Month: June 2019

What is bipolar disorder?

We all experience changes in moods from time to time depending on events we go through in life. But when these mood swings become more dramatic and severe and impair a person’s ability to function as usual at work, school, or in relationships, it may indicate the presence of a serious mood disorder.

Bipolar disorder, previously known as Manic-Depressive Illness, is a mental disorder that is characterized by severe mood swings cycling between periods of intense “highs” (mania or hypomania) and periods of intense “downs” (depression).

In mania, the individual experiences elevated perhaps extremely good mood, elation, or highly irritable mood that lasts for at least one week. This considerable increase in mood is accompanied by high levels of energy, combined with a noticeable decreased need for sleep.

The individual usually has a boost in self-esteem, tends to talk more and faster, experiences racing thoughts, and is easily distracted. Mania is also characterized by an increase in goal-oriented activities, and often leads to excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., excessive and irrational spending, sexual indiscretions, reckless driving).

In more severe forms, mania can be accompanied by psychotic symptoms such as hallucinations or delusions and almost always requires hospitalisation. Hypomania, a milder form of mania, causes less impairment but can often go unnoticed for several years before receiving appropriate diagnosis and treatment.

In the depressive phase of bipolar disorder, symptoms of clinical depression (or Major Depressive Episode) need to be present for at least two weeks and are similar to symptoms of unipolar depression (see the Canadian Psychological Association’s fact sheet on Depression).

These symptoms include depressed mood or sadness, loss of interest in most activities, decreased activities or social withdrawal, changes in appetite, increased or disturbed sleep, fatigue or low energy, decreased sexual desire, difficulties in concentration or making decisions, feelings of worthlessness and suicidal thoughts or plans.

In more severe forms, clinical depression can be life threatening and require hospitalisation as suicide is a significant threat in bipolar disorder.

In Canada, 2.2% of individuals will experience bipolar disorder at some point in their lifetime. Bipolar disorder usually starts in late adolescence or early adulthood, but it can also begin as early as childhood. If affects both men and women equally.

Bipolar disorder is a highly recurrent disorder, meaning that most individuals with bipolar disorder will experience several episodes during the course of their lifetime. Significant mood symptoms between episodes, problems with being able to get back to work, as well as relationship difficulties and break-ups are common in bipolar disorder.

Although we don’t know exactly what causes bipolar disorder, we do know that genes and chemicals in the brain play a strong role in making people vulnerable to developing the disorder.

Stress alone does not cause bipolar disorder, but episodes of mania or depression are often triggered by stressful life events. Risk factors for relapse in bipolar disorder include abusing alcohol or drugs, not taking psychiatric medication as prescribed, and changes in routine leading to lack of sleep or irregular sleeping habits.

What psychological approaches are used to manage bipolar disorder?

Pharmacotherapy, or drug therapy, is essential for the treatment of bipolar disorder. It usually involves the use of one or more mood stabilizers, such as Lithium, combined with other medications.

There is now strong evidence that psychological interventions can be added to drug therapy in order to help people better manage their illness and reduce repeated experiences of mood episodes.

Psychoeducation consists of giving patients and their relatives’ adequate knowledge about bipolar disorder and teaching illness self-management skills, so that people have a better understanding of their illness and its treatment. Psychoeducation is usually given in short-term (i.e., 5 to 10 sessions) group format.

Cognitive-Behavioural Therapy (CBT) and Interpersonal Therapy (IPT) are both short-term forms of psychotherapy that have been shown effective in the treatment of mood disorders, including depression and bipolar disorder.

In bipolar disorder, Cognitive-Behavioural Therapy uses psychoeducation and mood monitoring to help people identify triggers of mood episodes and develop a written relapse prevention plan.

Increasing activities in depression, reducing activities in mania, and correcting over-negative or over-positive thoughts are also strategies used in CBT. An adapted version of IPT, Interpersonal and Social Rhythm Therapy (IPSRT), has also been shown effective for bipolar disorder.

