Mental Health Resources

Tips and Resources

Your mental health journey starts with a search for information and support.

Below, we’ve gathered trusted tips and resources to help you find understanding and move toward well-being.

Disclaimer

HF Care curated the following resources through various channels, including three levels of government and community organizations. HF Care does not endorse any of the organizations listed. While we have screened these resources for credibility, HF Care will not be responsible for the accuracy or credibility of all information provided. Please use these resources at your own discretion.

Anxiety Disorders

Everyone experiences some level of anxiety.

These feelings may include feeling embarrassed, frightened, insecure, panicky, nervous, scared, or humiliated. These are all normal emotions.

However, if you are experiencing these feelings on most days and they are affecting your life, you may be suffering from an Anxiety Disorder.

Sometimes, these Anxiety Disorders can cause physical symptoms of muscle tension, headaches, heart palpitations, sweating, trembling, trouble breathing, choking sensations, chest pain, stomach problems, dizziness, numbness, tingling sensations, blushing, sleep problems, concentration problems, memory problems, or fatigue.

If your anxiety is so severe that you have trouble working or socializing with your friends and family, you may be suffering from a medical condition in which help is available. There is good scientific research available on the following medical conditions.

Panic Disorder

Do you suffer from sudden and unexpected bouts of panic symptoms like:

Pounding heart.
Sweating.
Trembling or shaking.
Sensations of trouble breathing.
Feeling of choking.
Chest pain or discomfort.
Nausea.
Dizziness or lightheaded.
Feeling unreal or detached from your self.
Fear of losing control or going crazy.
Fear of dying.
Numbness or tingling sensations.
Chills or hot flashes.

If you have 4 or more of these symptoms that suddenly appear all at once, you may be having a panic attacks. Panic attacks are quite common and can occur in many situations (for example: if someone were to throw a snake in your lap, you may get a panic attack).

Many people get panic attacks and are not bothered by them. Panic attacks on their own are not considered to be a medical condition.

However, if these panic attacks begin to influence your life or bother you significantly, you may be suffering Panic Disorder.

If you are constantly worried about getting another attack, worrying about losing control, worrying about having a heart attack, worrying about going crazy, or stopped doing some things to prevent another attack, you may be suffering from a medical condition called a panic disorder. If you become afraid of going into certain situations because you think you won’t be able to get out if you get a panic attack, you may be suffering from Agoraphobia.

These places include subways, buses, malls, grocery stores, bridges, driving, grocery stores, movie theatres, restaurants, elevators, crowds, line-ups, being alone, or going out of town. Approximately 2%-5% of the population will suffer from panic disorder. It usually develops in young adulthood, but can develop at any age. However, it is unusual to suddenly develop panic attacks after the age of 45.

You should see your family doctor right away if just developed panic attacks after 45 years old. It could be a serious medical condition.

Specific Phobia

A phobia is an excessive fear of an object or situation. These include certain animals, insects, heights, seeing blood, injections, storms, water, flying, elevators, enclosed spaces, choking fears or fears of vomit.

Many people will experience fear in the above situations. However, if the fear is severe enough that it affects your ability to work or socialize with your friends and family, you may have a Phobia.

Specific phobias are very common. Approximately 5%-10% of the population has a Specific Phobia.

Social Phobia

Do you feel scared or anxious when you have to do things in front of people or when you are just around people? Are you scared that you may embarrass or humiliate yourself? Would you avoid these social situations if you had the chance? If you answered yes to all these questions, you may be suffering from Social Phobia.

Social Phobia is more than just shyness. Shyness is a normal human trait and does not interfere significantly with one’s life. Social Phobia is a medical condition, which significantly interferes with people’s work functioning or social life.

It is a common condition that affects approximately 10%-15% of the population at least once in their lives. It usually begins in the teenage years.

Obsessive-Compulsive Disorder

Do you suffer from obsessions? Obsessions are recurrent and intrusive thoughts, images or impulses.

Examples of obsessions include recurrent concerns about being contaminated with germs or dirt, recurrent thoughts that you may not have locked your door or shut off the stove, excessive concerns that you may have hurt someone accidentally, intrusive religious/sexual/horrific images or impulses to hurt someone you don’t want to hurt.

Do you suffer from compulsions? Compulsions are behaviours you have to do a certain way or over and over again, in order to relieve a sense of tension or anxiety.

Examples of compulsions include excessive hand washing, repeated checking of things (for example: lights, doors, appliances, faucets), counting things for no reason, hoarding useless items (like bills, papers, or magazines), doing things in a specific ritual that other people do not do, and making sure things are lined up perfectly or placed in a certain way.

If you have an obsession or compulsion and it bothers you or it significantly interferes with your life you may be suffering from a disease called Obsessive-Compulsive Disorder.

Approximately 2%-3% of the population suffers from this disease.

Post-Traumatic Stress Disorder (PTSD)

Have you ever experienced an event that was overwhelming and traumatic? Examples of traumatic events include being in a war, being tortured, being in a natural disaster (earthquake, flood etc.), assault, rape, or a serious accident.

Did you feel extremely scared, helpless or horrified when the event was happening?

Do you have difficulties forgetting about the traumatic event? For example, you have constant thoughts about the situation, nightmares about the event, sometimes feel as if it is happening again, or get very nervous when something happens that reminds you of the event.

Do you avoid things that might trigger the fear you experienced during the traumatic event?

