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Navigating the transition from full house to empty nest
One of the main ironies of parenting is that your job is to make yourself irrelevant. Babies are born, children are nurtured and grow up, and then one day — eventually — most are independent enough to move out of the family home.
At least that was a typical trajectory in Canada. These days, the transition isn’t always so linear. Economic challenges such as the high cost of housing and precarious employment, as well as socio-demographic shifts like the need for more post-secondary education, mean so-called “boomerang” kids leave and then return, sometimes repeatedly.
For the parents who are left behind, whether temporarily or forever, this passage into the next phase of life can be difficult to navigate. Yet, as a parent, it also represents an opportunity to renew relationships with yourself, your partner, your friends, and your family, including the child or children who are making the leap into their adult lives.
My wife and I are on the cusp of this change: Our twin daughters will be starting university this fall. To help prepare for this double departure, Lisa and I are spending a lot of time talking to friends, neighbours, and colleagues whose children have already left or are about to leave home.
One friend told us that her kids moving out changed her life more profoundly than when they were born. Another, whose father-in-law moved in after his daughters went to university, talked about the sense of flux in his household, with caring for aging parents also affecting the configuration of his nest. My own mother cautioned me that our house might feel like a train station for a while: you won’t know who’s coming or going, or how long they’ll stay.
Next station
Although the range of reactions and circumstances varies greatly, as a whole what people told us reflects research findings and advice from mental health professionals. For Simon Fraser University gerontology and sociology professor Barbara Mitchell, the “stereotype of the empty nest syndrome has largely been debunked as a cultural myth.” She takes a matter-of-fact view of this and other major changes in life. That is, to approach the empty nest phase as one of many junctions in a fluid existence while staying mindful and ready for whatever might follow.
Mountain biking in Charlevoix, Quebec: The author with Daisy, Lisa Gregoire, and Maggie. Transitioning from full house to empty nest is an opportunity to renew relationships with yourself, your partner, your friends, and your family, including the children who are making the leap into their adult lives
“Most parents actually find it to be a positive experience,” Mitchell says. “They’ve done their job and are now free from day-to-day responsibilities. They’ve established roots for their children — and wings — so they can become autonomous adults.”
Despite that general trend, if rooted in a traditional mom-as-homemaker role, some women feel a strong sense of loss when the kids leave, as of course do some men. While this sadness and disorientation (commonly called “empty nest syndrome”) are often short-term, she points out that about 20 per cent of parents struggle with it, and in extreme cases it can require intervention.
Mitchell, who has been researching family transitions since she was a graduate student in the mid-1980s and is perhaps the only academic in Canada with this expertise, notes that the empty nest is a relatively recent phenomenon in North America. Historically, at least one child regularly stayed with aging parents, especially in rural areas. But as our population became more urban, as life expectancies rose, and as the affluent middle class boomed after the Second World War, mothers and fathers increasingly found themselves alone in their later years.
Of course, parents from what she describes as “collectivist cultural groups” often have entirely different experiences, such as remaining within a multi-generational household or viewing the departure of a child for education or marriage as a sign of success. “The context of the family environment is important,” says Mitchell. “There are many potential complexities.”
Among these complexities are compounding stressors like health issues or retirement, which can exacerbate negative emotions.
Mental health and wellness in Canada is in fact influenced by numerous factors, including life experience, workplace, and family environments, and social and economic conditions that fundamentally impact our well-being.
Edmonton psychologist Loriann Quinlan, who specializes in treating adults with anxiety and has helped clients with empty nest syndrome and other life transitions, knows that every individual and family experiences this change differently. And since it can be accompanied by a range of emotions, from sadness and grief to excitement and joy, she advises clients to approach the process without judgment, to sit with any discomfort, and to engage in self-care.
Taking the time to become better acquainted with yourself, your partner, and others in your circle can be healthy, she says, because as parents we invest a tremendous amount of time and energy into relationships with our children. No wonder we’re knocked adrift and feel empty when such a critical part of our identity — for so many years — is no longer clearly defined.
As parents, we invest a tremendous amount of time and energy into relationships with our children. No wonder we’re knocked adrift and feel empty when such a critical part of our identity — for so many years — is no longer clearly defined. —
Making the shift
This transition also offers a chance to appreciate the perspectives of the young adults who are leaving and taking steps toward independence.
“It’s an amazing opportunity for parents and kids to see each other through a new lens,” Quinlan says, “and to shift the dynamic and hopefully connect on a deeper level.”
To get there, she recommends keeping the lines of communication open. Talking about thoughts and fears helps us understand where other people are coming from. Not shying away from conversations about well-being also helps us know when it’s time to reach out for support. That could simply be a chat with a friend or connecting with a more formal mental health resource.
While the internet is making that access a little easier, rapidly advancing communication technologies and other recent phenomena, such as the pandemic and the tight housing market, are also influencing how parents deal with the departure of their children, notes Mitchell, who wants to do more research on the impact of these “overlapping factors.”
On one hand, young adults are stepping into an increasingly uncertain world; on the other, you can make a video call with them no matter where they are. At least in theory.
My friend Eleanor Fast, who will be seeing her younger son off to university when my girls leave next fall, confesses to “stalking” her older son online while he’s been away at college in the U.S. for the past two years. He doesn’t always respond to her texts, and it can be difficult to schedule video calls, so she checks his Instagram feed — “for proof of life” — and looks to see if he’s posted any recent running routes on the exercise app Strava.
“The world may be more difficult than it was when I was 18 and left home,” says Fast, “but kids still need to get out there. They’ve been isolated for the past couple years because of the pandemic and have missed a lot of living.”
COVID was Fast’s biggest concern when her son left home — she was worried he would be lonely doing online classes while confined to a dorm room — but turns out he was fine. And although she and her husband truly enjoyed having a full house, they found it really nice when there was just one kid to focus on. They’re already planning activities they can do as a couple, such as taking long-distance bicycle trips together.