The main goals of IPSRT are to help people better deal with relational difficulties and learn how to maintain a stable and healthy daily routine in order to regulate important biological rhythms, such as sleep, that can trigger mood episodes like mania.

Family Therapy interventions, which have been found to be helpful in schizophrenia, have also been successfully adapted to bipolar disorder.

In Family Focused Therapy (FFT) patients and their families learn how to better understand bipolar disorder by getting information on the disorder and its treatment (psychoeducation) and learning communication and problem-solving skills in order to deal more effectively with the consequences of bipolar disorder.

Finally, social support is also very important for people with bipolar disorder and therefore joining local support groups for mood disorders may be helpful.

Where do I go for more information?

More information regarding bipolar disorder can be found on the following websites:

• the Mood Disorders Society of Canada (MDSC) at http://www.mooddisorderscanada.ca;
• the Depression and Bipolar Support Alliance (DBSA) at http://www.dbsalliance.org; or
• the Canadian Mental Health Association at http://www.cmha.ca.

You can consult with a registered psychologist to find out if psychological interventions might be of help to you. Provincial, territorial and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, go to http://www.cpa.ca/public/whatisapsychologist/PTassociations/.

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Martin D. Provencher. Dr. Provencher is a Registered Clinical Psychologist in the Province of Québec and is Full Professor at L’École de psychologie de l’Université Laval in Québec City. His primary interests include Cognitive-Behavioural Therapy, mood and anxiety disorders, Bipolar Disorder and Generalized Anxiety Disorder.

Revised: June 2019

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

 

Parents play the most important role in children’s development

Psychological research and practice show us that parents are the most important influence on their children.  As rewarding as it can be to be a parent, it can also be a difficult job at times.  To be a good parent takes knowledge, a great deal of practice, a lot of flexibility and openness to keep learning. Just as our children grow and learn so must our parenting. Whether parenting with a partner, in one or two homes, or as a single parent, parents need support from family, friends, and their community. Parenting some children poses additional challenges that can tax the patience and the skills of even the most devoted parent.

Two basic ingredients – love and structure

The formula is simple: children need both love and structure to grow and thrive.  Putting this into practice is not always easy.  A loving relationship is essential for children to develop confidence and self-esteem. Parents show love in different ways according to their personal style and cultural background. Love is shown by smiles, hugs, compliments, interest in the child and by being available to spend time with them.

Regular time devoted entirely to the child (without distraction from phones, TV, or the computer) is the foundation of a good relationship. It also helps children to learn that they can turn to their parents when they are troubled. As children reach adolescence they still need special time with parents, but it may look different from when they were younger. Without a warm and loving relationship with their parents, children and youth are at risk for low self-esteem and lack of confidence. They may try to find other, more negative ways to get attention and to feel good about themselves such as, acting-out, risky behaviour to impress their peers, or using drugs and alcohol.

A loving relationship is necessary, but is not enough to ensure healthy development. Children also need structure, consistency and an appropriate level of monitoring. From an early age, children benefit from routines that help them know what to expect each day. Parents show children the limits of acceptable behaviour by setting clear rules and expectations. Parents help children to learn that their actions have consequences. By noticing and commenting on appropriate behaviour, parents strengthen good habits.

Physical punishment, yelling and humiliation hurt children. There are other and much more effective ways to address child’s misbehaviour.  When parents routinely attend to the child’s behaviour they want to encourage, mild logical consequences (such as temporary loss of privileges) or brief time-outs are effective alternatives to physical punishment and yelling. By using suitable positive and negative consequences parents can help their children learn to set their own limits and make good choices. Without structure, children may have difficulty learning self-control and the ability to follow rules independently.

Parents should never underestimate how much children learn from watching their behaviour.  We can provide an example of either positive or negative behaviours to our children. Through our own behaviour we can teach problem solving, impulse control, the healthy expression of feelings (both positive and negative), patience and tolerance.  Of course we have to be just as aware of how we may teach them poor coping skills, substance misuse, violent or bullying behaviour, or unhealthy ways of engaging in conflict. Parents are teachers in everyday life and this is a huge responsibility as the impact that we have is tremendous.

