News & Articles
Talking about speech disfluency
Over 300,000 Canadians stutter
October 22, 2018
Most Canadians take speaking for granted. It's just something we do – and we don't often have to think about it.
But for the over 300,000 Canadians who stutter, speaking is not always so easy.What is stuttering?
Most people naturally use disfluencies, or irregularities, in their speech. According to the Institute for Stuttering Treatment and Research (ISTAR), these include:
- Repetitions – "We, we went to the store"
- Interjections – "Um, ah,"
- Revisions – "I saw her today – I mean, yesterday"
But people who stutter speak with disfluencies more often. ISTAR lists some signs of stuttering:
- Repeating parts of words ("Ch-ch-children")
- Repeating full words more than twice
- Stretching certain sounds ("Thhhhhe")
- "Silent blocks" – getting stuck or hesitating on a word
Stuttering affects both children and adults, although it typically begins between the ages of two and five.
Adults can develop a stutter later in life. This is commonly due to brain injury, but it can also happen for other reasons.
Stuttering can have a profound negative impact on a person's daily life. On top of having communication difficulties, people who stutter may isolate themselves or avoid speaking in fear of being caught stuttering.
Stuttering can be situational, which means someone who stutters may stutter less (or not at all) in certain situations.What causes stuttering?
We don't know exactly what causes stuttering, but genetic, neurological and environmental causes are all factors.
Certain circumstances can worsen stuttering. These include frustration, anxiety and high expectations.
However, it's important to note that while anxiety can worsen a person's stutter, it's a misconception that people who stutter are naturally more anxious than people who don't.How do you treat stuttering?
While children sometimes lose their stutter as they age, others may have to go through treatment. No matter the age, treatment for stuttering involves speech-language therapy.
Treatment is specifically tailored to a person's age and circumstances. When working with children, parents are usually involved in treatment, since they play a strong role in the child's language development.What should I do when talking to someone who stutters?
When speaking with someone who stutters, ISTAR recommends:
- Maintaining normal eye contact
- Using body posture to show that you're actively listening
- Refraining from finishing sentences or offering advice (it might seem helpful, but it's often not)
- Being extra patient over the phone
For more information about stuttering, visit ISTAR.
September is World Alzheimer's Month
September 19, 2018
As we age, it's not uncommon for our memory to falter. What used to be easy to remember, like the name of an acquaintance, the restaurant we ate at last week, or the location of our car keys, might blur over time.
But for the 22,500 Manitobans with dementia, their loss goes beyond just forgetting some details. Dementia can be devastating – people with dementia can get lost on their own street, forget what year it is and even act like a completely different person.
And this loss doesn't just affect the person with dementia. According to the Alzheimer Society of Manitoba, 56 per cent of Manitobans are affected – either by having it or knowing someone who has it.
September is World Alzheimer's Month, and the Alzheimer Society of Manitoba is encouraging Manitobans to learn more about the disease.What is Alzheimer's?
Alzheimer's disease is a form of dementia, which is a general term that refers to a set of symptoms affecting the brain. The Alzheimer Society of Manitoba lists the 10 warning signs of Alzheimer's:
- Memory loss that affects daily functioning
- Difficulty performing familiar tasks
- Language difficulties
- Disorientation of time and place
- Poor or decreased judgment
- Problems with abstract thinking
- Misplacing things
- Changes in mood and behaviour
- Changes in personality
- Loss of initiative
Eighty-two per cent of Manitobans can identify memory loss as a symptom of Alzheimer's. And while many can identify confusion and personality changes as symptoms, only about ten per cent know about the other seven signs.
As the disease progresses, symptoms worsen – someone with late-stage Alzheimer's can be nearly unrecognizable from the person they used to be.What causes Alzheimer's?
We still don't know exactly what causes Alzheimer's, but researchers are aware of some possible risk factors:
- Age – The older you are, the more likely you'll be to develop Alzheimer's.
- Gender – Since women have longer lifespans than men, women are more likely to develop the disease.
- Genetics – Genetics are responsible for around 5 per cent of cases.
- Brain injuries – Research shows that brain injuries like concussions put you at higher risk of developing the disease.
- Diabetes – According to the Alzheimer Society of Manitoba, people with Type 2 Diabetes are twice as likely to develop Alzheimer's.
