Challenges & Choices: Finding mental health services in Ontario
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Mental health involves finding a balance in all aspects of your life: physically, mentally, emotionally and spiritually. It is the ability to enjoy life and deal with the challenges you face every day--whether that involves making choices and decisions, adapting to and coping in difficult situations or talking about your needs and desires.
Just as your life and circumstances continually change, so do your moods and thoughts, and your sense of well-being. It's important to find balance in your life over time and in a range of situations. It's natural to feel off balance at times: for example, sad, worried, scared or suspicious. But these kinds of feelings may become a problem if they get in the way of your daily life over a long period.
There are many beliefs about why people have mental health problems. Scientific studies suggest that many serious mental health problems involve biochemical disturbances in the brain. Professionals also believe that various psychological, social and environmental factors affect your well-being. As well, mental health is affected by the physical, mental, emotional and spiritual parts of your life. Stress can affect how you cope in any or all of these areas and can make it harder to manage day-to-day activities. You may have difficulty coping because you lack new skills and information that could help you.
You may be struggling with such difficulties as:
- going through a divorce
- dealing with the death of a loved one
- having a car accident
- coping with a physical health problem
- growing up in a war-torn country, leaving the country you came from or adjusting to a new country (which often means dealing with immigration and resettlement experiences
- dealing with racism or other forms of prejudice (because of sexual orientation, age, religion, culture, class, etc.)
- having a low income or being homeless
- not having equal access to education, work and health care
- having a history of mental health problems in the family or
- being a victim of violence, abuse or other trauma.
Your mental health can also be affected by how much love, support and acceptance you receive from family and others.
It is important to know that not all cultures view mental health in the same way. For example, in some countries, people who have schizophrenia are seen as having special powers and insights.
Alcohol and other drug use do not usually cause a mental health problem. However, they are often used to help cope with the problem. And they can make the mental health problem worse.
You and your health care provider need to work together to identify the problem, what may have caused or contributed to your difficulties and how you can be helped. Whatever the cause, you should know that mental health problems are not your fault. No one chooses to have a problem.
Mental health problems often take different shapes and forms at different times.
Some people feel depressed. Others feel anxious and fearful. A child might act out in class or avoid others. Some don't eat much. Others overeat. Some depend on alcohol or other drugs to numb their painful feelings. Still others lose touch with reality. For example, they may hear voices, see things that aren't there or believe things that aren't true. Some have suicidal thoughts--and some act on these thoughts. Some feel angry and aggressive. And some people are traumatized because of a single event, such as a serious car accident, or because of a more long-term problem, such as years of being abused as a child. Many people have more than one of these problems at a time.
For many years, we thought mental health problems would either keep coming back or would never go away. We now know that many people recover from these challenges. Many people with mental health problems get better by using their own strength and resilience, the support of family and friends, psychotherapy, techniques to lessen their stress and possibly medication.
In the next section, we will be using the term "disorder" to describe some of the most common mental health problems and labels used by the medical profession in making a diagnosis.
Some people may be relieved to know how doctors identify their problems. They may be glad to get a diagnosis that provides a theory about what's wrong and suggestions for how their problems could be treated. But others may not find it helpful to know a diagnosis. They may see it as a label or category that doesn't describe their situation. Or they may believe that their condition is due to difficult life situations rather than an illness.
In truth, some people are wrongly diagnosed and then given the wrong kind of treatment. Sometimes their mental health diagnosis changes so many times over the years that they lose confidence in the system. However, others find that an accurate diagnosis helps them choose the right treatment and results in the best care.
Here are some common diagnoses:
are believed to be the most common mental health problem in North America, particularly among people who are depressed. In fact, as many as two-thirds of the people who have depression also have strong symptoms of anxiety. While we all feel anxious from time to time, "anxiety" refers to excessive worrying that is hard to control. People who experience anxiety feel restless or "keyed up" and on edge. They may get tired easily or feel their minds going blank. They may also feel irritated, have tense muscles, trouble concentrating and sleep problems.
The main types of anxiety disorders are panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD) and social and specific phobias.