Do you feel emotionally numb?

Do you have difficulty with your sleep, get angry easily, have difficulty with your concentration, constantly on edge watching everything around you, or are you easily scared?

If you answered yes to all of the above questions and you find that you have difficulties coping with your life because of these symptoms, you may be suffering from a disease called Posttraumatic Stress Disorder. You should talk to your family doctor about this disease if you think that you may have it. There is treatment available. This is a disease that can affect up to 3% of the population.

Generalized Anxiety Disorder

Do you find yourself worrying excessively about ordinary things almost every day? For example, do you worry about your finances when they are fine? Do you worry about your health when you are physically ok? Do you worry about the health and safety of your loved ones when they are fine? Do you find these worries very difficult to control? Do you suffer from physical symptoms because of these worries? These physical symptoms can include fatigue, difficulties concentrating, irritability, muscle tension, sleep problems or restlessness/feeling on edge.

If this sounds like you, you may be suffering from Generalized Anxiety Disorder. Generalized Anxiety Disorder is a common disease that can occur in proximately 5% of the population. It usually exists with other conditions such as Major Depression.

What causes Anxiety Disorders?

Some research suggests that anxiety disorders develop when people learn to associate certain situations with fear.

They learn to overestimate the degree of danger and the probability of harm in certain situations. Some people with anxiety disorders also underestimate their own abilities to cope in certain situations.

A number of brain chemicals have been found to be associated with anxiety disorders. These brain chemicals include norepinephrine, serotonin, and GABA. Brain scan research has revealed that certain areas of the brain may be different in those people who suffer from an anxiety disorder.

There may also be a genetic component. Close relatives of people with an anxiety disorder tend to have a slightly higher chance of also suffering from an anxiety disorder.

Treatment for Anxiety Disorders: Cognitive-Behaviour Therapy

Cognitive-Behaviour Therapy is a form of treatment that involves two types of therapy.

It involves Cognitive Therapy and Behaviour Therapy. Cognitive Therapy helps you to look at your feared thoughts.

Usually, your fears are exaggerated or irrational. Cognitive Therapy helps you to examine and challenge your fears.

Sometimes people with anxiety disorders will avoid or escape fearful situations. These behaviours usually lead to more anxiety in the future. Behaviour Therapy teaches you how to gradually face your fears and not avoid or escape these situations.

Treatment for Anxiety Disorders: Medications

Antidepressants can be helpful for some anxiety disorders. Even though they were initially developed for depression, they have been scientifically proven to be helpful for most of the anxiety disorders.

It is believed that they help in balancing the brain chemicals that cause anxiety disorders.

Because one of the side effects of antidepressants can be a short-term increase in anxiety, your doctor may tell you to start the antidepressant at a much lower dosage to prevent this.

The initial increase in anxiety will usually go away after 1-2 weeks. Your doctor may also gradually increase your antidepressant over a period of 1-2 months, to dosages that are higher than that used for depression.

Scientific research has shown that you may need higher dosages of antidepressants to treat some anxiety disorders. It may also take longer for the medication to work.

It can take 8-12 weeks of being on the medication before you see any significant improvement. See section on medications for Major Depression for more information.

Benzodiazepines are a class of medications that are sometimes used in treating anxiety disorders. The common medications in this class are Valium/diazepam, Ativan/lorazepam, Rivotril/clonazepam, and Xanax/alprazolam.

These medications are quite effective in relieving anxiety temporarily. However, they can be quite addictive and difficult to stop. As a result, they are usually used for short periods of time, for example, 3-6 months only.

Suggestions For Families

Learn as much as you can about the symptoms and treatments for anxiety disorders.
Support your relative’s medication and treatment program.
View your relative’s anxiety behaviours, as symptoms, not character flaws.
Remember that your relative is a person with a disorder, but who is healthy and capable in many other ways.
Do not participate in your relative’s anxiety behaviours (for example, avoidance of certain situations or unusual compulsions), and explain to your relative that you are doing this to help support their treatment program. If you have fallen into the habit of participating in the anxiety behaviours, it will take some practice to change back to more normal behaviours.
Maintain a normal family life as much as possible, do not allow the anxiety disorder to take over.
Keep communications positive, direct and clear. State what you want to happen rather than criticizing your relative for past behaviours.
Keep calm. Avoiding losing your temper will contribute to a positive atmosphere.
Combine humour with caring. Support doesn’t always have to be serious. Respectful humour can help your relative detach from his or her symptoms.
If there are children in the home, explain that their family member behaves this way because he or she is sick with an illness, and reassure them that they did not cause it.
Depression can accompany an anxiety disorder. Learn the warning signs of suicide and make an emergency plan that includes these phone numbers: your relative’s psychiatrist or family doctor, emergency services and the police. If possible, make the plan with the assistance of your relative.
Take good care of yourself. Creating a low-stress environment for you by seeking and accepting support, cultivating interests that are just yours, and taking a little time out each day to recharge your batteries will give you the energy to support your relative.
The most important thing to remember is that life is a marathon, not a sprint. While you are doing the best you can to provide support to your relative, you will sometimes find yourself accommodating to anxiety behaviours before you realize it. Try not to be judgmental toward yourself when you fall into old routines, in the same way that you try not to judge your relative. Just start again.

Where Can You Get Help In Toronto?

