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CAMH Stories Centre for Addiction
and Mental Health

Can I Pay You in Potatoes? Yuliya’s Story

By Sean O’Malley

In some ways it is the classic immigrant success story. A husband and wife so poor they struggle to provide enough healthy food for their young child.  They come to Canada with nothing, and build successful careers from scratch.

All of that is true for Dr. Yuliya Knyahnytska, a staff psychiatrist with the Temerty Centre for Therapeutic Brain Intervention who emigrated from Ukraine a decade ago.

Dr. Yuliya Knyahnytska
What makes her story unique, is what she and her husband were doing for a living in their home country: they were both practicing psychiatrists.

“Psychiatry is not a very financially secure profession in Ukraine,” says Dr. Knyahnytska. “You get paid in food, like a sack of potatoes. Basically people tried to feed their physicians.”

Was it the same for male and female psychiatrists?

“As a female I got lots of candy too.”

Despite both coming to Canada as trained doctors, they had no qualifications to work in their chosen profession.  Yuliya’s husband got a job working in construction.

Her first job?  Selling Hallmark greeting cards.

“Nobody likes selling Hallmark cards when you are a physician, but I think it was an important first step,” says Yuliya. “I can’t really complain.  It helped me with my English and it taught me about the diversity of Canada.”

That ability to look for the positive in almost any situation has served Yuliya well in her new country.

Three years later, she found herself back in the healthcare field, when she joined CAMH under the auspices of world-renowned anorexia nervosa clinician Dr. Allan Kaplan.

Last year she won the CAMH Breakthrough Challenge for her work on a first-of-its-kind rTMS brain stimulation treatment for severe treatment-resistant anorexia.

In her spare time, she completed her PhD in Public Health, graduating from the University of Toronto in June, making her officially Dr. Knyahnytska in two countries.

“My colleagues call it a Canadian double double,” she says.

Until she began her clinical work at CAMH, Yuliya had never worked with anorexia patients before.  She admits to initially being baffled by the complexity and causes of the disorder.

“From my perspective as an immigrant who had not enough healthy food at home for my young son, I couldn’t wrap my head around being in this country with so much food and people are literally starving themselves to death.  That’s what got me interested in anorexia, because it was a problem I could not solve.”

Anorexia remains one of the most dangerous and difficult to treat and conditions.  Up to 40 per cent of people with anorexia are resistant to all treatment, with often fatal results.

“I feel in psychiatry you have to put a face to the condition,” says Yuliya. “When I saw those girls and the struggle they went through, it changed the way I see anorexia.  It’s not a financial issue, it’s not an education issue-- many of them are highly educated.  There is still no one theory why this happens.”

In a pilot study just completed this past summer, Dr. Knyahnytska’s patients were given  rTMS brain stimulation via a custom-made coil that targeted a specific area of the brain believed to be play a significant role in perception, mood, anxiety and eating behaviour.

She found that over the course of the 12-week trial, patients showed a significant reduction in obsessions and compulsions associated with anorexia.

Her hope is that once the pilot study is published that it will lead to larger studies in the future to demonstrate the efficacy of rTMS for treatment-resistant anorexia.

“There is a very clear niche for this treatment.  If all the other interventions are not working, maybe we have not been targeting it in the right way.  We needed to look in a different direction.”

 

 

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