For more information on anxiety disorders, contact the Anxiety Disorders Association of Ontario at (613) 729-6761 in Ottawa or toll-free at 1-877-308-3843. Or view their Web site at www.anxietydisordersontario.ca. For more information on OCD, call the Ontario Obsessive Compulsive Disorder Network at (416) 410-4772 in Toronto or view their Web site at www.oocdn.org
Attention -deficit/hyperactivity disorder (ADHD)
is one of the main reasons why children are referred for mental health services. ADHD affects a child's attention span and concentration. It can also affect how impulsive and active the child is. The energetic way in which children normally behave shouldn't be confused with symptoms of ADHD. Children who have ADHD are much more active, distracted, persistent and impulsive than other children. Symptoms of ADHD persist over time.
An Ontario study predicts that five to nine per cent of school-aged children may have ADHD. ADHD is three to four times more common in boys than girls. About two-thirds of children with ADHD continue to have the symptoms in adolescence.
ADHD is less common in adults. Adults with ADHD may be easily distracted (e.g., continually bored, forgetful or anxious). They may also be depressed, have low self-esteem, mood swings and difficulties at work and at other activities.
was previously known as manic-depressive illness. It involves extreme mood swings that may have nothing to do with what's going on in the person's life. Typically, people with bipolar disorder move between feeling very low or depressed and feeling very high or "manic." When people are manic, they may take part in risky and unusual activities, increase sexual behaviours or get in trouble with the law. They may also feel invincible or all-powerful, have racing thoughts and other symptoms. There's a good chance that people with bipolar disorder will feel "normal" and function well at times too. How long the episodes last and how often they occur will vary, depending on the person.
People often experience the first sign of a problem in adolescence or early adulthood. It may begin with an episode of depression and not be followed by a manic episode for several years. Women may have symptoms when they are pregnant, or shortly after. Overall, men and women are affected equally.
For more information, contact the Mood Disorders Association of Ontario (MDAO) at (416) 486-8046 in Toronto or toll-free at 1-888-486-8236. Or view their Web site at www.mooddisorders.on.ca
involve behavioural and emotional difficulties. Children and youth with a conduct disorder find it difficult to follow rules and behave in a socially acceptable way. They may cause property loss or damage, steal or lie, seriously violate rules or be violent toward other people or animals. While conduct disorders are the most common psychiatric diagnoses among children, the disorders can be present at any age.
is more than simply being unhappy. Someone who is depressed feels abnormally sad, despairing and hopeless in a sustained way for more than two weeks. Depression may impair how the person performs at work, school and in relationships. The person's sleep, energy, appetite, concentration, memory and sexual desire may also be affected. The person may lose interest or pleasure in life, feel irritable, worthless or guilty and, in some cases, may think of suicide.
Women are diagnosed with depression twice as often as men are. There are many theories about why this is true. One theory is that women seek health care services more often than men. Life and body changes may also play a part: women are more likely to become depressed after puberty, during their menstrual cycles and following pregnancy. Another theory is that women have less power and control in their lives, and are more likely to be victims of violence or abuse.
While women are more frequently diagnosed with depression, a rising number of men are also seeking treatment. Men may use substances, such as alcohol or other drugs, to cope. These drugs may hide their feelings of depression.
Other factors can also contribute to depression, such as prejudice and discrimination and being marginalized or excluded. This may mean being denied your rights, not being recognized or appreciated and not being allowed to participate in things that are important to you. Often, people of colour, older adults, lesbians, gays, bisexuals and trans-gendered people are affected by discrimination. People who have suffered major losses may also be more at risk of having depression.
For more information about depression, contact the Mood Disorders Association of Ontario (MDAO) at (416) 486-8046 in Toronto or toll-free at 1-888-486-8236. Or view their Web site at www.mooddisorders.on.ca
are a range of conditions involving an obsession with food, weight and appearance. This obsession negatively affects people's health, relationships and day-to-day living. The two main types of eating disorders are anorexia nervosa and bulimia nervosa.
People with anorexia have an intense and irrational fear of gaining weight and having body fat. They are obsessed with being thin. They may believe they are fat, even when they are well below the normal weight for their height and age.