Your Family Doctor

If you think that may be suffering from an anxiety disorder, make an appointment with your family doctor. At the beginning of your visit, ask your family doctor if you might be suffering from an anxiety disorder. If your family doctor thinks that you are suffering from an anxiety disorder, he/she will give you advice about what to do. If your family doctor needs a second opinion about your illness, he or she may send you to a psychiatrist, a specialist in this area of medicine.

Community Health Programs

HF Care
Tel: 416- 493-4242
This is the main agency for Asians with mental health issues.

Toronto Western Hospital – Asian Initiatives in Mental Health
Tel: 416-603-5800 ext.5349

South Riverdale Community Health Centre
Tel: 416-461-1925
This program is only for South Riverdale residents.

Wellness Centre
Tel: 416-291-3883

Local Hospital Emergency Room

If you are seriously thinking about ending your own life, you must see a doctor right away. You may go to your local hospital emergency room if you can’t see your family doctor right away. If your relative is talking about killing himself or herself, you can call their family doctor or the hospital emergency room. They will give you advice about what to do.

Links to other websites on Depression and Anxiety

(These websites are in english only)

Bipolar Disorder (Manic Depressive Illness)

Everyone of us has experienced mood fluctuation at sometimes in our life. Our mood can change several times a day from happiness to sadness, from excitement to boredom. However, some people experience dramatic changes in mood that may affect their daily living.

In such circumstances, they may be diagnosed as having bipolar disorder.

The essential feature of bipolar disorder (also called manic-depressive illness or manic depression) is a cyclic illness in mood which may shift from deep, frightening depression to extreme excitement, or elation. The initial episode that leads to hospitalization is usually manic. Both sexes are equally affected.

There does not appear to be a relationship between race and this illness. The age of onset is frequently in late adolescence or the early 20s. For many patients, episodes recur every few years; a few patients have frequent cycles per year.

Some patients have manic or depressive episodes as frequently as 4 times a year and this feature is referred as rapid cycling.

With increased age, the interval between episodes may decrease, and the length of episodes may increase.

Symptoms of Bipolar Disorder

Manic episode: the critical clinical feature of a manic episode is a mood that is elevated, expansive, or irritable. Associated symptoms include part of or all of the followings:

Excessively active in activities which often take the form of sexual promiscuity, political involvement, and religious concern.
Rapid in speech – the patient’s speech is pressured to a point of being impossible to interrupt.
Difficulty in concentrating that thinking and speech move quickly from one idea to the next.
Reducing in sleeping hours – often sleeps a few hours each night and yet has unlimited energy.
Increased self-esteem to the point of grandiosity – the individual feels on top of the world, and being capable in achieving everything.
Easily get distracted by surrounding sounds, people or smells.
Short attention span
Poor judgment – may lead to buying sprees, bad business decision, or dangerous behavior such as abusing drugs or alcohol.
Having delusion that centre on themes of unlimited power and influence.
Having hallucination such as hearing voices or seeing flashing colors and lights that may occur at the peak of the manic episode.

Depressive episode: The critical clinical feature of a depressive episode is a mood that is sad and despaired accompanied with part of or all of the following symptoms depending on the severity of the depression.

Loss of interest in people, work and activities
Loss of energy or fatigue
Appetite change leading to either weight gain or weight loss
Feelings of uselessness, hopelessness and excessive guilt
Disturbed sleeping habits-sleeping too little or too much
Slowed thinking, forgetfulness, difficulty in concentrating and in making decisions
Low self-esteem and feelings of inadequacies
Loss of interest in sex
Crying easily; or feeling like crying but cannot
Thinking about death or suicide

What can you do to cope with your illness?

People with manic depression may need to make some changes in their lifestyle in order to cope better with their illness, changes are such as:

Keep regularity of daily activities e.g. sleeping pattern, exercise
Avoid any alcohol and street drugs
Keep working (part-time, full-time or volunteer work etc.)
Maintain social contact with family members, friends or church members etc.
Compliance with treatments
Seek for professional help

What can family and friends do?

Always listen, avoid argument and show your availability to help
Take every threat or suicidal thought seriously; act immediately if necessary such as calling police, doctor or crisis help line for help.
Keep contact with other helping professionals who are trained to deal with crisis
Assist in money management for patient with his/her consent

Where to seek help?

Consult family doctor/psychiatrist
Contact HF Care’s intake staff at 416-493-4242 X 0, or other community service agencies
Contact the Metro Integrated Community Crisis Program at 416-289-2434 when needed
Contact nearby emergency departments.

Cannabis Facts and Risks

Click here for Cannabis Facts and Risks Brochure (PDF)

What is cannabis?
Cannabis sativa, also known as the hemp plant, has been cultivated for centuries for industrial and medical use, and for its psychoactive, or mind-altering, effects. Marijuana (grass, weed, pot, dope, ganja and others), hashish (hash), hash oil (weed oil, honey oil) all derive from the cannabis plant.

Medical Cannabis vs. Recreational Cannabis
Medical cannabis is used to treat certain health needs. It is used under the supervision of a trained health care professional whereas recreational cannabis is not.