“I love my kids and love being with them,” says Fast, “but I want them to have their own lives, and making plans for the future helps counteract the sadness of them leaving.”
That sums up the mindset Lisa and I have as we reflect on the past and prepare for our next chapter. One of our daughters will be moving several provinces away in a couple months, and even though the other will be going to university in the city where we live, and recently decided to stay at home instead of residence in first year, we’re conscious of the fact that this is simply a new rhythm to experience.
Our children are no longer children. They — and we — are both excited and nervous about the journey ahead. And like many times over the past 18 years, we can learn a lot from them.
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Addressing a void in mental health care systems
Fabiola Phillipe
Fabiola Phillipe — mother, sister, and friend — was kind, compassionate, generous, and humble. She also lived with mental health challenges that stemmed from experiences of loneliness and isolation during her youth. As she struggled with depression, she began using substances — as a comfort and a substitute for the support and understanding she needed.
Before her death in 2017, Fabiola’s struggle with addiction had lasted nearly two decades. While these years included periods of both contentedness and hopelessness, help always seemed beyond her reach.
As she sought out different institutions over several years, she either had difficulty accessing services or was turned away because her needs were considered beyond the scope of care. In response to such experiences, Fabiola began staunchly refusing treatment — despite the urging of family members — who felt unequipped and powerless to support her while trying themselves to navigate confusing health-care systems.
Based on the gaps they saw in the system, Fabiola’s sister, Marie Philippe-Remy, and daughter, Lydia Philippe, launched Fabiola’s Addiction and Mental Health Awareness and Support Foundation (FAMHAS) in 2018 to promote awareness and advocate for change in mental health care for African, Caribbean, and Black (ACB) communities.
Missing pieces
Fabiola’s sister, Marie Philippe-Remy
According to a Columbia University psychiatry department article, the adult Black community is less likely to seek support even though its members have a 20 per cent greater chance of living with serious mental health problems. Black emerging adults (ages 18-25) were also described as experiencing “higher rates of mental health problems and lower rates of mental health service use compared to White emerging adults and older Black adults.” While there are many reasons for such lower access rates in ACB communities, a 2020 Ottawa Public Health study emphasized three common themes: cost, wait times, and difficulty finding culturally competent providers with a shared identity and experience. By making care more difficult, these barriers exacerbate their mental health challenges.
As she provided support to Fabiola, Marie began learning more and more about mental health care systems. Yet, as her main champion, she often felt depleted when she could not find the care her sister needed. She was also regularly frustrated by her own inability to understand how Fabiola felt trapped by her depression and substance use. “How can you not want to get better?” she recalled asking herself at one point. Although caregivers who experience mental health challenges when supporting a loved one in crisis frequently express such sentiments, Marie’s question would help define FAMHAS’s focus: to address access barriers and stigma while offering complex, nuanced, community-focused care for ACB people experiencing mental health challenges.
Access and understanding
Fabiola Phillipe
Once FAMHAS was launched, it didn’t take long for Marie and Lydia to realize that ACB communities had little formal knowledge on mental health. Even after a dedicated search, there was no way to ignore this glaring gap. Where, they wondered, was the research, information, and organizations geared to mental health in these communities? With no answer in sight, they decided to use their own lived and living experience and reach out to their network.
“The best way to learn and reach the community was by actually talking to people,” Marie said. She explained that connecting with people who had been through similar situations was key to connecting, spreading awareness, and promoting understanding. Mental health has many faces and stories, but if you don’t see those people and hear their stories, how do you move past something like stigma?
The urgency of the foundation’s work became increasingly clear after key themes emerged from just a few conversations. For example, Marie and Lydia found that people wanted to break through what they saw as taboo. Simply having an open conversation about mental health and acknowledging it as a priority provided space for people in ACB communities to speak more freely. Without having to explain or defend themselves, meaningful conversations soon followed — and that had a domino effect. When FAMHAS presented its first Black Men Experience workshop, there were just two participants. But as word spread, it grew to 15, then 20. The Real Talk: Black Youth workshop saw a similar pattern.
“So many people are suffering in silence, and simply knowing that there’s help out there can change somebody’s life,” Marie said, noting that support is needed for those experiencing mental health challenges and other issues. She therefore advocates through FAMHAS for support systems that spread across networks and communities in a culturally relevant way, while acknowledging the complexity and diversity within ACB communities, which comprise numerous religions, cultures, languages, and ethnicities beyond a single “Black umbrella.”
That said, more work is needed to treat people in these communities with mental health concerns. Recent research from the Mental Health Commission of Canada (MHCC) found that trust is improved when the help seeker believes a health professional can relate to their experience. From the deep-rooted impacts of anti-Black racism to intergenerational trauma and cultural biases, sharing common ground facilitates connection building between patients and care providers. Unfortunately, few ACB psychotherapists are available in Canada today.
Because representation, cultural competency, and questions of affordability loom large — as do long wait lists — Marie sees that endorsing mental health work as a viable career path for ACB individuals is an important step in meeting this challenge. In the meantime, other steps being taken can be seen in the MHCC’s Case for Diversity project, a compilation of practices that are working in communities across the country.
So far, FAMHAS itself has also been able to offer 1,629 hours of free counselling — across seven provinces and territories in nine languages — to 701 applicants through a network of mental health professionals who have dedicated their personal time to the success of its mission. About 20 ACB professionals were able to see more than 400 applicants in three months, with a maximum wait time of just two weeks.
Marie is intent on building the foundation’s directory so more people can access such services. While free counselling is on hold until FAMHAS reignites its fundraising events, a gala is in the works for May 2023 that will help them generate funds while bringing communities and organizations together to celebrate ACB art and contributions to mental health awareness.
She is keen to continually cultivate community — the identity, belonging, and connection that lead us to a sense of safety, security, and happiness — in other words, the things that make us all feel supported and less alone.