- Vascular disease – Strokes increase the risk of memory problems in Alzheimer's and make symptoms worse.
- Education – People who are more educated are less likely to develop Alzheimer's, and staying mentally active can help reduce Alzheimer's symptoms.
While there's currently no way to fully prevent Alzheimer's, the Alzheimer's Society of Manitoba recommends taking steps to reduce your risk.
- Live a healthy lifestyle – Reduce alcohol and tobacco, eat a healthy diet, get regular sleep and keep your cholesterol levels in check.
- Be mentally active – Learn a new language, take up a new hobby or do the crossword. Much like physical exercise, mental exercise helps keep you healthy and could help prevent Alzheimer's.
- Protect your brain – If you're participating in possibly dangerous activities, wear proper headgear to prevent injury.
To learn more about Alzheimer's disease, visit the Alzheimer Society of Manitoba.
Alcohol, anxiety and depression
University of Manitoba trials online treatment tool
September 10, 2018
When Dr. Matthew Keough was working with people struggling with alcohol abuse, he found that it rarely occurred in a vacuum.
"One thing I quickly noticed was many are also struggling with other things," he says. "Namely, emotional struggles like anxiety and depression."
People with substance use problems are up to three times more likely to have a mental illness, according to the Centre for Addiction and Mental Health. Additionally, people with a mental illness are twice as likely to have a substance use problem.
As part of the Department of Clinical Psychology at the University of Manitoba, Dr. Keough's research focuses on reducing alcohol abuse in people with anxiety or depression.
"They'll often turn to alcohol... when the symptoms are really bad, and alcohol kind of helps to relieve those emotions, so they may feel an increase in their mood," says doctoral student Jona Frohlich, a research assistant with Dr. Keough. "It kind of creates this vicious cycle where, in the short term, their mood is improved if they have that drink or a few drinks, but in the long run they're actually increasing their reliance on alcohol, which we know has a negative impact on mood."
The newest phase in the team's research is Take Care of Me, a self-directed online treatment program designed to help people 18 to 35 cope with alcohol abuse, anxiety and depression.
It's an eight-week, 12-module program that aims to motivate people to reduce their drinking and teach them mental health coping strategies.
Take Care of Me is all about prompting people who are struggling to act, says Dr. Keough.
"It's getting them on board for change," he says. "It's about having them understand situations that are risky for them – so altering their environment, altering the way they think about certain situations, balancing things out."
"We're getting them to write about their thoughts, we're getting them to understand their environment, and we're getting them to plan for challenging situations," he adds.
It's an integrated approach that is all too rare in many addiction treatments, Dr. Keough says.
Some treatments take a sequential approach, where patients are instructed to work on one aspect at a time. Others take a parallel approach, where two different professionals target the alcohol use and mental health issues separately.
Neither method provides a cohesive treatment experience, which is what Take Care of Me aims to achieve, Dr. Keough says.
The intervention is entirely online, which is another advantage for the project, he adds.
"There's often stigma involved in substance use and alcohol use," he says. "Maybe they're not totally jazzed about going into a hospital and telling somebody that they're having these difficulties."
The accessibility of an online program means people across the province can get help with less pressure, he says.
"It might feel a little better to start off with something like this rather than going to a hospital and admitting your problem face to face," he adds.
"Another thing that sets it apart is the fact that we're trying to target people early on," Jona says. "We're really trying to target individuals before their symptoms are drastically impacting their life."
"[Maybe] their partner's not super happy about their drinking," says Dr. Keough. "Maybe their school work is suffering a little bit. Maybe they're feeling a little more depressed than they're used to. Anyone who has these kinds of feelings, I would encourage to check out the study link, fill out the eligibility questionnaire and express an interest in participating."
By participating in Take Care of Me, participants will also be taking part in a study to determine the effectiveness of its interventions.
If you're interested in learning more about Take Care of Me or would like to take part in the study, read more here.
Little critter, big bite – How to avoid ticks this summer
July 3, 2018
For many, summer is the most treasured time of year. The ability to spend meaningful time outside without bundling up is something almost every Manitoban can get behind.
But of course, it's all too common to have an outdoor outing interrupted by creepy crawlies. And for many people, nothing makes the skin crawl like a tick.
Ticks bite and feed on the blood of animals, including humans. Their bite is painless, which means they can go undetected for hours – or even days.