Cannabis Regulations in Ontario

You must be 19 and older to buy, use, possess and grow recreational cannabis.
You are permitted to purchase up to 30 grams (about one ounce) of dried recreational cannabis at one time for personal use.
You are permitted to possess up to 30 grams (about one ounce) of dried cannabis in public at any time.
You are permitted to grow up to four plants per residence (not per person).
Driving impaired by cannabis is illegal and you can face criminal charges. Zero tolerance for young (21 or under), novice (G1, G2, M1 or M2 licence) and commercial drivers.
Consuming recreational cannabis in the workplace remains illegal.
Please check local municipal bylaws, lease agreements, and the policies of employers and property owners, to see where you can use cannabis, both medical and recreational.

People can have very different experiences with cannabis.
Some may feel relaxed, lively, talkative, giggly and even euphoric, while others feel tense, anxious, fearful and confused. The kind of experience you may have can vary from one drug-taking episode to another, usually because of the amount taken, the method used and the frequency of regular cannabis use.

How cannabis affects you depends on:

How much you use.
How often and how long you’ve used it.
Whether you smoke, vape or eat it.
Your mood, your expectations and the environment you’re in.
Your age.
Whether you have certain pre-existing medical or psychiatric conditions.
Whether you’ve taken any alcohol or other drugs (illegal, prescription, over-the-counter or herbal).

Major Depression

Major Depression is a medical illness. Because it is a medical illness, many times the first signs of Major Depression can be physical symptoms such as fatigue, sleep changes, appetite changes, aches and pains, etc.

Everyone feels sad at times, especially when something bad has happened (for example, after the death of someone close to you or the loss of a job). This is a normal reaction if it goes away within a reasonable amount of time.

However, if you are experiencing sadness and most of the above symptoms almost every day for two or more weeks, you may have a medical illness called Major Depression. This is a common disease, which people don’t talk about.

It affects 10-15% of men and 15-25% of women. If you get treatment, there is a high chance the illness can improve within a short period of time (within the last 2-6 weeks). Without treatment, it may last 6-18months or even longer.

Do you feel a loss of energy for no reason?
Do you have sleep problems?
Do you notice that your concentration or memory is not as good?
Do you have thoughts of dying?
Do you feel sad almost every day?
Do you feel worthless or guilty?
Do you not enjoy things anymore?
Do you notice any changes in your appetite?

If you answered yes to most of these questions you may be suffering from Major Depression.

What causes Major Depression?

Genetics: People with a history of depression in their family have a slightly higher chance of becoming depressed. However, genetics alone does not cause depression.
Psychology: The way you have learned to deal with problems may contribute to depression. If you are the type of person who has a low opinion of yourself and worries a lot, if you are overly dependent on others, if you are a perfectionist and expect too much from yourself or others, or if you tend to hide your feelings, you may be at greater risk of becoming depressed.
Life Events: Early childhood trauma and losses (such as the death or separation of parents) or adult life events (such as the death of a loved one, divorce, loss of a job, retirement, serious financial problems and family conflict) can lead to depression.
Biological Factors: Hormonal or chemical imbalances in the brain may cause depression.

Treatments For Depression: Talk Therapy

Talking to a professional who has been trained in providing psychotherapy (otherwise known as talk therapy) to people who are depressed, can be helpful. The therapy helps to relieve distress by discussing and expressing feelings, to help change attitudes, behaviours and habits that may be causing the depression. Doctors, social workers, psychologists and other mental health professionals are trained in different models of talk therapy.

Scientific research has shown that two types of talk-therapy can be effective in treating depression. One type is Interpersonal Therapy. In this type of therapy, people look at how their relationships with other people may be causing their depression.

The other type of therapy is Cognitive Behavioural Therapy. This type of talk therapy helps people see how their negative thoughts and behaviours are causing their depression. Examples of negative thoughts are “I am useless and worthless”, “Nobody likes me”or“I have no future”. Examples of negative behaviours include avoidance of social interactions with people or decreasing activities that you enjoy. Cognitive Behaviour Therapy teaches people how to change these negative thoughts and behaviours.

Treatments For Depression: Medications

Medications called antidepressants can be used to treat depression. It is important to have a doctor you feel comfortable asking questions about medications and their side effects. Some people worry that they will become addicted to or dependent on medication. Antidepressants are not addictive. Many people believe being on antidepressants is a sign of weakness. Depression is a medical illness that, without treatment, can worsen significantly and even become life threatening. All medications can have side effects.

Common side effects from antidepressants are headaches, nausea, dry mouth, insomnia, increased anxiety, sleepiness and sexual difficulties. The headaches, nausea and increased anxiety will usually decrease the longer you are on the medication. If you are struggling with side effects it is important to tell your doctor and not suddenly stop your medication. A sudden stop of your medication can cause unpleasant reactions.

To get the best effect from a medication, your physician may gradually increase the dose to a therapeutic level. Unlike other medications that relieve symptoms very quickly, antidepressants usually take 2 or more weeks to take effect.

It is common for your doctor to try two or more different antidepressants before finding one that works well for you and has tolerable side effects. Once the medication has treated your depression, it is often recommended that you continue to take the medication for up to one year or more, in order to prevent a relapse.

Treatments For Depression: Other Options

There are other things that have not yet been scientifically researched but may be helpful. Learning skills to solve problems or how to be more assertive may be helpful. Lifestyle changes such as good nutrition, exercise and meditation may also be helpful.

