Vestibular Conditions: When the World Won’t Stop Spinning

Vestibular Conditions: When the World Won’t Stop Spinning

In Canada, anyone over the age of 40 has a 35% chance of experiencing a vestibular problem at some point in their lives. Vestibular conditions involve difficulty with balance, dizziness, and vertigo. They can also affect (and be affected by!) your mental health.

As a counsellor who has worked with thousands of clients with vestibular conditions, I can say without a doubt that these symptoms are not fan favourites! Feeling unsure on your feet or that you might fall over, or experiencing the nausea that can often accompany these symptoms, is alarming, upsetting, and demoralizing. If you can’t trust your body to keep itself upright it can be hard to relax. Often people with vestibular conditions cannot manage day-to-day tasks. Work, household chores, playing with or taking care of the kids, and more can all become difficult. Even getting up out of bed can be an unpleasant adventure! At the very least, feeling gross or worried can sap the joy out of a lot of normally fun or rewarding activities. It should be no wonder, then, that vestibular conditions are highly co-occurring with depression and anxiety.

 

Vestibular Conditions, Depression, and Anxiety

 

For people who are already experiencing anxiety or depression, adding a vestibular condition can make it a lot worse. If you are already having trouble getting out of bed because of depression, having the spins when you do certainly won’t help! Those who have struggled with anxiety and depression in the past can often see a return of their mental health difficulties along with the vestibular condition. It is certainly understandable that for someone who has gone through depression or an anxiety disorder, feeling helpless, overwhelmed or fearful because of their vestibular condition can trigger fears that they are sliding back into those mental health conditions.

Equally problematic is that anxiety and fearfulness can often make the experience of dizziness worse. People often feel sensations similar to dizziness when anxious, such as light-headedness. This can be misattributed to the vestibular condition, as these sensations don’t come with a clear memo as to what is causing them. (“I’m dizzy because of the concussion!”, as opposed to lightheaded because of the understandable anxiety.

Anxiety and depression can also hinder us in engaging in the activities that are useful in rehabilitating from a vestibular condition. They can lead to “catastrophic” all-or-nothing thinking. For example, “I’ll never get better!”, “I can’t do anything!”, “If I try going for that walk I’ll fall and break my neck!” and so forth. Furthermore, clients often struggle with having an “invisible injury”. They often can’t point to an obvious injury, like a leg in a cast, and may wonder if others doubt the severity of their condition, or may even doubt it themselves

 

Pathways Forward

 

Fortunately, there is a way out. Working with a vestibular physiotherapist can help to rebuild confidence in your capacities. They can provide treatments and exercises that can be done safely, without risking re-injury. Their deep knowledge and experience with these conditions can provide tremendous reassurance about what to expect with your condition, and what you can do safely.

In addition to this, working with a counsellor in conjunction with a vestibular physiotherapist (and other members of your health care team, like your family doctor), can really help you to adapt to the symptoms, provide coping skills to be more effective with them, as well as rebuild your hope in the future and faith in yourself. Working with both a counsellor and a vestibular physiotherapist is a “one-two punch” that I have seen be helpful for countless clients with vestibular conditions, providing the support and encouragement needed to help them get their lives back.

If you are interested in learning more about how counselling can help with your vestibular condition, please contact our reception team to request an appointment with me. We’re here to help!

How Can Therapeutic Dance/Movement Help Me?

How Can Therapeutic Dance/Movement Help Me?

Many people feel apprehensive or intimidated when they hear the word “dance.” Movement is a beautiful and intricate part of who we are. We are in constant motion, from blood flowing through our veins to neurons firing during thought processes and through the simplicity of breath. Our very existence depends on the continuous movement happening within the body.

Therapeutic dance, or movement, is a mind-body approach for working with emotions towards holistic wellness. We often dismiss the subtle signs of stress from our bodies until it becomes a chronic issue, preventing us from functioning in our daily lives. Therapeutic dance and movement explores the presence of emotions within the body and shows us how to care for the emotional symptoms that we may find.

What do you mean by emotions living in the body?

Have you ever noticed sayings like, “I have butterflies in my stomach,” “That gave me the heebie-jeebies,” or “My blood is boiling”? These sayings are examples of how we experience nervousness, fear, and anger in the body. Some people describe these feelings in their body as “gut feelings.” We often override gut feelings using the mind and ignore what is happening in the body. Learning to trust in the body’s wisdom is an important skill to possess in today’s fast-paced world.

In therapeutic dance and movement, the connection between the mind and the body is facilitated as a conversation used to achieve a deeper understanding of the self. Emotions in the body are made aware by paying attention to the subtle shifts in the body and linked back to spoken language.