Most Manitobans are familiar with the wood tick, whose bite can spread infections such as Rocky Mountain spotted fever. However, wood ticks pose a lesser threat than their smaller cousins – blacklegged (or deer) ticks.
Blacklegged ticks are less common than wood ticks in Manitoba, but they spread more harmful infections – the most common being Lyme disease. They're about the size of a sesame seed (3 mm to 5 mm), but they can swell to eight times their original size after feeding.
Lyme disease is caused by the bacteria Borrelia burgdorferi, which infected ticks can transmit through their bite.
Symptoms can show quickly (as early as three days) or over time. Typically, the first sign of disease is a bull's-eye rash at the wound site.
However, the frequency of this rash is disputed. Some sources say it affects 80 per cent of patients, while others say it affects a much smaller percentage. According to the Canadian Lyme Disease Foundation (CLDF), less than 50 per cent of people with Lyme disease get any over-emphasized rash, while only nine per cent get the bull's-eye rash.
Other initial symptoms include fatigue, headache, fever, muscle and joint pain, and swollen lymph nodes.
However, as the disease evolves, so do its symptoms – of which there are over 100. They affect nearly every aspect of the body, ranging from speech difficulty to bone pain to neurological problems.
The variety of symptoms makes Lyme disease difficult to diagnose. Some patients might have to see several doctors and run many tests before identifying the problem.
Making matters worse, half of those affected don't remember being bitten, according to the CLDF. This is partly because it can take weeks for symptoms to show. However, it is also because you can be infected by a tick in its nymph stage. At the nymph stage, blacklegged ticks are about the size of the period at the end of this sentence.
Lyme disease is easier to treat when it's caught early. Doctors typically prescribe a few weeks of antibiotic treatment to stop the infection and patients may go through several rounds to clear it up completely.
When Lyme disease isn't treated in time, it may become chronic, with symptoms periodically flaring up. It may remain for months or even years.
The easiest way to prevent Lyme disease is to not get bitten in the first place. If you spend any time outdoors near wooded or grassy areas, follow these precautions:
- Cover up – wear a hat, a long-sleeved shirt, long pants, socks and closed toe shoes. For further protection, tuck your pants into your socks.
- Wear light-coloured clothes – ticks will blend into dark fabrics, making them harder to spot.
- If you're on a trail, stick to it – don't go wandering through the bush.
- Wear tick repellant – chemicals like permathrin, DEET, oil of lemon and eucalyptus either kill ticks or keep them away.
As soon as you get back inside, do a thorough tick check. Have someone check your hair and skin carefully. Bathing soon after is also a good idea.
If you find a tick burrowed in your skin, try not to panic. Don't just rip the tick out – if you do, bacteria could rush into the wound and speed up any infection.
Grab tweezers and hold the tick by the head as close to the wound as possible, pulling slowly but firmly.
You can also purchase tick removal kits that have alternate (and safe) removal methods. However, don't rely on any "traditional" home remedies, such as fire or chemicals.
When you've removed the tick, don't destroy it – get your camera. Using the provincial government's Manitoba Tick Checker, you can submit a photo for identification. If it's a blacklegged tick, a representative will contact you with further instructions.
Ticks and your pets
Unfortunately, your pets aren't immune to tick-borne diseases. Just as you check yourself, you should do a thorough inspection of your pets after they spend time outside.
Tick season is generally from April to November, but it may last longer in warmer areas. Ticks are able to withstand colder temperatures, so snow on the ground doesn't guarantee they'll be gone. Keep this in mind when your dog is rolling in the remnants of the first snowfall.
Keep an eye out for vision damage: Summer eye safety tips
June 4, 2018
After a cooler spring, the summer sun might be a sight for sore eyes. Dr. Kirsten North, practicing optometrist and policy consultant at the Canadian Association of Optometrists (CAO), shares some tips on protecting your eyes from vision damage while you're outdoors.
Wear sunglasses with UV protection
Similar to how sunscreens protect your skin, sunglasses protect your eyes from sun damage. Sunglasses with UV protection help prevent eye diseases like cataracts and macular degeneration (age-related vision loss), Dr. North says. She also recommends buying sunglasses from a trusted source and checking the labels to ensure that they are 100 per cent UV protected.
"You can get an inexpensive pair of glasses that have 100 per cent UV protection and you can get very expensive ones that don't," she says.