Treatments For Depression: Help for Families

Seeing a relative with depression can make you feel sad, frightened, helpless and anxious. You may experience guilt, anger and frustration. Without information about depression, you might think that your relative is lazy, give well-meaning advice and become frustrated when he or she does not act on your advice. If your relative talks about suicide, you will understandably live with a great deal of worry. Families need to get as much information as possible about depression. Knowledge and understanding will improve your ability to assist your loved one and deal with your feelings. Information is available from the doctor, social worker or other mental health professional. Moderately depressed people may be able to hear your helpful suggestions, but be unable to act on your advice. Avoid quizzing them about what made them feel depressed. Do not blame them for the way they feel, or tell them to snap out of it. This will only increase their feelings of guilt, loneliness and isolation. Depressed people often cannot identify what made them depressed or what will be helpful.

If your relative is severely depressed, it is normal for you to experience his or her company as very draining. Short, frequent contacts are often the best way to deal with them.

When someone suffers from a serious illness, it is natural for family members to feel worried and stressed. This stress can lead to sleep problems, fatigue and chronic irritability. It is important to recognize these signs of stress in yourself and look after your own health. Make time for yourself. Make sure you have good support from friends and relatives. There may be a self-help organization in your area. These are usually offered at local hospitals or community mental health clinics. Accept that sometimes you will have negative feelings about the situation. These feelings are normal and you should not feel guilty.

Where Can You Get Help In Toronto? Your Family Doctor.

If you think that may be suffering from depression, make an appointment with your family doctor. At the beginning of your visit, ask your family doctor if you might be suffering from depression. If your family doctor thinks that you are suffering from depression, he/she will give you advice about what to do. If your family doctor needs a second opinion about your illness, he or she may send you to a psychiatrist, a specialist in this area of medicine.

Community Health Programs

HF Care Mental Health Association
Tel: 416- 493-4242
This is the main agency for Asians with mental health issues.

Toronto Western Hospital – Asian Initiatives in Mental Health
Tel: 416-603-5800 ext.5349

South Riverdale Community Health Centre
Tel: 416-461-1925
This program is only for South Riverdale residents.

Wellness Centre
Tel: 416-291-3883

A Local Hospital Emergency Room

Problematic Use of Digital Technology

Problematic Use of Digital Technology

This resource is to guide parents to better communicate with their children in coping with gaming problems. Although this resource focuses on the problematic use of digital technology, most patterns of gaming are not cause for concern. Some research even supports the positive impacts of gaming, such as developing and/or improving:

problem-solving abilities
perseverance
pattern recognition
hypothesis testing
estimating skills
inductive skills
resource management
logistics
mapping
memory
quick thinking
reasoned judgments

REDUCE OR REMOVE?

How much gaming is too much? It’s hard to say but our general guidelines suggest if your gamer is over 12 years old we want to target two hours or less per day, and ideally not every day. If your gamer is under 12 years old, we would suggest 30-60 minutes and again, not every day.

If your situation is not severe and you haven’t approached a detox plan before, we recommend to start with a plan to reduce gaming to those age limits. If your situation is more severe, or your situation has not improved with reduced gaming, then we would recommend to do a full detox.

Whether you are choosing to reduce or remove, stick with your plan for at least 30 days and then re-evaluate. Use the following tips to improve communication between parents and children.

THE BASICS

To reduce the impact of gaming, consider these ideas:

Let them earn it: Every game day is earned through a game-free day. Require gaming to be played in balance, with not only other activities but also days off.

Move devices to a common area: You want to reduce your gamers’ ability to be isolated in a dark room for hours on end. Bring their PCs and consoles into a central area of the home.

Shift to different types of games: Online games that are more competitive tend to be more problematic than other types of games. Consider switching to offline single-player story-based games. Common Sense Media is a great resource on games.

Not first thing: When gaming in moderation it is meant to be a complement or addition to their life not their single-focus. Don’t allow games to be played first thing in the morning, especially on weekends. Require exercise, time in nature, and other responsibilities to be complete first.

COMMUNICATION

Re-building trust and rapport: Whether you are reducing or removing gaming, rebuilding your family relationship is crucial. Be mindful of your communication.

Stop saying they are an addict: It’s confrontational and easy for them to dismiss. Instead speak to the mood or behavior change you are experiencing.

Have a family meeting: Sit down and have an open discussion as a family about technology at home. Give everyone space to share their thoughts and concerns. Use the ‘Family Screen Time Agreement’ on the next page, and read Reset Your Child’s Brain.

Create family sacred time: Set specific times for the family to connect without technology. Try eating meals together, plan activities for the weekend, and stop using smartphones in cars.

Ask for proof: Did they say they worked on their resume? Did they say they did their summer homework? Hold them accountable by seeing it for yourself.

Find Replacement Activities

The less your gamer is playing the more they will need to fill their free time with other activities. The key is to find activities that fulfill the same emotional needs that gaming fulfilled.

One of the reasons gaming is so appealing is because it fulfills many of their needs in ‘one’ activity, whereas other activities don’t offer this as much, so I recommend to find three specific types of activities to replace gaming:

Mentally Engaging Activities: this is something stimulating — a new skill to develop, an achievement or goal to pursue.

Resting Activities: something to do at home when they are tired from the day and/or bored that requires a low amount of energy.

Social Activities: to help them make new friends outside of games, and that ideally gets them out of the house.

It can also be helpful to find physical activities, and ways to spend more time in nature, both of which are proven to help a gaming addict come back to the real-world.