What does an appointment look like?

Clients are often surprised that a session does not have to involve dance whatsoever. Sessions are NOT like a dance class, experience in movement is not even required. Therapeutic dance/movement is an approach that gives your body the space to express what words cannot. Do you ever move your hands when you talk? That’s a form of therapeutic movement! A session can consist of talking to someone, along with the optional invitation of moving, breath-work, or spontaneous dance. It’s entirely up to you! Another way to interpret therapeutic dance/movement is as a counselling session. Your whole body is invited into the conversation, and expression is created from the inside to the outside.

There have been times clients have said, “I’m not sure why I just did that.” The body knows what the mind may not understand quite yet. Therapeutic dance/movement helps to bring understanding and self-compassion to patterns of being. Session goals are co-created between client and practitioner. With this, a therapeutic movement session becomes a journey of creative expression and experiential processing.

What can therapeutic dance/movement help with?

Therapeutic dance/movement can help with anything, such as stress, pain, difficulty sleeping, relationship issues, chronic illness, temper tantrums, developmental disabilities, and neurodiverse diagnoses.

 Some other issues therapeutic dance/movement can support:

  • Feeling stuck
  • Feeling agitated or angry
  • Anxiety
  • Depression / low mood
  • Trauma
  • Autism Spectrum Disorder
  • Attention Deficit Hyperactivity Disorder
  • Tantrums and intense emotional upsets
  • Strengthening relationships

How Can I Start Moving?

Whether you want to start moving by speaking, storytelling, writing, drawing, or dancing, get your emotions moving today by calling our office to book a therapeutic dance/movement session. Have a quick question about therapeutic dance/movement? Click here to email our therapeutic dance/movement practitioner, Stefanie.

How Can I Prevent Depression During COVID-19?

How Can I Prevent Depression During COVID-19?

The COVID-19 pandemic has had many of us in social isolation and practicing social distancing when in public for weeks now. For a fortunate few, this has been a welcome reprieve from an otherwise hectically paced life. For the majority, it has meant being cut off from friends, family, community, and routine supports such as gyms, recreation centres, and social gatherings. We have become a people who are afraid to even greet one another in person. It’s because of these shifts that some of us, particularly those who have struggled with depression before, may be asking the question, “How can I prevent depression during COVID-19?”

 

How Can I Tell If I’m Depressed During COVID-19?

Anxiety about the risks of catching the Coronavirus are at an all-time high as are concerns about the future of jobs, financial security, and the availability of needed supplies, the education of children, and so on.

When ongoing anxiety is combined with a lack of social and community support, the result can be despair and even full-on depression. Depression is defined by features such as:

  • A feeling of purposelessness or hopelessness about life
  • Feelings of intense sadness often combined with heightened irritability
  • Failing to attend to one’s personal hygiene
  • A loss of interest in activities previously enjoyed
  • Changes in appetite
  • Failure to adhere to previous routines
  • Sleep disturbances
  • Loss of motivation

 

Some of the features indicated above are currently forced upon us by the pandemic. For example, simple aspects of hygiene such as going for a haircut are not currently available. And, even if we can find the motivation, many of the activities we would do are structured and rely on facilities such as a gym or a recreation centre which are currently closed.

 

The Effects of Social Distancing on Depression

Perhaps most alarming out of all of the effects of the pandemic is the imperative that we practice social distancing (or maybe more aptly, physical distancing). While this is entirely necessary at the present time, it can serve to greatly contribute to the development of depression. It is primal in human beings to gather with a friend, a family member, or community supports when experiencing stress. As it happens, we are incurably pack animals – maybe like orcas or wolves. Rare is the person who wants to be alone for extended periods of time while anxious. Rather, we naturally gravitate toward one another and, furthermore, we need social connection to remain emotionally and psychologically healthy. The need for social distancing has forced us to behave in a manner that is counterintuitive to our being healthy in the world.

 

Ways to Prevent Depression During COVID-19

What all of this means is that we will need to be very deliberate and stubborn in our efforts to fend off depression. I have a few suggestions for us all to consider, as I try to answer the question, “How can I prevent depression during COVID-19?” Here they are:

  • Contacting with friends or supports by phone or video. Don’t be shy about admitting that you’re in a funk and just need to talk.
  • Go for walks outside alone or with others (6 feet apart of course…)
  • Do a bit of what you enjoy – whether it’s a hobby, listening to your favourite music, etc
  • Pay close attention to your nutrition and don’t let it slide into bad habits
  • Exercise – whether it’s a run outside, a workout following a TV or YouTube instructor, throwing the ball for your dog, riding a bicycle, etc. 20 minutes of exercise daily is ideal to fight depression
  • Reach out for professional support if needed. Yes, we’re open for business and can safely meet with you if you feel that a counsellor is needed to support you for a time.
  • Stick to as much routine as possible. Get up at a decent hour, get showered and dressed even if you aren’t going out. And then do that 20 minutes of exercise mentioned above

 

We don’t currently know how long the pandemic will last and that uncertainty can be very upsetting. Preventing the anxiety and the upset from becoming depressed in life is one of the few factors that we can actually control with some decided effort.