Aishah Khan
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Talking to retail, front-line, and essential workers about their pandemic experiences
For employees, the past two-plus years have been a whirlwind. After COVID-19 threw the world into disarray, people were forced to grapple in the dark and adjust to new work environments.
While the months passed, we went from lazy days on the couch and socially distant driveway beers with neighbours to becoming lethargic, lonely, and frustrated as the lockdown cycles began taking their toll. Wave after wave kept crashing, but we slogged through while feeling imprisoned in our homes day after day.
Megan Di Lucca
Well, at least some of us did.
This experience of COVID-19 is not universal. Lounging on the couch and lingering on the driveway is an option if you have shelter. But the reality is that many people don’t have the free time or space to enjoy these luxuries. Complaints about Zoom fatigue can sound trivial if you’re on the front lines doing essential work and have never had the option of working from home.
Yet that’s the case for the vast majority of Canada’s employees who sustain our society, whether they work in retail, manufacturing, and construction or as medical personnel, social workers, and delivery drivers.
Among them is Megan Di Lucca, a cashier at Save-On-Foods in Victoria. Looking back to those first frantic days of 2020, she recalled the unusual behaviour from some customers; in particular, how they relieved their stress by snapping at one another or at staff members.
“With everyone buying as much toilet paper, canned goods, and random products (like yeast) as they could, all I could do was to ring in their unusual choices with a smile and do my best to help ease their stress by listening. While hearing what customers had to say helped them, it also helped me realize that it was important not to let others’ personal matters affect me.”
Yet Di Lucca was experienced enough to be able to find her way through such challenging situations. For those who are new to the workforce, that isn’t always the case. As Ottawa theatre-chain manager Shane Bennett pointed out, “many people in front-line and retail roles are young and inexperienced or are trying to balance personal issues while working in fast-paced environments.” Beyond those challenges, most of these roles are paid less on average than other jobs and are classified as contract or “gig positions” that offer few if any benefits or leave provisions. Because such employees can’t work from home if they’re ill or fear being exposed to the virus, their choice is as harsh as it is simple: go to work or sacrifice a day’s wages.
Shane Bennett
Compounding factors
In speaking with friends and colleagues who work in essential roles, it’s clear that they’re trying to come to terms with the shifts their lives have taken during the pandemic. Many are contending with personal issues, which have been made more difficult by stressors such as the threat of illness, financial strain, job insecurity, and diminishing mental health.
Not only have front-line workers faced layoffs and uncertainty in their jobs, they are also at greater risk of exposure to the virus. Many go home to immunocompromised family members after having to work a shift with inadequate personal protective equipment.
While managing their own stress, these workers have also been forced to deal with the stress of countless others each day. This may not be a new phenomenon for those who work with the public, but the situation has certainly gotten worse during the pandemic. In addition, they’ve been made responsible for enforcing ever-changing public health mandates — safety measures that are new to everyone, including themselves. When employers expect them to monitor actions to keep patrons and themselves safe, front-line workers take the brunt of the frustration from the customers who refuse to comply. With so many other stressors in their lives, that’s an enormous responsibility — one that has increased the abuse, harassment, threats and violence they face. According to Bennett, his theatres have been forced to call police on multiple occasions to help them deal with such incidents.
Because employees can’t work from home if they’re ill or fear being exposed to the virus, their choice is as harsh as it is simple: go to work or sacrifice a day’s wages. —
Pathways to support
Front-line workers do jobs that are typically undervalued and require a lot of physical and emotional energy. One example is “Sabrina,” a veterinary technician at an animal hospital in Eastern Canada who worked in emergency and critical care as well as speciality surgery. The hospital was the only 24-hour location in her region. It also accepted cases from remote locations (including Nunavut and Newfoundland and Labrador), making it essential to locals and clients across this wider area.
At the beginning of the pandemic, Sabrina’s workplace provided room for dialogue and supported employees who had to care for their children, were themselves unwell, or experienced reservations about bringing the virus home to immunocompromised family members. But after a few months this open approach seemed to change. Still, she worked her regular shifts and often stayed longer to assure the job was done correctly, putting in 10-12 hours on her feet while backfilling for others who had left the clinic. As demand continued to surge, Sabrina put in many extra weekends. Yet eventually, she became burned out and — with a sense of disillusionment — decided to leave.
“Sabrina”
As with many care workers in this situation, her decision was a difficult one. Contending with a sense of guilt about what would happen to the clinic’s quality of care if she left didn’t allow much time to tend to her own health. When she did start down the path of addressing these concerns, she pushed them from her mind when she thought about the tedium of it all. “You have to do a lot of legwork to get the help you need, and so you can feel less inclined. When you’re physically and mentally exhausted, the last thing you want to do is go figure out how to help yourself,” she explained.
Sometimes that sense of bureaucracy does become a barrier. That’s especially so for front-line workers in short-term or contract positions, who must endure long wait times and probationary periods to access care. Having to change roles and negotiate new contracts can also feel like too many hoops to jump through, especially when people are also dealing with financial and other stressors.
At the same time, such experiences are opening conversations around the workplace shifts that are needed to support front-line and essential workers — beyond platitudes. For example, employers are helping their staff implement empathetic listening in their interactions. Or, like Bennett’s theatres, they are investing in The Working Mind, evidence-based training from the Mental Health Commission of Canada that helps participants overcome stigma around mental illness. “The Working Mind is all about giving managers the tools to see changes in their staff and identify where they are on the mental health continuum,” he said. “It gives us a template to frame difficult conversations and be mindful about the mental health of our teams.” Once managers have the skills and tools they need, his company intends to roll out The Working Mind to all its employees. “I hope that makes it easier to discuss mental health in the workplace,” he added, “and that it allows our workers to feel better supported.”
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They’re called comfort foods for a reason: sugar, salt, and carbs give us a quick boost of flavour and familiarity. Making the case for comforting foods that nourish our mind and body.