Always the same, but constantly changing…

Children of all ages need love and structure. As children get older, parents need to change the ways they show love and provide guidance. A baby thrives on rocking, broad smiles, and singing. A teenager is likely to feel cared for by a parent who is a good listener while driving to an activity. In helping a toddler to learn that it is not acceptable to pull the cat’s tail, the parent may say “No” firmly and provide guidance on how to stroke the cat gently. Because teenagers need to develop responsibility and the ability to make healthy independent decisions, parents should negotiate with them about issues such as curfews and appropriate dress. Parents have to learn when to step back.  So for example, they might give choice to a young teenager over hairstyle, which is a temporary outcome, but be firm when it comes to tattoos which have more long term outcomes.  Successful parents promote growing independence in their children and help them to make good decisions.  At times that means that we have to allow enough space for our children to make mistakes so that they can learn from these situations as well and become more resilient to future challenges.

Parenting can be especially tough at times…

Adults may find parenting especially challenging when they are having a hard time making ends meet, feeling stressed at work, dealing with separation or divorce, or when a child or adult in the family suffers from a mental or physical illness. Children present a variety of challenges depending on their temperament, developmental level, learning style and cognitive abilities.

There are supports to help parents as they strive to help their kids. Sometimes these supports focus on fine tuning a parent’s skills to address specific situations or difficulties that their child might be experiencing.  Sometimes parents can benefit from more formalized supports.  Parents of children with, for example, mood, anxiety, acting-out or learning disorders are likely to benefit from evidence-based psychological services.

How can psychology help?

Research has helped psychologists to learn about parenting that works and to develop a range of services for families. Parent support provides information about normal child and adolescent development as well as problem behaviours. It helps parents use positive approaches to parenting that help the child to learn and develop. Parent support is offered face-to-face, via workbooks, and on-line to groups, couples, and  individuals, to help parents learn and practice strategies that research has shown to be effective in promoting positive relationships and in reducing misbehaviour.

Parents learn how to notice and pay attention to behaviour they want to encourage, how to set clear routines and expectations, and how to effectively deal with problem behaviour. Parent support is most effective when parents have opportunities to observe and practice the techniques they are learning. Following this type of parent support, parents increase their use of positive strategies and the majority of children show significant improvements in their behaviour, both in the short and long term.

Parents can also notice signs and symptoms that suggest there is a problem. It is ideal to address problems early on, before they become much harder to handle.

Parents who have their own problems such as feeling depressed, anxious, or in an unhappy relationship, may require help with their own problems as well as getting parenting support. Cognitive-behavioural therapy is effective in helping parents deal with their own problems such as depression, anxiety, chronic pain, or marital distress.

Cognitive-behavioural therapy is effective in improving communication, anger management, and problem solving in the family.

Where do I go for more information?

For more information visit:

The Incredible Years – Parents & Teachers. A series of interlocking evidence-based programs for parents, children, and teachers, supported by over 30 years of research:  www.incredibleyears.com

Triple P Parenting. Positive Parenting Program works for toddlers and teens. Get parenting tips and classes in Canada; face-to-face or online: www.triplep-parenting.ca

 You can consult with a registered psychologist to find out if psychological interventions might be of help to you. Provincial, territorial and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, click https://cpa.ca/public/whatisapsychologist/PTassociations/.

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Catherine M. Lee, Professor Emerita, School of Psychology, University of Ottawa who is also a consultant with Triple P Canada. 

 

Revised: June 2019

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

 

What Is Diabetes and How Prevalent Is It?