Tips

The type of game your gamer plays can provide a lot of insights into what their underlying motivations and interests are. For example, if your gamer plays competition-based games, they may be more into sports or activities that provide them a similar level of challenge and immersion. Whereas if your gamer enjoys role-playing games, they may be more interested in activities such as filmmaking, improv, or theatre. Ask your gamer what type of games they like to play, and you can also search the game on YouTube to learn more about it.

Add Structure

Gaming tends to be the all-encompassing activity gamers use whenever they have free-time, or when they’ve fulfilled their ‘obligations’ for the day. It’s their go-to autopilot hobby.

During recovery you need to increase the amount of structure they have. Define the new activities they can do instead. Have these activities listed on a whiteboard in their room or around the house. Provide them with a calendar or daily agenda.

Many gaming addicts struggle with time management, so finding ways to help them improve this skill will support them in improving their lives.

Often we have structure for obligations such as school or work, but we have little-to-no structure for our free-time in the evenings, on the weekends, or during holidays. These are times that structure is crucial, otherwise it’s easy for gamers to fall into bingeing habits.

Without defined new activities to replace gaming, you may find yourself with someone who is no longer gaming, but they are just laying around watching YouTube or Netflix instead.

SETTING BOUNDARIES

If you experience violence, or concerns of self-harm, contact the police, emergency services, or a crisis line immediately!

Setting boundaries is not easy, but it’s important for a healthy relationship. Kids are wired to test boundaries and as parents it’s crucial you remain firm in the boundaries you set. Hang in there! It’s common to experience tantrums after you limit or remove access to technology, which occurs either due to an anxious attachment style, or acting out to gain control or power.

Define your boundaries: be clear and concise, considering writing them down. What are your values? What principles are you living by? You must model this behaviour for them.

Hold them accountable: if they cross a boundary, you must respect yourself and have clear consequences. Otherwise, your boundaries are meaningless and they will not respect them.

Be kind to yourself: be aware of your own emotions. If not, they will find ways to manipulate them against you.

NEED PROFESSIONAL HELP?

It is recommended when you are navigating technology overuse issues that you work in collaboration with licensed professionals. Due to the limited number of professionals who currently specialize in video game addiction, we encourage you to be patient and keep searching until you find the right fit for you and your family. It is also recommended to have a family therapy approach and to avoid only focusing on the ‘gamer’.

HF Care does not endorse the resources below. They are provided for your interest only.

HF Care Youth Counselling Services
Free counselling service for young people age 12 to 25 and their families, in Cantonese, English, Korean, Mandarin and Vietnamese.

Good to talk
Offers free, confidential support to post-secondary students in Ontario 24/7.

Sunnybrook Family Navigation Project
Provides expert navigation of the mental health and addictions service system for youth aged 13-26 and their families living in the Greater Toronto Area (GTA).

Kids Health Phone
Services for youth under 20, including 24 hour helpline (1-800-668-6868).

Stella’s Place
Community Based Peer Support for youth 16-29.

Pine River Institute
Services for youth with addictions and their families.

Children’s Mental Health Ontario
Network of child and youth mental health centres with 4,000 professionals ready to help children, youth and families with free counselling and treatment.

What’s Up Walk-In® Clinic
Immediate mental health counselling for children, youth, young adults and their families, and families with infants.

Resources:

Continuum of Gaming
Resources for Parents: Technology Use & Transition Age Youth by Centre for Addiction and Mental Health (CAMH)
Stop the Summer Gaming Binge by Cam Adair

Schizophrenia

Schizophrenia occurs in all societies, and one in 100 people will be diagnosed with schizophrenia at some time in their lives. It is the most common among all the psychotic illnesses. Most researchers and clinicians agree that schizophrenia is a biopsychosocial disorder.

This means that syndrome of schizophrenia has a biological basis and that in patients who eventually develop the illness this biological predisposition has interacted with psychosocial stressors.

What are the symptoms of Schizophrenia?

Schizophrenia affects the way people think, behave and react when they are influenced by its active symptoms. Schizophrenic symptoms can be divided into three categories: positive symptoms, disorganized symptoms, and negative symptoms.

Positive symptoms: This refers to having symptoms that ordinarily should not be there. Positive symptoms are sometimes called psychotic symptoms since the patient has lost touch with reality in certain important ways. Some of the positive symptoms are:
- Delusions: A false/unreal belief that people with schizophrenia sometimes have. Their belief may be that people are reading their thoughts, that someone is plotting against them, or that they can control other people’s minds.
- Hallucinations: This refers to hearing, seeing, smelling, or feelings that are not there.
Disorganized symptoms:
- Thought and speech: People with schizophrenia sometimes have trouble communicating in coherent sentences or carrying on a conversation.
- Behaviour: Schizophrenia can cause people to move more slowly, repeat rhythmic gestures, or make ritualistic movements.
- Perceptions: People with schizophrenia sometimes have a hard time making sense of everyday sights, sounds, and feelings. Their perception of what is going on around them may be distorted so that ordinary things appear distracting or frightening. They may be extra-sensitive to background noises and colors and shapes.
Negative symptoms: Negative refers to a lack of certain characteristics that should be there. The symptoms are not as dramatic as positive symptoms, but they can interfere significantly with the person’s functioning.
- Flat/blunted emotions: schizophrenia can make people with it have difficulties to express their emotions clearly. They may speak in a monotone or show little expression on their faces.
- Lack of motivation/energy: People with schizophrenia may seem to lack energy and have trouble starting projects or following through with things. At the extreme, they may have to be reminded to do simple things like taking a bath or changing clothes.
- Lack of interest: People with schizophrenia may not take much pleasure or interest in the things around them, even things they used to find enjoyable. They may feel that it is not worth the effort to get out and do things.
- Limited speech: Their speech is brief and lacks content. They often have trouble carrying on a continuous conversation or saying anything new.