“You are what you eat” — We’ve all heard the saying. It’s meant to nudge us toward healthier choices, but it doesn’t reflect all the links between diet and health, including the connections it has with chronic conditions such as diabetes, high blood pressure, obesity, and stroke. It also doesn’t include research over the past 50 years showing how much nutritional choices effect our brain and mental health, which is so striking that we should probably add “Good food for a good mood” to the phrase.
Dr. Bonnie J. Kaplan
Research into the connections between nutrition and mental health began in 1972, when Bonnie Kaplan, then a grad student in experimental psychology, started looking into the physiological and psychological effects of malnutrition during pregnancy and the first few years of life. When she published “Malnutrition and Mental Deficiency” in the Psychological Bulletin that same year, her results struck a chord. She was deluged with requests for reprints of her groundbreaking research, which became the precursor to the field of nutritional psychology. The article’s key takeaway still resonates: “We can’t control our genes, but we can control what we eat so that we can be better nourish our brains and our mental health,” wrote Dr. Kaplan, now a retired research psychologist.
More recently, she co-authored The Better Brain: Overcome Anxiety, Combat Depression, and Reduce ADHD and Stress with Nutrition with Dr. Julia Rucklidge. The book takes a nutrition-first approach to mental health in relation to resilience with a focus on tryptophan — an essential amino acid in the nutrients we can consume — and its connection to serotonin, the “feel-good hormone” that can affect our mood. A short article like this could never fully explain the process of enzymes, co-factors, and chemical reactions involved, but a building-block effect Kaplan describes in her lectures has led her students to the “aha” moment where they can see these connections and are inspired to improve their diet.
The book’s suggestions for healthy eating are by now well known — whole foods (not ultra-processed), fewer carbs, less salt and saturated fats, and a preference for Mediterranean-style cooking — and originate in the “SMILES” trial (2017). In that study, participants with severe depression were randomly placed into two groups, one receiving social support and the other nutrition counselling that recommended a Mediterranean diet of fruits, vegetables, legumes, seafood, olive oil, and seeds. While both groups’ symptoms improved twelve weeks later, people in the Mediterranean diet group saw greater improvement, with 32 per cent of participants’ depressive symptoms going into remission (versus eight per cent for the social support group).
You seem “hangry”
I ask Kaplan: Can you give me a sense of how that happens? Well, she explains, “We cannot eat serotonin in food, right?” Like a rapt student I jot down the key point: “There is no food that contains the feel-good hormone, so we must eat things that enable our bodies to manufacture serotonin and other necessary micronutrients.”
Suddenly, I feel peckish. Chips come to mind — mmmm, all that satisfying salty, carby crunchiness. Except that I also just learned we need at least 30 different micronutrients to properly support our brain’s metabolism, which runs every minute of every day. Such ultra-processed foods can fill our stomach, but they also starve our brain because they’re deficient in vitamins and minerals. It’s the cerebral equivalent of feeling hangry when you’ve waited too long to eat. Kaplan calls this state “hidden brain hunger,” which happens when we consistently lack necessary micronutrients, so the brain lacks what it needs to function optimally and support our mental health. Why is this “hidden”? Because the resulting effects are not always directly felt.
These days, price hikes from inflation make stocking the pantry with such foods a costly challenge for many. Having limited access to fresh foods is also a problem, particularly for those living in food deserts, who must pay even more with the additional time and travel. —
No easy answers
It turns out that our brain is actually the greediest organ in our body: while it accounts for just two per cent of body weight, it absorbs at least 20 percent of all the nutrients we consume, Kaplan says. Feeding that beast means nourishing the brain with micronutrients. Canada’s latest food guide snapshot shows us what this could look like: filling half the plate with a rainbow of fruits and vegetables, and each of the other two quarters with protein and whole grains.
If only it were that simple.
These days, price hikes from inflation make stocking the pantry with such foods a costly challenge for many. According to Food in Canada magazine, grocery prices have spiked more than seven per cent over the past year — the fastest increase in 13 years. Canada’s Food Price Report forecasts that the most significant increases for 2022 will be in the healthy food category, including dairy and vegetables. That means, an average family of four will pay nearly $15,000 for food this year, almost $1,000 more than in 2021. Having limited access to fresh foods is also a problem, particularly for those living in food deserts, who must pay even more with the additional time and travel.
While Kaplan’s findings can tempt us to draw easy parallels between a change in food and mood, depression is a complex state for those who experience it. We should also keep in mind that changes in diet alone are no substitute for seeing our physician or therapist and taking prescribed medications. Still, as the field of nutritional psychology grows, it is helpful to see its recommendations become part of an integrative or alternative treatment for mental health challenges, something that one in five people in Canada live with.
Views and opinions expressed in this article do not necessarily represent the views and opinions of the Mental Health Commission of Canada.
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It’s Pride Month! These celebratory events — signature weeks and months, T-shirt days, and other public acknowledgments — provide visibility and a sense of collectivity. Let’s not let the colours fade when the calendar changes.
We skipped toward the main drag with our extended family for some quality time after months apart because of pandemic isolation orders. It was nice to be off screens and among people as we took in the sights on a Sunday in small-town Ontario. This day had all the check marks: great weather, ice cream stands, antique shops, people picnicking, and traffic that halted for jaywalkers zigzagging from shop to shop. At the strip’s entrance was a rainbow crosswalk, providing a highlight for pedestrians entering the busy thoroughfare, and visibility of another kind. Pride crosswalks are designed to promote inclusion and awareness of 2SLGBTQ+ communities, and they range from six-colour rows to chevroned designs that underscore intersecting identities.
Like a lot of municipal infrastructure, this particular project needed an update after a few years of wear and tear. The chipped paint seemed like a bit of handy symbolism as I reflected on Pride Month and many symbolic days and months that bring people together around an issue and idea — which sometimes fade away when the calendar page flips.