If you’re resonating with anything I’ve written, know that I’m rooting for you. We’ve all been there, and we’re all in this together. If you’re asking yourself how you can prevent depression during COVID-19, I’d love to help you out. Give us a shout at the office, and set up an appointment. Don’t go through this alone, we all need some help sometimes and I’d love to be there for you through this.

What Is Seasonal Affective Disorder?

What Is Seasonal Affective Disorder?

“I love that it gets dark at 3 pm, that it’s pouring rain constantly, and that I haven’t seen the sun in 4 months!” said no one ever. Although some people may prefer the cold winter weather, there are a lot of us who are counting down the hours until patio season starts up again (okay, maybe that’s just me). So, until then, we are binge-watching TV, sleeping in, indulging in comfort foods, and pretty much avoiding the outdoors unless we absolutely have to go outside. The different seasons and the weather impact what we do and how we feel, which is why many of us prefer indoor activities during this time of year and for the next few months to come. However, on a rare day that the sunlight does shine through or when summer finally rolls around, we are quick to get outside and enjoy the sun. We may notice that our mood improves when the sun comes out and it can be a bit easier to get things done. Other times, we notice that when it’s dark and rainy, it’s a little harder to get out of bed, be alert, or even feel happy.

If you’re relating to this post right now, you’re not alone! Approximately, 17% of Canadians are also feeling pretty low during the winter months (CMHA, 2013). You can thank Seasonal Affective Disorder (SAD) for these mood changes, which is a form of depression that occurs at certain times of the year, specifically between September/October and April/May. It affects anyone and everyone but is more common amongst women, individuals between 15-55, people who live further up north or farther down south away from the equator, or individuals with a family history of SAD or other types of depression (HealthLinkBC, 2017).

 

How Do I Know If Seasonal Affective Disorder is affecting me?

 
You may be experiencing Seasonal Affective Disorder if you identify with these statements:

  • I feel sad, moody, or anxious
  • I feel tired or slowed down all the time
  • I’ve lost of interest in work, friends, or interests
  • I’m gaining weight
  • I’m craving carbohydrates such as “comfort foods” like bread or pasta
  • I’m having trouble concentrating
  • I’ve been experiencing changes in my sleep, such as sleeping too much or not enough

(CMHA, 2013; HealthLinkBC, 2017)

 

Why Do We Struggle With SAD?

 
But why is SAD even an issue to begin with? It is thought that the lack of sunlight creates a change in the chemicals in our brain, specifically serotonin, which is responsible for regulating our mood. Additionally, because it is darker, it can signal to our brain that it’s time to sleep which can cause an increase of melatonin in our brain, which is responsible for regulating our sleep/wake rhythm. The truth is that we’re not completely sure why it happens, just that it does, and to many people in our community.

 

What Can I Do About SAD?

 
It’s great to identify if we have SAD. One of the main ways to help yourself if you’re struggling with SAD is to increase your exposure to the right wavelength of light. This can include:

  • Spending more time outside during daylight hours
  • Opening the curtains or blinds during the day
  • Rearranging the space that you are in to allow more sunlight to enter
  • Arranging office/household furniture so you can sit close to a window
  • Adding lamps into your space
  • Using a SAD Lamp

(CMHA, 2013)

Counselling can help with the symptoms of Seasonal Affective Disorder by giving us a better understanding of how SAD affects us as individuals and helping us to cope with the effects that come about during this time of year. It can also be useful in helping us to look at our thoughts, feelings, and behaviours and how they influence our mood and can aid us in creating strategies for making changes in these areas. In addition to this, being able to talk to someone who is able to empathize and listen to us can be very beneficial.

If you’re struggling with Seasonal Affective Disorder, you’re not alone and you don’t have to go it alone. Seeing a Registered Clinical Counsellor or one of us counselling interns can be a great help!

If you’re not sure if what you’re struggling with is Seasonal Affective Disorder (SAD), please go to your family doctor who can help you determine if this is what you’re dealing with, and can refer you to a specialist if needed.

In the meantime, we’re here and we’d love to support you until the sun comes back! Feel free to contact us!

