomach and intestinal medication.
  • Prescription medication: bring more than enough medication to last your entire trip, at least an extra week. Carry a list or prescription of your medications from your health care provider. If you use needles or syringes, carry a medical certificate from your health care provider explaining that they are for medical use. Bring extra medications. Pack all medications in your carry-on baggage in their original, labelled containers to facilitate airport security and customs screening. Prescription medication is usually exempted from the liquid restrictions but must be presented to the screening officer separately from your carry-on baggage. More information about travelling with medications and with medical devices can be found on the Health Canada Website.
  • Destination specific medication: antimalarial pills, medication for altitude sickness.
  • Be aware that some over-the-counter medications, dietary supplements and herbal and homeopathic products are illegal for import and use in other countries or may require a prescription.
  • Other useful items: moisturizer, eye drops, ear plugs, extra glasses/contacts, sunscreen, water purification tablets or filter.
  • Emergency Contact card – with name and number of emergency contact, health care provider, address and phone number of accommodation at destination. You can also include information about hospitals/clinics at destination, number for your country’s embassy/consulate.
  • Proof of insurance coverage and emergency contact number for travel insurance.
  • Immunization record and proof of immunization — especially if going to a country that requires specific vaccinations (eg. yellow fever).

 

Precautions to take while travelling abroad

When travelling abroad, you don’t want illness and a hospital visit to ruin your trip. Here are some simple precautions that you can take to ensure that you stay healthy while away from home.

  • Prevent insect bites – many travel related diseases are spread by diseased insects like mosquitoes, ticks, fleas, flies. Be aware of insects at your destination that cause disease, make sure you have the appropriate preventive vaccines/medications, and take protective measures to avoid bites.
  • Eat and drink safely – the most common illnesses among travellers are generally from eating food or drinking beverages that are contaminated by bacteria, parasites, or viruses. Precautions include washing hands, only eating food that is well-cooked and served hot, avoiding raw/undercooked food, peeling or cooking fruits/vegetables, avoiding food from street vendors, drinking water only if it has been boiled/disinfected or if it is in a commercially sealed bottle, brushing your teeth using purified or bottled water, avoiding unpasturized dairy products/fruit juices. I know… it seems like sort of a drag since doing some of these things are part of getting a “local” travel experience… but when you think about the consequences (i.e. getting sick with traveller’s diarrhea or worse), it’s worth taking the precautions. Make decisions based on your location of travel and the local health and safety standards.
  • Be careful when swimming and bathing – water (pools, lakes, ocean, hot tubs etc.) may look clean but could be contaminated or inadequately treated. There are also water-based parasites that live in certain countries. Be aware of water safety when doing water based activities (eg. motorized water vehicles, safety of equipment).

 

Travelling with children

Travelling with children can present certain challenges. Here are some tips to make your trip run more smoothly!

  • In children, there is a higher risk for most vaccine-preventable diseases when travelling abroad and these diseases tend to be more severe in children than in adults. Make sure all immunizations are up to date! Some immunizations can be given early or on an accelerated schedule if necessary. Talk to your doctor for more details.
  • Ear pain due to changes in pressure during airplane travel (especially during take off and landing) is more common in children than in adults. To lessen the pain, infants can bottle or breast feed. Older children can chew gum, swallow or yawn.
  • Children can be more sensitive to jet lag and motion sickness. Avoid reading in moving vehicles. Sleeping or focusing on the horizon can also help with motion sickness. An anti-nauseant medication may also be helpful. Make sure you follow the age-appropriate dosing instructions.
  • Travellers’ diarrhea in children can be concerning because they become dehydrated more quickly than adults. Make sure children stay hydrated and consider using an oral rehydration solution.
  • Unfamiliar environments and a change in routine may cause stress for children. For older children, familiarize them in advance with the food, customs, and language of the destination and involve them in developing the travel itinerary. For younger children, a favourite toy or special snacks may help them adjust to a new environment.
  • Traffic laws differ around the world. Even if the use of safety devices like car seats, seat belts, and bike helmets is not required in the destination country, caregivers should follow the practices recommended in Canada as closely as possible. Remember to bring your age-appropriate car or booster seats from home as availability abroad may be limited.

 

Want more information? Check out these links:

http://travel.gc.ca/

http://www.cdc.gov/travel

 

How To Set Health Goals That Work

By Dr. Yvette Lu.

25% of people give up on their New Year’s Resolutions after one week.
36% give up after one month.
By six months, only 46% of people are still working on their New Year’s Resolutions.
Clearly, we have a problem!

The leading causes of death in Canada are heart disease, stroke, and cancer, particularly lung cancer. You can prevent and reduce your risk for these diseases by making lifestyle changes. It’s easy to say you’re going to change, but how to set a goal that will actually work to help you achieve lasting change?

Check out our chat on how to set goals that work. Let’s troubleshoot those New Year’s Resolutions!

 

 

 

Two additional troubleshooting points that we didn’t have a chance to cover in the video:

  • Make sure your goal is something you actually want to do.
    • If you’re having trouble with your health goals, it may be because you’re not ready to make change. It’s very hard to make change if you’re not ready and motivated. Perhaps you’ve only set the goal because somebody else is pressuring you! Go back and look at your goal, and ask yourself, what would I like to change about my life. You are more likely to be successful at your resolution if you truly want to achieve it and are motivated internally.
  • Get help.
    • If you find that you’re still not able to achieve your goal, then you want to go and talk to your doctor and get help. A lot of habits like smoking and overeating are self reinforcing. Our brain gets a chemical reward when we do those activities, so it makes it hard to quit. For example, when we overeat or eat sugary foods, our bodies release endorphins, chemicals which make us feel happy. Your doctor can help with behavioural strategies, and in some cases medications. There are some medications that are available to help reduce cravings, especially for smokers. Some people may also have an underlying disease like depression or anxiety that may be causing them to smoke, overeat, or drink too much alcohol. It’s important to treat the underlying illness, as those habits will be very tough to break without treating the underlying problem that’s causing those behaviours.

 

Troubleshooting summary for setting health goals:

  1. Set specific goals.
  2. Make sure your goal is achievable.
  3. Don’t exhaust your willpower by working on too many goals at once.
  4. Make sure your goal is internally motivated.
  5. Get help!

 

Now, go out there and set yourself some goals! Good luck!