Diabetes is a well-understood disease in which the body either cannot produce insulin or cannot properly use the insulin it produces. Type 1 diabetes occurs when the pancreas is unable to produce insulin, whereas Type 2 diabetes occurs when the pancreas does not produce enough insulin or the body cannot use the insulin it produces effectively. Most Canadians with diabetes have Type 2 diabetes (90%), which is strongly associated with obesity, inactivity, and unhealthy eating patterns and aging.

According to Diabetes Canada, approximately 10% of Canadians currently live with Type 1 or Type 2 diabetes, with the prediction that this will rise to 12% by 2034.[1] The estimated total cost to the healthcare system in 2024 was $18.25 billion, with out-of-pocket expenses of up to 12% of family income for those with Type 1 diabetes and up to 7% of family income for those with Type 2 diabetes. The 2025 International Diabetes Federation Atlas estimates that 589 million adults currently live with diabetes world-wide (~11%), with this number expected to increase to 853 million by 2050.[2]

Prediabetes is a diagnostic category, which, although not Type 2 diabetes per se, reflects the beginning of insulin resistance and is associated with metabolic risk (especially macrovascular risks). Evidence suggests that taking action early, especially health behaviour change, can delay the onset of Type 2 diabetes.

How Is Diabetes Treated?

Many people think that diabetes treatment is very straightforward once the right amount of medication or insulin has been determined. Unfortunately, management is much more complicated. Successful management rests on the person actively engaging in self-management and prioritizing diabetes tasks over other life tasks. Important psychological milestones associated with successful self-management include disease acceptance, treatment acceptance, and readiness for self-management. Psychological intervention can aid in helping people with diabetes achieve these outcomes.

The treatment of diabetes rests on following a daily routine of medication or insulin usage, self-monitoring blood glucose levels (either by self-testing using a lancet or using a continuous glucose monitoring device), and adhering to healthy eating and activity guidelines. All of these tasks must be performed multiple times per day in a highly coordinated fashion. Diabetes is a disease that is managed primarily by a complicated regime of self-care behaviour. It has been estimated that adhering to all of the behavioural requirements of self-management would require over an hour a day for Type 2 diabetes and more than 1.5 hours per day for Type 1 diabetes.

Diabetes self-management is difficult for several reasons:

1. The demands of diabetes self-management can be overwhelming. Ideally, when people learn new and complicated routines, they try out new behaviours in a gradual way, eventually making them part of the new routine. Yet, with diabetes, the individual must quickly learn a large number of new behaviours and they must begin performing them all immediately and at once (e.g., the newly diagnosed individual is instructed in self-testing, dietary modifications, medication/insulin usage, and exercise at a minimum).
2. Diabetes self-care is complex involving the multiple impacts of several factors that work in opposite directions. For example, activity, insulin, and the passage of time lower blood glucose, whereas food and stress elevate blood glucose.
3. A principle of successful behaviour management is the opportunity to take breaks or “time out” from difficult tasks. However, with diabetes self-management, there are no weekends off, no vacations, and no retirement. The demands of diabetes self-care are constant.
4. Diabetes management can be frustrating because effort does not always produce predictable results. There are times when individuals do all that they are asked and still their control is not what they expect.

While most people with diabetes will live with it for life, for those with Type 2 diabetes, it may be possible to achieve remission. Diabetes remission is a term recently introduced to describe a person with Type 2 diabetes who, primarily through significant weight loss (~15% of body weight), can maintain normal glycemic levels without the need for medication. Adherence to healthy behaviours appears key to the maintenance of diabetes remission for those who can achieve it.

What Are the Psychological Implications of Living with Diabetes?

There are a number of psychological aspects of living with diabetes that interfere with function, health, and quality of life.

Diabetes distress is a recently validated construct that refers to distress associated with the emotional burden of diabetes, the regimen of diabetes self-management, the social stigma associated with diabetes, as well as interpersonal distress associated with relationships with family and friends and relationships with healthcare providers. There are a series of validated diabetes distress instruments, which can be self-administered, scored, and interpreted by accessing www.diabetesdistress.org.