Wearing a wide-brimmed hat, staying in the shade, and not rubbing your eyes when you have sand on your hands also helps protect your vision.
Wear safety glasses while playing sports
The regular frames you get for your glasses won't protect your eyes when you get hit by a soccer ball. Regular glasses break easily and could damage your eyes. Safety glasses and sports frames allow you to stay safe while playing outdoor sports, adds Dr. North.
Don't wear contact lenses under water
Most people don't know that you can get swim goggles with prescription lenses, Dr. North says. She advises against wearing contact lenses and instead suggests wearing swim goggles when under water.
Protect your eyes from screens
Protecting your eyes from computer, television and mobile screens is a good idea any time of the year. Make sure you're getting appropriate breaks and set your screen an arm's length away and 20 degrees below eye level, Dr. North advises.
The CAO recommends following the 20-20-20 rule to give your eyes some rest. Every 20 minutes, take a 20-second break and focus your eyes on something at least 20 feet away.
Add some Omega-3 to your diet
The food you eat can affect your vision too. Salmon, tuna and nuts are great sources of Omega-3, which aids in eye health, Dr. North says. Green leafy vegetables like kale and spinach, citrus fruits and orange bell peppers are also great for eye health. During summer, you can grow spinach and kale in your garden so you know they're healthy and organic, she adds.
Smokers are at a higher risk of developing eye diseases and infections like dry eyes, uveitis (an inflamed iris), age-related macular degeneration and cataracts, according to the CAO. Don't smoke if you haven't started or quit smoking to prevent vision damage, Dr. North recommends.
Be careful in your yard
Wear safety goggles while doing yard work, Dr. North suggests.
"Debris and sharp objects can get flung up while using the lawn mower or whipper snipper and hurt your eyes," she says.
She also recommends trimming branches that are at eye level (both yours and your children's) and washing your hands after using fertilizers and weed killers.
Protect your eyes around bonfires
Try to keep a safe distance from bonfire smoke, Dr. North says. Wearing glasses around a bonfire also keeps smoke off the surface of the eyes. If you've been exposed to a lot of smoke, she suggests using artificial tears or eye-washes to flush toxins off the surface of the eyes.
Go for regular eye exams
One in seven Canadians will develop a serious eye infection during their lifetime, according to the CAO. Most eye diseases have no symptoms and can only be detected during an eye exam. It is especially hard to find out if kids are having vision problems because they don't mention anything to their parents.
"They just assume everyone sees things the way they do," Dr. North says.
She recommends scheduling regular eye check-ups to find out if you need glasses or have an infection. For more eye safety tips, visit the Canadian Association of Optometrists.
Hard to detect, easy to prevent: How hypertension affects you
May 21, 2018
More than a quarter of Manitobans are living with high blood pressure (hypertension) and the numbers are rising every year, according to data collected by Manitoba Health, Seniors and Active Living.
You might get the occasional headache or feel dizzy, but most people with hypertension show no symptoms at all, which makes it hard to detect until you check your blood pressure. May is Hypertension Awareness Month and Hypertension Canada is asking you to get your pressure checked at pharmacies across Canada.
What is hypertension?
Your heart pumps blood that travels around your body. Blood pressure is a measure of the force of blood against the walls of your blood vessels or arteries. When pressure increases, your heart has to work harder to pump blood through the arteries. This elevated pressure is called hypertension.
Understanding blood pressure numbers
When you get your pressure checked during your annual check-up, the numbers on the blood pressure monitor probably don't mean much to you. To understand those numbers, you need to understand systolic and diastolic pressure. Systolic pressure is the number on top of the monitor. It measures the force of blood against your arteries when your heart is beating. Diastolic pressure is the number below – it measures the pressure when your heart relaxes in between beats.
As you get older, your arteries narrow and your heart has to work harder to pump blood. That is why if you're over 80, you have a higher blood pressure than most. People with diabetes or kidney diseases are also more likely to have high blood pressure.
Ideally, your blood pressure should be around 120/80. It is natural for pressure to increase when you're exercising or stressed but if your pressure is consistently at or over 140/90, it's too high.
Control your pressure
Hypertension is the leading cause of stroke and heart disease. People with high blood pressure may also suffer from kidney disease, impaired vision, memory loss and erectile dysfunction. The good news is that you can easily keep your pressure in check through medication and some simple lifestyle changes. The Public Health Agency of Canada suggests some ways to do that.