People with bulimia go through cycles of bingeing and purging. Bingeing involves eating large amounts of food quickly. This makes people feel physically ill and anxious about gaining weight. Then they will purge, which can involve vomiting, depriving themselves of food, over exercising or using laxatives and diuretics.
About 90 per cent of people diagnosed with eating disorders are girls and women. However, these days boys are being diagnosed with eating problems more often. These disorders typically begin during adolescence.
For more information, contact the National Eating Disorder Information Centre at (416) 340-4156 in Toronto or toll-free at 1-866-633-4220. Or view their Web site at www.nedic.ca
People who have a personality disorder
behave and communicate in ways that are very different from what is expected in the society they live in. They may have problems with self-image or having successful relationships. They may have a different way of seeing themselves, others and the world. And they may have a rigid way of thinking, feeling and acting. This makes it difficult for them to get used to changes and stresses that are an unavoidable part of everyday living.
While personality disorders may look different in different people, anyone who has a personality disorder deals with feeling uncomfortable with themselves or others. Personality disorders begin in adolescence or early adulthood. Some personality disorders may result from childhood sexual or physical trauma.
affects all aspects of a person's functioning--how he or she feels, thinks, acts and relates to others. People with schizophrenia often have difficulty figuring out what is real and what is fantasy. For instance, they may see or hear things that aren't actually there. They may also have difficulty carrying out everyday tasks such as bathing, getting dressed and preparing simple meals.
Men and women are both affected equally by schizophrenia. However, men tend to experience their first episode in their late teens or early 20s. Women may not experience symptoms until they are a few years older.
For more information about schizophrenia, contact the Schizophrenia Society of Canada at (905) 415-2007 in Toronto or toll-free at 1-888-SSC-HOPE (772-4673). Or view their Web site at www.schizophrenia.ca
. You can also contact the Schizophrenia Society of Ontario at (416) 449-6830 in Toronto, toll-free at 1-800-449-6367, or through their Web site at www.schizophrenia.on.ca
Substance use disorders
involve dependence on or abuse of substances, such as alcohol, medication or illegal drugs. Most people who use substances do not progress to problem use or become dependent on substances. But those who do develop a substance use problem are at high risk of having a mental health problem as well. For instance, people with anxiety, depression or conduct disorders or those who have a history of child abuse may use alcohol or other drugs to help them cope (e.g., to feel more calm or less worried) and then become addicted to the substance. Sometimes substance use hides the mental health problem, so the problem does not get addressed
Some drugs--such as alcohol, sedatives (to help people sleep or feel less anxious), stimulants or "uppers" (that make people feel they have more energy) and marijuana--can lead to depression, anxiety or psychosis (e.g., schizophrenia, bipolar disorder). Often these problems will go away when the person stops using the substances.
When someone has both a substance use and mental health problem, they have what is called a concurrent disorder. Like mental health problems, substance use problems affect how people think, behave and relate with others. They also affect people's interests and performance in school or work.
Descriptions of these mental health problems can be downloaded from the Canadian Mental Health Association (CMHA), Ontario Division Web site at www.ontario.cmha.ca
and from the Web site of the National Institute of Mental Health at www.nimh.nih.gov
To get a more detailed description of these mental health problems and information about others not listed here, contact the Centre for Addiction and Mental Health (CAMH)'s 24-hour information line at (416) 595-6111 in Toronto or toll-free at 1-800-463-6273, or check About Addiction and Mental Health
on this website.
For a small charge, you can obtain booklets on obsessive-compulsive disorder (a type of anxiety disorder), depression, bipolar disorder and schizophrenia by contacting CAMH's Marketing and Sales Services at (416) 595-6059 in Toronto or toll-free at 1-800-661-1111.
Contact the Ontario Drug and Alcohol Registry of Treatment (DART) for up-to-date details about alcohol and other drug treatment services across the province. Their toll-free number is 1-800-565-8603. Their Web site is www.dart.on.ca
Challenges & Choices: Finding Mental Health Services in Ontario