The well-being of people with diverse gender identities can be greatly affected by the characteristics, norms, practices, and spaces of our institutional environments. This is reflected in the things we see and the actions we take. —
On this day
“I’m Black all year,” a friend likes to quip as we head into February and she bemoans the litany of requests for very visible speaking engagements, which arrive in the weeks before Black History Month, while offers for secure and steady paid work in her field never materialize. When you experience the gap between a passing visibility and the very real inability to provide for yourself, acknowledgment months can sometimes feel like window dressing. I suppose that’s part of the risk of putting a lot of energy into special months or T-shirt days. But it might also lead us to ask ourselves what contribution is being made. Is it a surface effort? A small step toward systemic change? I’m not ready to write off these events just yet — though their snapshot effect may obscure the complexity of the lived and living experiences in the communities being recognized.
The tagline for GLADD, the American media advocacy organization, says that it “rewrites the script for LGBTQ acceptance.” Its Pride Month Resource Kit for journalists takes a huge step toward this by highlighting some of the pitfalls and assumptions telegraphed through footage and images in Pride events coverage. “No single image should be put forth as representative of either the LGBT community or the range of events that occur at Prides,” it counsels, noting that “colorful and unconventional participants play an important role at Pride events and celebrations.” GLAAD encourages journalists to “avoid the tendency to ignore the diversity that exists at Pride events,” since relying on “outrageous or over-the-top images and footage marginalizes subjects by taking them out of context to depict them as abnormal — perpetuating misconceptions.”
These suggestions bring to mind the drag parade float images of past coverage and lead me to realize how such things can become visual shorthand for progressive movements that are dynamic and complex. Such movements can also quickly become co-opted from their origins in social change. Recent protests to counter “rainbow-washing” — supporting anti-2SLGBTQ+ interests while claiming public allyship with 2SLGBTQ+ communities — have emerged alongside calls to extend Pride initiatives beyond one month, particularly in remote communities.
Representation matters
The well-being of people with diverse gender identities can be greatly affected by the characteristics, norms, practices, and spaces of our institutional environments. This is reflected in the things we see and the actions we take. For the Catalyst, the Mental Health Commission of Canada’s (MHCC’s) online magazine, this means avoiding oversimplification in our storytelling while emphasizing recovery and optimism. We want to offer hope, but not false hope — and no single, tightly construed narratives. In other words, we believe it’s important to recognize the both-and in any given experience — a perspective illustrated in recent COVID-19 research. New Leger polling for the MHCC and the Canadian Centre on Substance Use and Addiction shows that 2SLGBTQ+ communities have faced heightened rates of stigma, discrimination, and harassment during the pandemic yet were also feeling more resilient, hopeful, accepting, and inclusive.
The poll’s other findings reflect a similar complexity. While about one-quarter of 2SLGBTQ+ respondents reported excellent or very good mental health during the pandemic, rates were significantly lower for 2SLGBTQ+ youth, people from low-income households, and those from East and Southeast Asian, South Asian, and African, Caribbean, and Black (ACB) communities. This same pattern was found in connection with the stresses of COVID-19. Though only half of 2SLGBTQ+ respondents reported being able to cope with pandemic stress, fewer 2SLGBTQ+ youth and ACB respondents could do so.
On an individual level, we also have a chance during Pride Month to reflect on its evolution and what it means for Indigenous communities. As well, we might consider why something so seemingly simple as crosswalks are being subjected to defacing and vandalism, thus reducing the visibility of that quiet sign of support. In context of the pandemic, Pride can be a chance to build networks to support 2SLGBTQ+ youth and racialized communities, who are contending more than most with overlapping crises, by being an ally throughout the year.
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When older adults make the move into care homes, it becomes essential to forge new bonds. Finding ways through loneliness and isolation with music.
Evidence that strong interpersonal connections are essential to our mental and physical health is growing. And these ties may be more important as we age, particularly among older adults living in retirement residences and long-term care homes. According to Dr. Kristine Theurer, who’s been a researcher in the long-term care sector for more than two decades, “We all yearn to connect with others, and for many people, moving into a residence means seeing friends and family less frequently. So it’s crucial for them to make new connections.”
The harmful effects of social isolation and loneliness on mental and physical health are well known. Several studies have found that isolation increases the risk of cardiovascular disease, obesity, anxiety, and depression and that loneliness can lead to depression, alcoholism, and suicidal thoughts.
During the pandemic, public health measures such as masks, physical distancing, and size limits on gatherings have added to social isolation and loneliness. In retirement and long-term care homes, in‑person visits with family members and volunteers were banned for months, and residents only interacted with staff wearing protective masks, face shields, and gowns.
While these conditions pushed isolation to the limit for these residents, growing public concern was at least able to bring more attention to the issue and give Theurer a chance raise awareness about fostering human connections. A 2015 article she was the lead author on in the Journal of Aging Studies article had already documented the value of standardized peer support and peer mentoring. “The Need for a Social Revolution in Residential Care” argued for an overhaul of programming in retirement residences and long-term care by incorporating activities that advanced residents’ social identities, encouraged reciprocal relationships, and increased social interaction. The goal of that vision was to transform the model of resident care into one of resident engagement — a state that covers basic needs but also allows people to thrive and be enriched.
“Many homes focus on light group activities, such as games and crafts, without recognizing that the crucial benefits actually come from meaningful interactions between peers,” Theurer said. “The focus needs to be on building those meaningful connections.” —
She began harnessing the power of peer support groups and peer mentoring to foster meaningful interactions in 2011, after founding Java Group Programs. The efficacy of the organization’s three research-based programs — Java Music Club, Java Memory Care, and Java Mentorship — has since been demonstrated in a series of studies. Today, hundreds of retirement residences and long-term care homes across North America have implemented them. The most popular is Java Music Club, a peer support activity that focuses on interaction and altruism.
Laura Forsyth, regional manager of life enrichment for Chartwell, a company that runs more than 200 residences across four provinces, has seen its effectiveness firsthand: “For our residents, Java Music is magical,” she said. “I regularly see residents who don’t know one another bond and connect through the program.” After we implemented it in 2014, “Java Music has been so successful that it has influenced Chartwell’s corporate culture. We now emphasize meaningful interpersonal connections in nearly everything we do.”