- Go for a jog or join that yoga class you've been meaning to sign up for. Getting just 30 to 60 minutes of exercise a day can help reduce pressure.
- Cut processed food and sodium from your diet. The Heart and Stroke Foundation of Canada recommends Canadians eat less than 1 teaspoon of salt a day. Eating a healthy, balanced diet filled with fruits, vegetables, whole grains and protein will improve your heart health.
- Use this as an excuse to quit and go smoke free. If you don't smoke, try to limit being around secondhand smoke.
- Take some time out to relax and de-stress during the day. Finding healthy ways to manage stress can reduce your pressure levels.
- If you consume alcohol, limit yourself to two drinks a day. Substitute the third glass with water and juice.
- If you have a prescription, remember to take your blood pressure medication every day. Make it a part of your daily routine so you don't forget.
If you've been diagnosed, invest in a quality at-home blood pressure monitor and measure every day. Checking your pressure during different times of the day will help track how it can vary so you can control it. To see a list of devices recommended by Hypertension Canada, click here.
Wellness at work – Caring for your mental health on the job
May 2nd, 2018
One in five Canadians live with mental health-related illnesses but every Canadian deals with mental health, according to the Canadian Mental Health Association (CMHA). May 7 to 13 is Mental Health Week and the CMHA is asking people to have conversations around mental health.
One particular area of mental health that may not always be discussed is mental health in the workplace.
Our relationship with our work is similar to the relationships we have with our family and friends, says Terri Johnston, counsellor at Manitoba Blue Cross's Employee Assistance Centre (EAC).
"There are people who will spend their entire lives being unhappy with that particular relationship," Terri says, in reference to their work dynamic.
Full-time employees spend a significant part of their day at work and taking care of their mental health in the workplace is important. Seeking help for mental and emotional health is just like seeking help for physical health, she says.
"If you have an ache or a pain and it's not going away, eventually you're going to see a doctor and they're going to diagnose you, get a sense of how serious it is, and give you some ideas for how to fix it."
Attending counselling can help those who are struggling, and it shows that they are taking their relationship with work seriously, Terri adds.
Signs of stress
Our mental and emotional health often reflect on our physical health, and vice versa, Terri says.
"When people are struggling, some red flags to watch out for are not eating or sleeping well."
According to the Canadian Sleep Society, stress, anxiety and depression are the most common causes of insomnia. Chronic insomnia may, on the other hand, increase the risk of depression.
Workplace demands and stress are concerns for many employees who seek help at the Employee Assistance Centre. According to Terri, the first step is to deciding what needs to change.
"We can either change the outside or the inside," says Terri. "So, we start with that."
If it's the "outside," she suggests finding out if there is something external we need to change such as talking to a supervisor about lightening a heavy workload or trying to organize our time in a different way.
If it's something an employee is struggling with internally, Terri suggests trying to find a new way to see or understand things. An example might be shedding the unrealistic expectations we have of ourselves.
"A lot of people are perfectionists and sometimes they need to let go of that."
Conflicts at work
Conflicts with supervisors and colleagues can also make work days hard. In those situations, we need to decide if we're going to have a conversation with the person who the conflict is with or find a way to let it go, Terri says.
But letting go is hard for some people because it might seem like we're agreeing with the issue, she adds.
"You don't have to agree with it," she says. "You just have to decide that you don't want to suffer with it anymore."
Resolving workplace stress
Other things that can help with workplace stress include having a good network of friends and learning to put ourselves first. With summer coming, it's also a good idea to get outside and take a breath of fresh air if we're having a bad day at work, Terri says.
With our busy lifestyles, taking time out to sit down and reflect on what we want to do can be hard. Counselling can help deal with work issues, but Terri doesn't tell people what to do during her sessions with them at the EAC.
"A lot of time is spent clarifying," she says. "We help them figure out what the best choice is for them in this circumstance, given who they are."
Mindfulness can also lead to greater self-awareness and self-compassion, which in turn can help an individual figure out a solution best suited to them.
"For example, people say you should go to the gym," Terri says. "If you're not the kind of person that likes to go to the gym, that's just going to make you feel really bad. After getting to know who you are and what works for you, you can come up with other ideas."