 

References:


Find Help Now. (2013). Retrieved from https://cmha.bc.ca/documents/seasonal-affective-disorder-2

Seasonal Affective Disorder (SAD). (2017, May). Retrieved from https://www.healthlinkbc.ca/health-topics/hw169553

How Can I Support Someone Who Is Grieving?

How Can I Support Someone Who Is Grieving?

It can be difficult to know what to say or do when someone has experienced a loss. It is a delicate subject to approach since we do not want to say the wrong thing or come off as intruding or prying towards someone who is grieving. We don’t want to add to anyone’s pain, so sometimes we go back and forth between being present and supportive, to taking a step back and giving a person their space to cope. Both of these can be beneficial for the other person, but our uncertainty about how to respond can make us feel unhelpful or that we are adding to their pain. When it comes to offering support, however, being present and available to help or spending time with them can be healing.

What else can we do to be supportive during this difficult time? Here are a few practical ideas of how to help a friend or family member who is grieving:

 

  1. Know what “normal” grief is and how to respond check out my last article for a primer
    • Know that there is no one right way to grieve, every response and emotion is valid; people who are grieving may feel relief, guilt, anger, emptiness, sadness, etc. These emotions may be intense or extreme or they may be more mild. Be prepared for any reaction, and know that the reaction isn’t about you, it’s a response to pain.
    • There is no timeline or linear process to grief; each grief process is unique. People will cope in whatever way feels right for them and will take as long as they need.

 

  1. Expressing support
    • Be empathetic by acknowledging the bereaved individual’s feelings (e.g. I can’t imagine how difficult this must be for you). Showing acceptance and support of their emotions, whether it’s anger, sadness, or otherwise, can provide a safe space for the person to experience their emotions openly.
    • Give them space to tell their story. The person may want to discuss the details of their loss repeatedly or in detail as a way to come to terms with what has happened.
    • Reach out to the person who is grieving whether it be through a phone call or an in-person visit. Remember them as time goes on and check in. Many times, people respond immediately and then support fades quickly.
    • Avoid saying things like: “Everything happens for a reason”, “They’re in a better place”, “At least…”, “It’s time to move on”, “I know how you feel”, “You can always have another child/get another job/get remarried”, “Time heals all wounds.” Avoid finding a silver lining to the loss or trying to fix what’s happened.
    • Instead, say things like: “I’m here for you.”, “I don’t know what to say, but I care.”, “I’ll call you/visit in a few days.”, “What can I do?”, “I can’t imagine what you must be going through.”
    • Saying nothing and just listen. It’s okay to listen or just be present with the other person. Sometimes there’s nothing at all that we can And certainly, whatever we say is unlikely to make the situation better.

 

  1. Providing practical support can be very helpful, such as offering to:
    • Help with arrangements related to the loss, such as funeral arrangements, packing, finding a new place to live, etc.
    • Complete household chores or run errands
    • Cook or drop off meals in non-reusable containers so they don’t have to worry about washing your dishes and getting them back to you
    • Watch their children or pets if needed, giving them time for themselves
    • Help with insurance or other paperwork
    • Answer or make phones calls or for them
    • Take them out for a meal or a movie

 

  1. Watch for signs of depressed feelings or complicated grief
    • We’ll take as long as we need to cope with our loss, but we do need to eventually come to terms with what has happened. Over time, we’ll adjust to a new normal and be able to move forward. However, sometimes we don’t move on and get stuck, which is called complicated grief which involves:
      • Being unable to move on from the loss
      • Being unable to carry out daily routines
      • Isolating ourselves
      • Having feelings of intense loneliness, numbness, or sorrow
      • Wishing to be dead with the loved one who has passed

 

Depression can also occur and is often a part of complicated grief. The challenge with depression and complicated grief is they can be hard to tease apart, and often co-exist. Both can come in waves, or be constant companions.

If you’re noticing a complexity in the grief of a loved one, or signs of depression, then it’s best to encourage your loved one to seek out mental health support such as counselling. This can provide a space for emotions and thoughts related to the loss to be processed and allow for healing to occur. It can also provide an invaluable resource for depression and trauma screening by experienced professionals who can direct care most appropriately.

A loss isn’t something that can be fixed or repaired; it is something that has to be lived with. The pain cannot be taken away, so instead, we can help others by sitting with them in their pain. It is okay not to know what to say or how to help; if we can show up, listen, and be present, then that’s enough, and is valuable!