While preventing social isolation and loneliness might sound easy, it isn’t — especially for older adults struggling to adapt to life in a retirement residence or long-term care home. Most residences and homes don’t offer programming that fosters meaningful connections.
“We still have much to learn about the mental health and well-being of people living in long-term care and how to optimize their quality of life,” said Danielle Sinden, who is the director of the Centre of Excellence in Frailty-Informed Care. Part of Perley Health, which serves a community of more than 600 seniors in long-term care and independent-living apartments, the centre conducts and shares the practical research needed to improve care.
Several of its research projects focus on the mental health and wellness of older adults. One pairs up residents living with Alzheimer’s disease with university students and tracks the results over many visits. Another promotes social connection, emotional health, and meaning in life through an online peer support group. The centre is also evaluating Java Music among a group of residents in long-term care.
“I think there’s something about being a passive recipient of care that fosters loneliness and depression,” said Theurer. “Helping others is a pathway to joy and meaning. Properly designed group programs provide opportunities for people to help their peers. And that makes us feel good.”
Informal caregivers who are concerned about the mental well-being of loved ones can find other strategies to help build connections in the Caring for Older Adults During COVID-19 tip sheet from the Mental Health Commission of Canada and in ongoing research into other aspects of caring for older adults.
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There is no strong silent type when it comes to men’s mental health
By Michel Rodrigue
Michel Rodrigue, left, enjoying a soft drink (a treat!) in preparation for the hockey game – the Montreal Canadiens, of course.
Long before I knew what mental health was, I knew that men didn’t talk about it. Certain topics were simply off the table, with deep personal feelings heading the list. To talk about those things would be unnatural, unwelcome, and uncomfortable — not to mention unmasculine.
It was only later, when I learned the concept of stigma, that I understood the truth. When men stay silent, it hurts everyone, most of all themselves.
Of the roughly 4,000 suicide deaths in Canada each year, 75 per cent are men. For men between the ages of 15 and 39, suicide is the second leading cause of death (after accidental death). Clearly, we have a lot to talk about.
Stigma breeds silence
My father worked in construction most of his life. In his all-male crew, if someone was injured on the job, the first aid response was unflinching. There was no hesitation about doing or saying the wrong thing. There was no reassessment of that person’s masculinity or judgment of their character. Everyone understood the reality — that it could have happened to any of them.
In the same way, no one is immune to mental illness. Yet, if someone would have had a panic attack on the job site, I suspect the response would have been entirely different. That’s stigma at work.
But there’s another feature that sets mental illness apart — it’s invisible.
We can see the limp of an injured leg or read the temperature of a fever. Mental health problems, on the other hand, often hide in plain sight. —
I learned this the hard way when I lost a close friend to suicide.
From the outside looking in, Sylvain had everything to live for. A loving wife, two beautiful daughters, a caring family, close friends, and a thriving business. At least, that’s what we thought.
It was only after his death by suicide in May 2005 that we learned he’d been pretending to go to work for many months.
I try to imagine what that time must have been like for him. How ashamed and embarrassed he must have felt to keep that secret so closely guarded. I think about the role stigma played in his death. And I think about how much work we still have ahead of us, especially men.
Turning insights into action
In my seven years with the Mental Health Commission of Canada, I’ve learned a lot about men’s mental health. I’ve learned about the growing evidence of a distinct male-type depression, characterized by externalizing symptoms such as irritability, anger, and substance use.
A young Michel with his parents Lionel and Lucille.
I’ve learned that while loneliness, substance use, and depression are among the strongest risk factors for suicidal behaviour in men, other factors put certain subgroups at an even higher risk. For example, the rates of attempted suicide for First Nations, Inuit, and Métis who identify as sexual and/or gender minority men (including gay, bisexual, men who sleep with other men, and transmen) are up to 10 times as high as for men in this group who are non-Indigenous.
But perhaps the most important thing I’ve learned is that, as men, we need to get comfortable being uncomfortable. Talking honestly about our mental health is one of the best ways we can protect it, no matter how unnatural it might feel at first.
At best, the cost of silence is isolation, even in the company of other people who would willingly offer their support. At worst, that silence can cost a life. It’s time for all men to embrace the discomfort, break through the masculine ideals, and leave nothing off the table.
Michel Rodrigue is president and chief executive officer of the Mental Health Commission of Canada.
Michel Rodrigue
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Showing Support Means Not Having All the Answers
Cuba Gooding Jr. as Rod Tidwell and Tom Cruise as Jerry Maguire from the 1996 film, which led to countless “help me, help you” memes.
A popular quote from the movie Jerry Maguire is, “Help me help you.” It comes from the scene where the namesake character, played by Tom Cruise, is coaching football player Rod Tidwell, played by Cuba Gooding Jr., who is digging in his heels and resisting advice. It’s a familiar exchange that you may recognize in yourself. I know I do. If I see someone in pain, I have the strong desire to jump in and “fix” what I believe to be the “problem.” Despite that desire, I have learned that support does not equal fixing. It’s not my job or your job to fix others.
Let’s start at the point where you have recognized a mental health “problem,” say with a loved one, colleague, or friend. Perhaps you see the signs and symptoms of a decline in their mental well-being, or else the person has told you directly that they are going through a mental health problem. In that moment, it can be tempting to think, “What has worked for me will work for them.” If that happens, it’s natural to want to try and fix things by giving advice on how to make it all better. You may even want to give them a toolbox full of fix-it things.
But there are good reasons not to do that.
“Effective support can also involve sitting beside someone — not speaking a word, simply being there while providing a safe space for them just to be.” —
SHOULDA, COULDA, WOULDA
First, it’s best not to assume we know how that person feels and what they should do. I often say, “Don’t let anyone “should” on you today, and don’t “should” on yourself. So, let’s get away from our preconceived notions of what the person should do.