Discovering the Illness

Schizophrenia usually develops in the teens or early adulthood. When the illness first attacks a person, there are changes experienced by him/her or observed by his/her relatives.

These changes may be gradual for some people and sudden and acute for others. The changes may include trouble sleeping, suspicion, fear, and a decrease in general functioning (e.g. having problems in studying, keeping a job, taking care of themselves and relating with others).

Stress in studies or a breakdown in relationships do not cause the illness, these are merely precipitating factors.

How is Schizophrenia treated?

Symptoms of schizophrenia can come and go. They are active in a psychotic episode and require acute treatment. Acute treatment is aimed at ending the current acute psychotic episode.

It may include hospitalization.

When the symptoms are mostly controlled, maintenance treatment is continued on a long term basis to improve functioning and prevent future psychotic episodes.

The person may or may not have persistent symptoms during this phase of maintenance treatment. Successful treatment involves the use of medication, psychotherapy and rehabilitation.

Anti-psychotic medication: Medication is necessary in both the acute and maintenance treatment phase. During the acute phase, medications help relieve the acute psychotic symptoms. After the acute phase, ongoing anti-psychotic medication greatly reduces the chance of relapse. Medication may cause side effects. It is important to discuss medication with the doctor who prescribes it.
Psychotherapy: It helps persons with schizophrenia learn about their illness and develop coping skills, and have emotional support.
Psychosocial rehabilitation: It aims to enhance the abilities of persons with mental illness in their daily living.

What is the outcome?

The course of schizophrenia varies from one patient to another. It is a chronic illness and complete cure (i.e. no need to take medication) is rare. About 25% of schizophrenic patients have complete remissions, about 10% remain severely psychotic, and others are with minor residual symptoms or alternate between impairment and acute psychotic lapses.

There are enormous variables that affect the outcome of the illness, such as functioning before the onset of the illness, type of symptoms, familial and sociocultural context.

What can a person with Schizophrenia do to manage his/her illness?

Comply with medication or other treatment
Understanding the illness
Monitor his/her mental condition
Strive for her/his recovery
Have hope
Join a peer support group

What can families and friends do to help?

Help the patient find appropriate treatment
Encourage the patient to comply with treatment Cooperate with professionals (such as doctor, social worker) offering treatment
Learn to recognize warning signs of relapse
Learn to handle crisis
Understand the patient and set appropriate expectations
Attend family support group

Where do you get help when you or your family members appears to have Schizophrenia?

Ask your family doctor to refer you for help.
Approach social services and health agencies for information.
Contact HF Care‘s intake staff at 416-493-4242 X 0 or other community service agencies
Contact the Metro Integrated Community Crisis Program at 416-289-2434 when in crisis situation
Contact nearby emergency departments

Stress, Emotions, Health

Check out our Stress, Emotions, and Health Brochure (PDF)

Stress is the response of our body and mind to “CHANGE”. Change is the going from one thing, form, phase, place or state to another. Change is the natural part of living.

Stressors are the ever-present real, anticipated, unexpected, imagined element objects, events and circumstances that bring about change.

Anticipated and desired change is often considered positive stressors. Positive stressors bring challenges but also motivation and energy (e.g. a planned celebration or vacation).

Unexpected, undesired or forced change is considered negative. Negative stressors bring worries, anger and grief (e.g. a job transfer, or the loss of a loved one).

Stressors can be related to:

Our physical body (e.g. a viral infection, an injury or overwork).
Our mind (e.g. perceived danger or excitement).
Our emotions (e.g. argument, conflicts).
Our environment (e.g. high noise level, extreme heat or extreme cold).
Situational (e.g. being chased by a bear, a job change or migration).
The impact of stress on our health is dependent on how we perceive or react to the stressors. A specific stressor may be considered positive to some people but negative to others (e.g. public speaking or air travel).

Change is unavoidable. A balance of change and constancy contributes to harmony & well-being.

What happen when we encounter stress?

When we encounter stress, we immediately evaluate the situation. When we perceive “danger” or “needs for actions”, our body starts off a chain-reaction. The brain signals the production of Adrenalin and other stress hormones.

These stress hormones bring changes that prepare us to “fight or flee”– our heart beat faster, we breathe faster, we are more alert, our body release stored sugar and fat for energy, more blood flows to our brain and muscle, and our other body systems down.

When the stress is resolved, our body returns to its natural or normal state.

When we have too much stress or persisting stress, our body cannot get the necessary rest and relief to stay healthy. Severe, chronic and cumulative stress can lead to illnesses and even death.

How does stress impact our health?

When we experience persisting stress, our body tries to maintain the fight-or-flee response. This instinctive response affects every single system in our body. In time, our body is unable to meet the demands and we become ill.