Other important psychological consequences of living with diabetes include fear of hypoglycemia and, for those with Type 2 diabetes, psychological insulin resistance (negative attitudes toward the use of insulin when insulin is required due to beta cell insufficiency). Moreover, those living with diabetes may be more likely to develop an eating disorder than those not living with diabetes. One specific eating disorder associated with Type 1 diabetes is called Type 1 Disordered Eating (T1DE), which involves withholding insulin for the purpose of losing weight.

Diabetes-specific psychological issues interfere with health and quality of life and can be associated with the development of depressive or anxiety disorders.

What Can Psychologists Do to Help People with Diabetes?

Diabetes presents a significant challenge and stress for people with diabetes and those who support them. Psychologists can play a valuable role in helping people live well with diabetes (see here for a recently published report on the roles and competencies of the clinical psychologist in diabetes care).

Psychologists are well trained in emotion management and behaviour change interventions. The Clinical Practice Guidelines from Diabetes Canada recommend psychological screening and support for all individuals living with diabetes. Psychologists work with individuals with diabetes and/or their loved ones in several ways:

1. They can help the newly diagnosed individual to understand the impact of this diagnosis and their role in managing it.
2. They can problem solve to help the individual learn the daily behaviours needed for successful maintenance.
3. They can recognize and treat psychological distress including depression and anxiety that may develop when living with an unpredictable disease.
4. They can help in assisting the individual to develop and maintain the motivation needed to follow the daily routine of self-care.
5. They can provide strategies for how to deal with social pressures (e.g., regarding food/drink choices, exercise) that don’t align with the individual’s self-management routine.

Where Can I Go For More Information?

The following websites provide useful information on diabetes and self-care:

• Diabetes Canada athttp://www.diabetes.ca
• American Diabetes Association athttp://www.diabetes.org
• International Diabetes Federation at https://www.idf.org/

Breakthrough T1D (formerly the Juvenile Diabetes Research Foundation) and Diabetes Canada have launched a diabetes-specific training program to educate Canadian mental health providers in diabetes, with the view hope of increasing access to trained mental health providers. A directory of graduates of this training program is being created to improve referral options for those seeking psychological support for diabetes management (https://directory.jdrf.ca)

You can consult with a registered psychologist to find out if psychological interventions might be of help to you. Provincial, territorial, and some municipal associations of psychology may make available a referral list of practicing psychologists that can be searched for appropriate services. For the names and coordinates of provincial and territorial associations of psychology, go to  https://cpa.ca/public/whatisapsychologist/PTassociations/.

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Michael Vallis, Associate Professor, Family Medicine, Dalhousie University.

Revised: August 2025

Your opinion matters! Please contact us with any questions or comments about any of the PSYCHOLOGY WORKS Fact Sheets:  factsheets@cpa.ca

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[1] https://www.diabetes.ca/getmedia/9c717b08-e53e-47c4-a522-c0937ce0861b/2024-Backgrounder-Canada-EN_FINAL_1.pdf

[2] https://diabetesatlas.org/data-by-location/global/

The Psychological Consequences of Cancer in Adults

Having cancer can be a distressing and stressful experience for patients and their family members, and can lead to a variety of psychosocial difficulties. While there are many different types of cancer – over 200 – each with its own particularities, there are some similarities in their psychological consequences. For example, most cancer patients report some symptoms of anxiety (e.g., fear of recurrence and of dying) and/or depression to varying degrees. Cancer and its treatment can also produce other symptoms with a strong psychological component such as insomnia, fatigue, pain, sexual difficulties, trouble concentrating, and memory problems. Body-altering cancer treatments (like mastectomy, oral facial surgery) can also lead to problems of self-esteem and body image.