Whenever I hear the word should, I try to consider where it’s coming from and what intentions are behind it. Who has the right to say what we should do anyway? Who are they to decide what is best?
The desire to fix by “shoulding” ignores other possibilities. What if they’ve already tried what worked for you and had little success? What if it’s the first time someone has really been a witness to their pain? What if they say, “everything is fine,” and go away? What if your timing isn’t their timing (excluding situations of imminent harm to themselves or others)?
A more helpful approach is focusing on how their behaviour is impacting the life they want to live. It’s better to build rapport and trust or encourage them to seek professional (or other) support than put them on your to-do list. They are not your project. And there’s no need to keep at them with questions such as, “Did you do what I told you to do?”
FEELING HUNGOVER
Another potential reaction to trying to fix things is having the person ignore you the next time they see you. Whenever that happens, we tend to blame ourselves: “Did I say something wrong?” “Did I overstep?”
I invite you not to take those thoughts on, since the person may in fact be experiencing shame, denial, or fear. When people disclose something personal and share their emotional pain, it usually leaves them feeling vulnerable.
It’s what I often refer to as the “vulnerability hangover.” They’ve just shared something that leaves them with a gaping emotional hole — that open, raw feeling. In such situations they may be having internal dialogues like, “They must think I’m weird or have a character defect” or “Maybe they don’t like me anymore.”
Yvette Murray
On top of the symptoms they may be experiencing, going through a decline in their mental well-being will affect their self-esteem and self-worth. Strong feelings of “I’m not good enough” or “There must be something ‘wrong’ with me” can rear their ugly heads.
As a psychotherapist, my training involved having to do my own inner work along with group work. One of the biggest “aha” and healing moments I had during that time was when I recognized pain in a colleague or mentor. In that moment I thought, “You mean, you feel this way, too?”
Such an experience provides hope, optimism, and comfort in knowing that someone is not the only one with such feelings. It helps them focus on how to feel better without the extra burden of what my good friend and mentor Janine Driver calls, “stinkin’ thinkin’,” the internal dialogue and self-stigma that can directly interfere with our healing journey.
KNOWING ME, KNOWING YOU
To truly support someone, “Help me help you” really is the best approach. How do we do that? The first step is asking them! For example, ask “How can I best support you?” “What do you think would happen if you did this or that?” “How can I support you today?” “What does help look like for you?”
You could also remind them of what worked for them before. Everyone of us has been through challenges. To overcome them, chances are we’ve used support systems, inner strength, perseverance, courage, and persistence. Reminding the person what they’ve previously come through can be helpful. When someone feels better, they tend to forget that.
Have you ever had a bad flu and thought to yourself, “I don’t know how I’m going to function in the next hour, never mind getting up and going to work the next day”? Fast forward a few weeks, and someone at the office reminds you, “Remember, you were off sick that week?” “Ah, I had forgotten ‘cause now I feel better.” By reminding someone what has helped them before, know that it could be the very thing that helps them now.
Effective support can also involve sitting beside someone — not speaking a word, simply being there while providing a safe space for them just to be. When I don’t feel good, having someone trying to make me feel good or change how I’m feeling can be counter-productive.
Having empathy is key, as American researcher Brené Brown says, while making sure not to jump in with “at least” statements: when someone tells you they are getting a divorce, for example, and you respond with something like, “Well, at least you got married.” Some might find such a comment funny, but it may not be helpful. A more empathetic response would be “Thank you for sharing that with me. Please help me understand what you are going through.”
Key aspects of supporting other people are listening and communicating non-judgmentally. Those things become a lot easier once you remind yourself, “It’s not for me to put my belief systems about how life ‘should’ be or how people ‘should’ act onto others. It’s their life and experience, not mine.” By connecting as an authentic fellow human being, heart to heart, and by really listening, you are going to provide excellent support.
For those that have a hard time receiving support, allow me to whisper in your ear, “know that helping you, helps me too!”
Photo: ©TriStar Pictures/Courtesy Everett Collection
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Staying mentally well in a digitized world
While Digital Health Week was a celebration of the advantages of connected care — from virtual consultations to e-health records to useful apps — it was also an opportunity to reflect on how we maintain our best mental wellness in an increasingly digitized world.
“There’s no doubt that the pandemic has increased our reliance on virtual connectivity and social media,” affirmed Dr. Keith Dobson, professor of clinical psychology at the University of Calgary. “And while there are some positives associated with our capacity to remain plugged in to our relationships, we can’t be blind to the very real pitfalls.” —
Those pitfalls are having an especially adverse effect on the mental health and wellness of young people — especially young girls.
“Our brains tend to believe what we can see,” Dobson said. “While intellectually, we might comprehend that a photo is doctored, that an image has been filtered or retouched — a waist nipped in, eyes made bigger — our brain doesn’t readily make that distinction.”
Seeing is believing
Dobson explained that the primacy of our sense of sight is largely why we as a society are so enamoured with digital platforms like Instagram that offer powerful visual stimulants. We’re also reeled in by the hit of dopamine, the feel-good hormone that kicks in when we’re using a medium that offers us easy wins. Likes, hearts, shares, and comments give us bite-sized endorphin rushes, without requiring much in the way of effort.
“Normally, we get a sense of well-being from an accomplishment,” he added. “Something that has required us to invest meaningful time, energy, and effort. Instead, social media provides us with a short-cut. But it’s one that comes at a high cost. The industry we’re up against is a formidable foe — one that has invested billions to buy access to our innermost thoughts and most intimate insecurities.”
Ironically, Dobson noted, we don’t need to feel good while we’re actively engaging on social media. That activity might make us feel less-than, unattractive, not-good-enough. But interestingly, when we shut down our phones, we start to feel good again.