Muscular system: Muscles are designed to tense and relax; under stress, the muscles may not relax and become fatigued or injured. Symptoms: Back pain, leg cramps, jaw pain, neck and shoulder pain, tension headaches, muscle aches, trembling or shaking.
Immune system: Constant stress depresses our immune systems and reduces our ability to fight infections. Symptoms: Acne, colds/flus, sores in mouth, herpes, skin rash, asthma, allergies, yeast infection, cancer.
Non-Vital system: Under stress, less supply of energy and oxygen is sent to the non-vital systems (digestive, urinary) which slow down and eventually become weakened. Symptoms: Heartburn, indigestion, colitis, Chron’s Disease, nausea, water retention, weight gain or loss, diarrhea, constipation, urination difficulties, sexual dysfunction…
Vital system: Stress hormones make the heart pump and cause the blood vessels to constrict. Symptoms: chest pain, dizziness, high blood pressure, migraine, strokes, heart disease, rapid heart rate, shortness of breath, cold hands or feet.
Hormonal System: Stress hormones act on other glands in our body to release quick energy; eventually, the hormonal system cannot function normally. Symptoms: arthritic joint pain, diabetes, infertility, lowered sexual desire, menstrual difficulties.
Emotional system: Stress affects chemical reactions in our brain and intensifies our emotions. Symptoms: anger, anxiety, guilt, depression, restless, jealousy, worries, hopelessness, panic attacks, insecurity.
Cognitive System: Our brain becomes hyperactive under stress, and in time, it becomes easily stimulated even with lower levels of stress hormones. Symptoms: boredom, low energy, poor judgment, racing thoughts, insomnia, nightmares, preoccupation, restlessness, fatigue, irritability, and distrust.

Stress, Emotions and Health – What’s the link?

Since life is change, stress is an unavoidable and natural part of living. We all experience stress daily, but each of us responds to stress differently.

Our ability to handle stress depends on:

Our biological threshold for stress
Our age and health status
The meaning and significance we assign to the stressors
The number and intensity of the stressors
Our ability and skills in dealing with the stressors
Our habitual response (emotions and reactions) to stress
Our personality and perspectives towards life
Our health practice (healthy eating, active living, relaxation, etc.)

Emotions are the ways we tend to respond to specific situations (stressors). Our past experiences and personal meanings influence our emotional response, which includes our feelings, facial and outer expressions, and the changes inside our body.

It is believed that some emotional responses are essential for survivals.

For example, fear in response to danger helps to trigger our fight-or-flee responses and keep us from harm; and love is essential for bonding between individuals.

Like stress, emotions play an important role in our health. Research shows that positive emotions (e.g. joy, interest & contentment) contribute to better health while negative emotions (e.g. anger, sadness & guilt) lead to illnesses and poorer health.

Since stress intensifies our emotions, persisting negative stressors tend to reinforce negative emotions and lead to serious health problems.

What can we do to reduce stress and promote our emotional health?

Our health is influenced by individual, environmental and social factors.

While we do not have control over all our health factors, we can develop personal skills and holistic health practices that reduce the impact of stress and promote health.

Holistic Health Practice?

Holistic health practice is a set of strategies that help to slow down our body’s hyperactivities related to stress. They allow our body systems to recover and promote positive emotions, which act as a reservoir to counteract negative stressors and negative emotions and keep us well.

Quiet time: Quiet time helps to calm our mind and allow us to recover from stress. E.g. take a long bath, read a book and listen to music, etc.
Deep Breathing: Deep breathing calms the body and mind, improves our blood circulation system, and increase our capacity to deal with stress.
Exercise, Stretching & Having Fun: Regular exercises improve our body endurance; increase oxygen, blood flow and nourishment to the brain and all our body parts. Stretching increases flexibilities of muscles and tendons and mobility of the joints.
Healthy Eating: Avoid or reduce the intake of caffeine, alcohol, nicotine, fat, salt, sugar, and spicy or acidy or fried food. Caffeine makes our blood vessels constrict and may lead to migraines and high blood pressure; spicy or acidy food irritate the digestive system; alcohol and drug may worsen depression. Drink at least 8 glasses of water each day. Eat a balance diet of grain products, vegetables and fruits, milk products and meat/alternatives. Healthy eating helps the immune system and repairs our cells. (Refer to Canada’s Food Guide) Good Postures: Good postures like standing and sitting up straight promote the relaxing of muscles. (Consult doctors, ergonomic specialists, chiropractors and other service providers for suggestions) Progressive Muscle Relaxation: The tensing and relaxing of specific muscles in the body help to release tension and allow more blood flow and bring oxygen to tired muscles.
Massage: Massages and heat improve blood circulation, relax tense muscles and help to relieve muscle pain.
Meditation: Meditation quiets our mind through an active process of focusing on our breathing or music or an object. Meditation increases our mindfulness – the nonjudgmental awareness of the present moment. It also decreases our stress hormones, relaxes our muscles, improves our brain function and enhances the health of our body, mind and spirit
Guided Imagery: The use of images of a scene, an event or a place that we perceive as safe, peaceful, beautiful, restful and happy can help to reduce stress.
Stress Journal: Keeping track of our stress, responses and how we function under stress can help to identify our optimal level of stress, causes of our stress and ways to reduce or cope with stress.
Positive Reframing: Negative emotions and too much stress make it easy for us to lose perspective. Learning to see the positive aspects of every situation helps to reduce stress.
Affirmation: Positive affirmation can be used to counteract negative thoughts. When used with other holistic health strategies, affirmation can contribute to positive emotions and build our self-confidence.