Cancer-related Factors that Increase the Risk of Psychological Distress

The Canadian Association of Psychosocial Oncology (CAPO), along with many other countries throughout the world, has endorsed ‘psychological distress’ as the ‘Sixth Vital Sign’ to be assessed at crucial times of the cancer care trajectory with every patient.  Numerous factors can contribute to the risk of psychological distress, such as:

• Receiving a cancer diagnosis at a young age is more likely to interfere with life projects (family, career) and can bring with it psychological difficulties. In addition, young people are often parents and have children to take care of, which may be more difficult when they are ill. Cancer treatment administered at a younger age can also result in premature menopause and infertility and have a negative impact on one’s sense of femininity and masculinity, which can be very distressful.
• Cancer affects men and women differently. Studies have shown higher rates of psychological distress (including symptoms of depression and anxiety) in women with cancer. Research also suggests that men tend to show their psychological distress differently with more irritability, low sexual interest, extra devotion to work, and substance abuse. It also appears to be harder for men to reveal their distress and ask for help.
• People who have suffered from a past psychological disorder are at a greater risk of experiencing psychological distress in reaction to cancer.
• A more advanced cancer at diagnosis and having experienced a cancer recurrence have been found to be associated with greater psychological distress, a greater fear of cancer recurrence and lower quality of life.
• Cancer treatments have many side effects that may increase psychological difficulties. For example, treatment-induced menopause (or “andropause” in men) is a side effect that may impact mood, sleep, sexual functioning, concentration, and memory. Fatigue is another undesirable effect of cancer treatment that has been shown to be associated with increased psychological disturbances and impaired quality of life. Pain is another distressful symptom that may due to the cancer itself but also to its treatment. Following cancer treatment (e.g., chemotherapy), individuals often report having cognitive difficulties. While most cognitive impairments are short term, some remain long-term and can affect one’s ability to work at the same level as prior to treatment for cancer.
• The quantity and quality of social support (practical help, emotional support, information) from the people in one’s circle may be affected by cancer. Some close friends or relatives may be uncomfortable with the disease and keep their distance. Others may become closer. It is easier to live with cancer with an adequate social support.
• “Passive” coping strategies such as behavioural avoidance (e.g., not reading about cancer, not asking questions to your oncologist about the illness) and cognitive avoidance (e.g., trying not to think about cancer) have been shown to be less effective coping strategies. It is often better to confront reality, even if this is harder to do at first.

Does Stress Cause Cancer? Do You Need to Keep a Positive Attitude to be Cured?

Some people believe that stress or other psychological factors (like past traumas, grief, depression) may have caused their cancer. Although this belief is very common, numerous studies have looked at this and have not established a link between stress and the onset or progression of cancer. Cancer is a very complex disease. It has many causes, including certain genes, hormones, viruses, behaviours (e.g., smoking, sedentary lifestyle, exposure to sunlight) and environmental factors (e.g., asbestos). Cancer arises from a combination of these factors that vary from person to person.

Another widely held belief is that a person’s attitude plays a determining role in recovery and that a positive attitude and fighting spirit will give a better chance of being cured. Once again, there is no scientific evidence for this idea in the literature.

Why is it important to change these beliefs? Because studies have shown that they increase the risk of psychological distress associated with cancer. More precisely, blaming yourself for your cancer (for example, believing you got cancer because you have been unable to cope with your stress) is associated with more psychological symptoms like depression and anxiety. Similarly, the belief that a cure will depend on your mental attitude can be very detrimental because it’s impossible to be positive all the time when you’re suffering from a disease like cancer. As soon as a negative feeling arises, which is completely normal even in the absence of cancer, it brings with it a strong sense of guilt (“it will be my fault if my cancer returns, I’m too stressed”) which may lead to a sense of hopelessness and symptoms of depression and anxiety. On the other hand, if you have too many negative thoughts, leading to persistent feelings of depression, anxiety, guilt and anger, there are effective strategies to reduce their impact. This may not affect your longevity, but will clearly improve your quality of life.

What Kinds of Interventions Can Help People with Cancer?

Anyone with cancer may experience some psychological distress, but not all need professional help. If your worries, sadness or other difficulties are severe or are affecting your daily functioning and quality of life, speaking with a psychosocial counsellor such as a psychologist is a good idea.