 

 

 

References

Complications of Grief. (2017). Retrieved from https://www.healthlinkbc.ca/health-topics/aa129291

Grief and Loss Resources. (2017). Retrieved from https://livingthroughloss.ca/

Helping Someone Who’s Grieving. (2018). Retrieved from https://www.helpguide.org/articles/grief/helping-someone-who-is-grieving.htm

How Does Neurofeedback Training Work?

How Does Neurofeedback Training Work?

Neurofeedback is one of the most amazing technologies at our disposal for so many reasons. It’s an invaluable tool for overall resilience, cognitive flexibility, mental health management, sleep enhancement, and so much more. One of the most common questions I get, however, is how on earth does it work? I’m going to do my best to explain it here for you!

 

Dynamic Neurofeedback Training

 

The type of neurofeedback training that we use here at Alongside You is called dynamic neurofeedback. What this means is that our neurofeedback system constantly monitors the brain using electroencephalography (EEG) and provides feedback to train your brain. To put this into perspective, our system monitors the brain 256 times per second. That’s a lot of feedback!

The feedback happens through video and audio sources. During neurofeedback training, you’ll be watching a computer screen that displays a variety of moving images and listening to an audio soundtrack. The neurofeedback system monitors your brain activity through EEG, and when it senses that your brain activity on the various wavelengths is outside of the optimal range for your brain, it interrupts the video and audio signals briefly. Because this interruption is tied to your specific brain activity, your brain knows to connect the dots. This allows your brain to know what it is doing at that point in time, and adjust accordingly.

 

I Still Don’t Get How It Works Andrew!

 

Let me explain a little bit more then! One of our misconceptions is that because our brain is constantly working, it must know what it’s doing at all times. This is unfortunately not the case. It’s like when I grew around 6 inches in one year, I kept walking into door frames because I didn’t realize where my shoulders were in 3-D space! What our brain is able to do, however, is adjust itself for optimal health if it has the information it needs. Neurofeedback training is what helps provide the necessary information for the brain to change itself.

Imagine you’re driving. Anyone who has driven for any length of time knows that the mind wanders sometimes. Every once in a while, we’ll wander too far to the right and our right tires will go over the shoulder, and we’ll feel a rub strip or gravel under the tires, and hear a noise that signals to us that we are over the shoulder. What happens next is automatic – we naturally move over to the left a little bit. We generally don’t even need to think about it, we just do it. This is analogous to what happens with our brain during neurofeedback training. The interruptions in the audio and video signal to the brain where it is on the wavelengths. The brain uses this information and adjusts itself accordingly. Over time, this training helps the brain stay within the optimal range on the various wavelengths on an ongoing basis.

 

How Long Does Neurofeedback Training Take?

 

This is the million-dollar question! It’s also an understandable one. We all want to know how long something is going to take. It’s really no different than wanting to know how long counselling is going to take. Unfortunately, the answer may not be any more gratifying than the answer to how long counselling is going to take: it depends.

Here’s the truth – it depends because every brain is different. It’s also challenging to predict because dynamic neurofeedback training is not a specific treatment for a specific symptom, it is a whole-brain training aimed at helping the entire brain function better. Because of this, we can’t claim that neurofeedback will cure your anxiety, depression, or otherwise. What we can say, however, is that by helping your brain to function better, symptoms that exist because your brain is not functioning at its best are likely to improve. What I can say, is that this has definitely been my experience in working with clients with neurofeedback. Symptoms of concern do improve, our ability to manage any remaining symptoms gets better, and we become more flexible and resilient, but it takes time.

It may be helpful to think of neurofeedback training as gym training for your brain. When we go to the gym, we don’t see much improvement after one workout. We see improvement over a series of workouts, and over a consistent effort to train. How fast each of us builds muscle, and get in shape depends on a whole lot of variables, so in the same way, we can’t predict how long it’s going to take for you to build the muscles you want and get in the shape you’re looking for. What we do know, however, is that if you train consistently over time, you’ll build muscle, and you’ll get in better shape.

 

How Do You Know It Works?

 

This is a great question. Monitoring brain changes can be challenging, but here’s how we do it. Before you start, we use a variety of tracking tools to track the symptoms you have concerns about, and over the course of the sessions, we repeat these tracking tools to look at improvements. In addition, we check in with you each session to see how things are going and what you’re noticing. The true indication of whether it’s helping is the answer to a very simple question: “How do you feel now versus how you felt before we started?” Sometimes it’s hard to notice the shifts, and this is where we can also help you monitor by asking the right questions to pick up on shifts.

I have noticed significant positive results in my clients who have done neurofeedback training. In fact, it’s uncanny how positive it has been. I hope this article has helped explain a bit more about neurofeedback, how it works, and how it might be helpful. If you have any more questions, give us a call and we’d be happy to answer them!

+