To get to know ourselves better and deal with stress, Terri recommends the Mindfulness Based Stress Reduction Course offered by the Canadian Mental Health Association.
Keeping on track: a dietician from our Assistance Program shares her travel advice
March 12, 2018
Whether we're on the road or overseas, it can be difficult to eat a healthy diet while travelling.
But that doesn't have to be the case, Dina Daniello-Santiago says. A Registered Dietician with Manitoba Blue Cross's Assistance Program, Dina works with clients to assess their needs, set goals and help improve their health. Clients often approach Dina to facilitate healthy weight management, increase their literacy around food labels, control diabetes or heart health and improve their overall nutrition.
March is Nutrition Month, and with many people planning their summer trips, Dina has some tips to eat healthy while on the go.
When working on your itinerary, you'll want to keep meals in mind, Dina says.
"Depending on where you're going, you can always book ahead," she says. Some restaurants have their menu on their website, so it's relatively easy to pick something healthy in advance, she adds.
Between meals, "Pack healthy snacks," Dina says. If you're prepared, you can avoid the gas station snack raid that often ends with chips and chocolates. Fruit, whole grain crackers, trail mix and even certain granola bars offer good nutritional value and are easy to pack, she says.
"Convenience doesn't have to be in a package," Dina says. "Convenience can be a banana and an apple. But we usually don't think of it that way," she adds. In some countries, fruits and vegetables are widely available in stands, markets or stores, making a nutritious snack even more convenient.
Getting a room with a mini-fridge or a kitchenette will grant you even more options. Being able to store healthy snacks like yogurt, fruit or hardboiled eggs can keep you from making that late-night run to the bodega or greasy taco stand down the block.
Go for the greens
Preparation is important, but it's also easier said than done. Your dinner plans might fall through, or a scheduling change might take you to a restaurant you hadn't anticipated.
Depending on where you're going, it might be impossible to plan ahead. A restaurant in a small town or village might not have a website, and nutrition information might not be available. And even if it is, language barriers can make it harder to understand.
In that case, try to avoid deep fried foods and aim for the greens, Dina says.
"Fill up on vegetables," she says. Salads can be a great choice, because many of them include fruit or nuts that turn them into a full meal.
Control your portions
When we order a heaping plate of food, it's all too easy to devour it – often with negative effects. And even when we plan on taking some of it home, it doesn't always go as expected, Dina says.
"If we have in our head that we're going to take half of it home, but we ask for the full size, we end up eating the whole thing," she says. If you want to save some for later, Dina recommends asking your server to box half of it before he or she serves it to you.
If you're trying to avoid oversized meals in general, share with a friend or get a lunch-sized portion, which is usually smaller and cheaper than a dinner portion, Dina says. Appetizers are also a good choice – in some countries, sharing small plates (like tapas) is a cultural activity, which can make portion control even easier.
"Don't drink your calories," Dina says. We often don't notice, but the calories in juice, soda or alcoholic drinks can add up quickly. For instance, many beers contain over 100 calories, while a glass of wine has a similar amount.
But it's not just the alcohol that may cause an issue. "When you drink alcohol, food usually goes along with it, and it's not usually celery sticks and carrots," Dina says.
Be careful about how much you drink: not only is excess alcohol harmful, but it also lowers your inhibitions, meaning you'll be more likely to reach for those extra snacks when you've already had plenty, she says.
Keep your routine
Keeping things routine is most important, Dina says. "Try to stick to your regular routine as much as possible with a little bit of flexibility," she says. If you normally stay active, try to build that into your trip. Whether you're hiking through the jungle, reaching your tour sites on foot or just booking a hotel with a gym, incorporating activity into your travels will help keep you on the right path.
An illness, not a choice
February 1-7 is Eating Disorder Awareness Week
February 1, 2018
Eating disorders can affect anyone.
That's the main message of this year's Eating Disorder Awareness Week, which is organized by the National Eating Disorder Information Centre (NEDIC). Eating Disorder Awareness Week aims to educate Canadians about these dangerous and sometimes misunderstood conditions.
Eating disorders can be deadly
According to NEDIC, eating disorders are deadlier than any other mental illness.
"One of the reasons is because of the impact it has to all organs of the body," says Lucille Meisner, an eating disorder specialist at Manitoba Blue Cross's Employee Assistance Centre.