A number of psychological treatments have been shown to be effective in the treatment of cancer-related distress, depression, and anxiety. Cancer centres throughout Canada all have counselling services for cancer patients and their family members and can either provide specific interventions and/or have information on how best to access specific services locally. For example:

• Psychotherapy is an intervention that allows an individual, a family, a couple, or a group to talk openly and confidentially about their concerns and feelings with a trained professional. The question as to whether psychotherapy is best when used alone or in combination with an anti-depressant/anti-anxiety medication depends on the problem and its severity. Examples of specific psychotherapeutic interventions include cognitive-behavioural therapy (CBT) and mindfulness-based interventions.
  • The efficacy of CBT in helping people cope with cancer is well established. If you choose this type of psychological intervention you will learn how to modify certain behaviours. For example, if you have reduced your activities, a behaviour that increases the likelihood of depression, you will be encouraged to reintroduce pleasant and energizing activities into your daily schedule. Also, if you have a tendency to have negative thoughts, cognitive strategies will help you question and change them into more realistic interpretations. For example, if you are worried about your cancer returning and dying from it, you will learn to look at the real chances of something like that actually happening and to better live with this uncertainty.
  • Although the efficacy of mindfulness-based interventions has been less studied in the context of cancer, they can be very beneficial. If you opt for this approach you will learn how to concentrate on the present moment and to be more accepting of your negative emotions. Mindfulness-based interventions have gained in popularity and are often offered in cancer centers. There are also several smartphone apps available.
• New and emerging strategies for therapy and self-management such as professionally facilitated on-line support groups (e.g., CancerChatCanada; https://cancerchat.desouzainstitute.com ) and telemedicine-facilitated counselling via videoconferencing  (e.g., Skype, Facetime) from you home with a trained psychosocial oncology counsellor are becoming more and more available.
• Support groups allow you to share your experience with other people living with the disease and can help you to feel less alone. You can contact the Canadian Cancer Society (www.cancer.ca) to learn about the services they can provide and the support resources offered in your community.
• Anti-depressants and anti-anxiety medications are often prescribed to patients with cancer to reduce their psychological distress, help them sleep better, and to reduce some of cancer treatments’ side effects (e.g., antidepressants for hot flashes), especially when these problems are severe. All medications have side effects. If the side effects that you experience are too disturbing or if you prefer not to take a medication, talk to your doctor about effective alternatives. It is often more effective to combine medication with psychotherapy.
• Physical exercise is particularly effective in reducing the fatigue associated with cancer and can have beneficial effects on many other symptoms like anxiety, depression and insomnia, although it isn’t generally sufficient to treat severe psychological disturbances. It’s important to start gradually and, ideally, to seek the services of a professional (e.g., kinesiologist) who can help you prepare a personalized program, make sure that exercise is safe for you, and follow you in your training.
• Wellness interventions such as yoga and relaxation favor well-being and the release of tension. More general interventions like these can produce positive effects but they are rarely enough to treat severe psychological distress.
• Consulting a couple or a sex therapist can be very helpful to better cope with the effects of cancer and its treatment on the quality of your conjugal relationship and your sexual functioning.

Where can I get more information?

• Canadian Cancer Society; cancer.ca
• Savard, J. (2010). Faire face au cancer avec la pensée réaliste. Montréal : Flammarion Québec.

 

You can consult with a registered psychologist to find out if psychological interventions might be of help to you. Provincial, territorial, and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, please visit:  http://www.cpa.ca/public/whatisapsychologist/PTassociations

This fact sheet has been prepared for Canadian Psychological Association by Dr. Josée Savard, School of Psychology, Université Laval, CHU de Québec-Université Laval Research Center and Université Laval Cancer Research Center.

The author and the CPA would like to thank Dr. Scott Sellick, Thunder Bay Regional Health Sciences Centre for his assistance during the development of the first version of this fact sheet.

Revised: June 2019

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657