The ‘negative feedback’ loop
“It’s called a negative feedback loop,” he said. “Think of it like this: you have a negative thought — ‘I’ve left the stove on,’ for example. Then you need to check the stove to make sure it’s off. After you find relief in checking, the pattern begins again.”
Holly Craib, a 21-year-old art student in Ottawa, agreed. “I don’t even consciously decide to check my social media. In a moment of boredom, quietness, or loneliness, I just automatically reach for my phone and start scrolling.” She describes the frustration of an hour or two slipping by, checking Twitter or “doom scrolling,” pulling herself up short when she realizes she’s making herself insecure by comparing her accomplishments to those she’s seeing on her feeds.
Dobson echoed Craib’s assessment, explaining that there are myriad things that pull us toward social media. We may fear we’re missing out. Then there’s the pull of social currency: wanting to be sure we can contribute to a conversation about a particular social media event, personality, or meme.
But things can take a dangerous turn when our insecurities are being mined as precious data by organizations seeking to profit from our distress. Eating disorders have increased during the pandemic, and researchers are connecting the link between being in lockdown and having constant access to tempting content that reinforces negative thoughts and damaging behaviours.
A love-hate relationship
“It’s a vicious cycle,” said Craib. “I think like a lot of people my age, I have a love-hate relationship with my phone. I’ll often see friends posting the equivalent of ‘you’ll have to reach me on my landline’ because they are taking a breather from all the noise on social media.”
Once you’ve shown an interest a certain kind of content, algorithms designed to snag your attention quickly respond with reinforcing information. Suddenly, a single search like “How to lose five pounds” becomes a tsunami of diet content. If you weren’t convinced you needed to slim down before that innocuous search, you’re suddenly inundated with the message that you absolutely do.
“And therein lies the danger of being a passive consumer,” said Dobson. “I realize that the tools we have in our arsenal are relatively weak against a billion dollar behemoth that lives in our pocket and seemingly reads our minds, but that’s why we’ve got to be doubly savvy.”
Coming to grips with virtual reality
If you grew up with Seventeen magazine, for example, which you could read and put aside, it may be hard to conceive just how ubiquitous social media’s influence has become. It’s not just the latest trends, funny jokes, and a way to stay in touch with grandma. It’s the whole world in the palm of your hand — and for a lot of young people it becomes their validation, their connection, and their biggest detractor.
Craib said cutting herself off from her phone would be like cutting a lifeline, especially during COVID. “Virtual connection has been part of my life since I was logging on to MSN Messenger when I was in elementary school. I got my Facebook account when I was 13. I don’t know how not to connect with people this way. But I also understand it’s playing on my vulnerabilities, and that’s a fine line to walk.”
Dobson advocates education as the most powerful tool we have — especially for parents of young people. He urges parents to learn about social media and to openly discuss the content their children are seeking, teaching them from an early age how to be critical consumers. “Having them ask, ‘What is the purpose of this image?’ And then, ‘How does it make me feel?’ gives them an opportunity to see if their thoughts are being distorted by unhealthy, unrealistic standards of beauty or accomplishment, for example.”
He also advocates clear boundaries that, he readily admits, won’t necessarily be easy to enforce.
“Some obvious ones for me are no phones in the bedroom, time-limited access to phones and computers, and pursuing other activities that give you an endorphin rush that’s earned without strings attached.”
Learning an instrument, exercising, going for a walk, or having a meaningful conversation with a close friend are social media alternatives that give our brain a feel-good boost, without the inevitable crash.
But for Craib, the work she does as an artist keeps her tethered to the platform she finds most problematic. “Instagram is a natural place to showcase my art, which I love making. But it’s also a forum where you can start to feel unseen, drowned out, or less prolific. I suppose in that way it’s a bit like having a frenemy. On the one hand, you’re able to put yourself out into the world. And, on the other, the world is there to respond.”
Taming the beast
But for April Yorke, there are ways to tame the beast. During her time as the Mental Health Commission of Canada’s manager of digital marketing, she has mastered the skill of making social media work for her, rather than the other way around. And she’s quick to point out that using the platforms can also have positive mental health benefits.
“One of the best things about social media is that it lets you home in on your interests. If you love puppies, fly fishing, and knitting, you can bet you are going to see puppies and fly fishing and knitting, morning till night.”
But if you sense that the algorithm has turned against you (when #HowToLoseFivePounds is all the content you see), Yorke recommends turning the algorithm to your advantage. “Start searching for what makes you happy. When you find it, make sure you like, follow, subscribe, and comment — any action you can take to engage with it. It won’t take long for the algorithm to pick up on where your new interests lie and start pushing you in that direction.”
And if you are still seeing something you don’t like? “Report it. Block the account. Social media gives you those options because they don’t want to show you stuff you don’t want to see and eventually lose you as a customer. Complete the feedback loop by also making it clear what you don’t want.”
Craib is also a proponent of this approach. “I’ve given Twitter a list of words or phrases or subjects a mile long that I am not interested in reading about ad nauseam. It’s not perfect, but it’s a step in the right direction.”
Dialing it back
If those two options aren’t enough, Yorke has another idea. “Act like a feuding celebrity and take yourself back to zero. Unfollow absolutely everyone you are currently following. Remove your own posts and photos that you no longer wish to see.”
Yorke has a friend who took a multi-year break from social media. When he made his return, he used only one network and carefully curated who he was following.
“Now,” said Yorke, “using social media makes him feel inspired in a way that it never did before.”
It’s not usual to see articles recommending strategic avoidance or deleting apps altogether. While that may be the right move for some — it’s not really an option for social media managers or people like Craib, who are required to leverage the connectivity of social media to showcase their work or run a business.
But as Yorke said, “Once you winnow down your list of follows, it doesn’t take as long to ‘get caught up’ (whatever that means), so you spend less time on the app. Now I mostly see my close friends and ads for travel bags with lots of pockets — an important reminder that a big wide world beyond the screen is out there.”
Suzanne Westover
Illustrator: Holly Craib https://www.hollcee.com/