Our bodies use stored fat for energy when we restrict calories, which is why we lose weight when dieting, she says. But when we are starving and fat is depleted, our bodies use muscle to survive. The heart is a muscular organ – if blood chemistry is imbalanced, it can cause abnormal heart function, she adds.
Chronically low blood sugar can cause seizures, and purging or vomiting can cause internal bleeding, Lucille says. Ongoing and persistent malnourishment can even stop a woman's menstrual cycle, and the decrease in estrogen can impact bone density.
"I'm counselling women who have been diagnosed with osteoporosis, and they're 30 years old," Lucille says, noting that osteoporosis usually occurs in seniors.
Narrow views lead to treatment barriers
Eating disorders affect people of all ages, genders, sizes and cultures, Lucille says.
"Sometimes, there's a very narrow view and belief about what an eating disorder looks like and who gets them," says Lucille. "And that's often one of the barriers to seeking help."
When people think of eating disorders, they usually think of anorexia and bulimia – and believe if they don't have either, they don't have an eating disorder, she says. Anorexia is typically characterized by a fear of gaining weight, which causes people to exercise excessively or avoid food. Bulimia is characterized by binge eating and then "purging" the food through vomiting or laxatives.
Often, we fail to consider other ways in which food, weight and body preoccupation cause severe emotional distress and impair day-to-day functioning, Lucille says.
Some people struggle with compulsive overeating – periods of bingeing followed by periods of starvation, Lucille says. Others have binge-eating disorder, which is characterized by bingeing but is not followed by compensating behaviours (purging, vomiting or restricted eating).
On the other hand, there's purging disorder, where a person consistently engages in purging behaviours (vomiting, using laxatives), but doesn't binge.
There are also other disorders such as pica (the eating of non-food items like soap or hair) and night eating syndrome (excessive eating after an evening meal or in the middle of the night).
An illness, not a choice
In a 2014 Ipsos Reid poll, 40 per cent of Canadians surveyed thought eating disorders were a personal choice.
"It is not uncommon for those who don't understand eating disorders to think that it's a choice rather than a serious and dangerous illness," Lucille says. "The common misconception with any addictive or compulsive disorder is, 'Why don't you just stop?'"
"It prevents people from asking for help," Lucille says.
The "ideal" body can take its toll
"We live in a society that worships a certain body type," Lucille says. While she's worked with eating disorders since the 1980s, it's a concept that has stayed the same throughout the decades, she says.
In the '80s, the "ideal" female body type was thin and tubular, while today, it's more of an hourglass shape, Lucille says. But she still sees the same desire to fit in with the ideal.
"The pressures never change," she says.
It's that need and drive to be "perfect," to fit in at all costs, that often leads to eating disorders, specifically anorexia or bulimia, Lucille says.
"It's a bit of a no-win," she says. "If you dance that line of being the ideal stereotype and the perfect flawless body, you risk mental illness."
That no-win scenario can create challenges in treatment, she adds.
"If the person fits the ideal for the perfect body, it makes it hard to be motivated to change," she says. "Because on the outside, they're getting positive reinforcement for their appearance. What goes on behind closed doors is a secret.
"Body shaming is a serious problem in our society," she says. "It begins during childhood and for many, it becomes internalized as adults. We become our harshest critics when we believe we don't 'measure up.' We live in a society that worships thinness and a youthful look – at all costs.
"It becomes a vicious cycle," she says. "I see all ages and genders. Sometimes my client is an athlete who has to achieve a certain weight, sometimes it's a man or woman who feels like perfecting their body will perfect their life, and sometimes it's an adolescent who feels their body is the only thing they can control."
Seeking assistance often means giving up the ritual that provides relief, helps us fit in or gives us a sense of control, she says. It can also mean giving up a shame-filled secret that consumes someone's entire life.
When a person with an eating disorder does seek help, counselling focuses primarily on reconciling emotions that drive the disorder, she says.
"When you're struggling with an eating disorder, your feelings underneath it are most often avoided," she says.
"There is often fear and insecurity, loneliness, rejection and shame," she says. "Preoccupation with the body and the feelings related to starving, bingeing and purging are the primary feelings the person knows, and those are often self-deprecating and self-defeating. The satisfaction that comes with fitting into society's ideal image is fleeting at best. It is a no-win.
"People with eating disorders often feel helpless and hopeless and have low self-esteem. One of the goals of counselling is becoming more connected with our true self," she says.
While eating disorders can resemble alcohol or drug addiction, they present special challenges in treatment, Lucille says. "We have to find a way to incorporate healthy eating," she says. "Abstinence is not an option."
Lucille often has to help people introduce food into their lives, she says.
"I often refer clients to nutritionists and dietitians so that they may learn to enjoy food again," Lucille says. "For many, it has been decades of a conflicted relationship."
"If you starve yourself, you have to discover a way to be with food," she says. "If you're a binge eater, the goal is to be with food and stay present and avoid the binge trance. If you purge, the goal is to become comfortable again with food that is digesting in the stomach."
Getting well involves developing self-compassion and learning to care for our bodies and ourselves, Lucille says. A healthy body image and a relaxed relationship with food is the goal.
"To change the number on the scale only temporarily changes how we feel inside," she says. "To change what we say to ourselves when we look in the mirror... that is an inside job and a very personal journey."
Manitoba Blue Cross members with Employee Assistance as part of their employer health plan can contact the Employee Assistance Centre directly to inquire about counselling services or to schedule an appointment:
If you are unsure as to what benefits are available to you and your family, check with your Human Resources representative.
National Eating Disorder Information Centre helpline: 1-866-633-4220 (toll free)
5 tips to make your resolutions stick
January 15, 2018
If you're like many others, you've resolved to improve yourself in 2018. Maybe you've committed to doing nightly push-ups; perhaps you've sworn off sweets. Making resolutions is commonplace this time of year – but unfortunately, so is breaking them.
So, how do you keep your resolution? Here's what experts from around Manitoba recommend.
1: Make a plan
Blindly stumbling into your resolution typically doesn't end well. One way to prevent that is to create a personal action plan, says Jim Evanchuk of the Winnipeg Regional Health Authority.
"Your personal action plan is a thoughtful and honest conversation with yourself," he writes. "It helps you identify an action or behaviour that is highly important to you, one that you can envision yourself doing and feeling good about achieving."
Making a plan involves acknowledging the change you want to make, creating your goals, noting the difficulties you may experience and knowing the resources you can rely on.
2: Narrow it down
Maybe you're trying to eat healthier, so your goal is to eat more vegetables. That isn't clear enough, says the Sport Medicine & Science Council of Manitoba (SMSCM). "What does more mean?" the organization writes. "Is more eating a few peas on your plate? You need to be specific."
Rather than "more," you might aim for four servings a day, the SMSCM suggests. Being specific also makes your success easier to measure, because you'll know for sure if you've hit your four-serving minimum (rather than guessing whether you've eaten "more").
3: Be realistic
"One reason why I expect that resolutions tend to fail is that people try to accomplish too much, too quickly and precisely when they are still in recovery from the holiday season," writes Jason Leboe-McGowan, a psychologist at the University of Manitoba.
The SMSCM agrees. "Look at your goal and ask yourself if this is something that you can achieve based on your workload and schedule," the organization writes.
It's easy (and fun) to be ambitious, but consider whether you can see yourself succeeding in your goal months down the line, when your post-holiday excitement has faded and life is back to normal.
4: Plan around life obstacles
"I suspect that many resolutions ultimately fail because the structure of a person's life makes fulfilling the resolution impossible," writes Leboe-McGowan. For instance, if you're trying to get in more exercise, you'll need to look at the reasons you haven't exercised in the past. Does your work schedule conflict with your workout schedule? Do financial constraints prevent you from buying equipment or a gym membership?
"Adjustments to many other aspects of our lives may well be necessary if we are going to succeed at implementing even a modest New Year resolution over a practical timeline," Leboe-McGowan writes.
Unfortunately, making substantial life changes isn't easy. You'll have to create your resolutions with your situation in mind and see what changes you can reasonably make.
5: Forgive yourself
Sooner or later, you'll probably hit a setback. Maybe you'll miss an exercise day, or maybe you'll eat more sweets than you planned.
"Don't beat yourself up over your failure," writes Jim Evanchuk. "Instead, believe that you can get back on track. It's also important to not compare yourself to others. Your personal goals are just that."
It's important to realize that simply attempting change is a great first step. "At the very least, trying to improve ourselves will steal time away from doing things that are bad for us," says Leboe-McGowan.
Here's to a happy and healthy 2018!