The wrong medicine

By Aaron Wherry - Monday, September 26, 2011 at 9:46 AM - 4 Comments

Douglas Porter quibbles with the Prime Minister’s prescription for economic woe.

“We could be making some of the same mistakes. Certainly, there are echoes of 1937,” agreed Douglas Porter, deputy chief economist at the Bank of Montreal. Last week, Prime Minister Stephen Harper and British Prime Minister formed an unusual alliance of debt hawks, coming down firmly on the side of stricter austerity as the way out of the crisis – at least in Europe … 

Mr. Porter said Mr. Harper’s call for global austerity is “precisely the wrong medicine at this time.” Government bond yields in Canada, and in most other countries, have sunk to multi-year lows in recent days. That’s a sign that financial markets are stressed about economic growth prospects, not government deficits or inflation, according to Mr. Porter. “Governments shouldn’t be aggressively cutting spending when the economy is gasping for air,” he said. “That’s certainly the wrong prescription.”

Is America in a depression?

By Jason Kirby - Wednesday, September 21, 2011 at 6:20 AM - 12 Comments

Shannon Stapleton/Reuters

Everywhere Darren Enns looks these days he sees the devastation wrought by America’s grinding employment crisis. As the treasurer of a construction union in southern Nevada, the state with the highest unemployment in the country, Enns has watched as friends and colleagues—the bricklayers, electricians and drywallers who thrived during Las Vegas’s housing boom—struggle to move on to other careers. Few succeed. Many have simply given up hope. “When you look at the unemployment rate during the Great Depression, we’re beyond that in the construction industry here in Las Vegas,” he says. “We’ve got close to 70 per cent unemployment, so for us, the economy is extremely depressed.”

When the financial crisis tipped America into a deep recession in 2007, it was tempting to draw comparisons to the Great Depression of the 1930s. Those fears subsided once the stock market pulled out of its nosedive and America’s economy began to grow again, albeit at a crawl. It was a brief respite. Four years later, American towns and cities remain overrun with millions of unemployed workers even as the economy risks slipping back into reverse. It raises the question whether the U.S. ever really emerged from recession in the first place. Instead, some are suggesting those early fears may have been justified after all: the United States appears to be in the throes of an outright jobs depression.

Earlier this month, Robert Reich, a professor of public policy at Berkeley and the secretary of labour in the Clinton administration, said the current crisis is an extension of the “depression” that began in December 2007. Meanwhile, Richard Posner, a high-profile judge in the United States Seventh Circuit Court of Appeals and regular political and economic commentator, said it’s time for America to give up any false hopes that the economy is on a path to recovery. “If we were being honest with ourselves, we would call this a depression,” he wrote in the New Republic. “That would certainly better convey both the severity of our problems, and the fact that those problems have no evident solutions.”

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Why it’s time to retire the enforcer

By Emma Teitel - Monday, September 12, 2011 at 10:15 AM - 6 Comments

Jeff McIntosh/CP

Imagine a job has become available at the office of your dreams. The description is straightforward: all you have to do is pick a fight every day with someone you’re not angry at and you don’t necessarily dislike. You make a fraction of what your co-workers make and every fourth day or so you incur an injury that could culminate in a degenerative brain disease conducive to depression—or worse. But there’s a perk: you get to work in the office.

Meet the NHL enforcer—an unpopular position of late, and the subject of innumerable Canadian media debates following the “apparent suicides” or “accidental deaths” of hockey tough guys Derek Boogaard, Rick Rypien and, most recently, 35-year-old Wade Belak. New York Ranger Derek Boogaard was just shy of his 29th birthday when a lethal mix of alcohol and oxycodone took his life in May. Winnipeg Jet Rick Rypien, 27, was found dead in his Alberta home in August, after more than 10 years of battling depression. Wade Belak, retired enforcer and father of two, apparently committed suicide in a Toronto hotel/condominium on Aug. 31.

The majority of people in sports, from broadcasters to bloggers and NHL players themselves, are loath to concede a connection linking the deaths. Any three people in any profession, they argue, could have ended their lives within a few months of one another for reasons unrelated to their line of work. As usual, they contend, the media’s impulse to equate hockey violence with depression is sensational journalism at its worst.

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Wade Belak’s final hours

By Charlie Gillis - Friday, September 9, 2011 at 10:00 AM - 17 Comments

Glenn James/NHLI/Getty Images

In broadcasting, as in hockey, reliability ranks high on the list of professional virtues. Dead air or squandered studio time are radio sins on par with an empty dressing-room stall before practice. The responsible party can expect retribution and, if he keeps it up, a ticket to the bush leagues.

Some athletes-cum-commentators take a while to grasp that, so the text Wade Belak sent Jeremy Bennefield last Tuesday night came as reassurance to the Nashville radio producer, who had been tasked with grooming the former NHL tough guy to host a weekly show on an all-sports FM station. “I’ll be there on Friday night,” wrote Belak, who was in Toronto at the time. “Staying until Sunday. Any way we can tape a show in that time slot?” The time signature on the message read 11:29 p.m. ET. Bennefield didn’t pick it up until 9:15 a.m. the following day, and he made sure to fire off a quick reply: “Yes, we’ll make it work.”

Three hours later, Belak was found hanging in his hotel room in downtown Toronto, the victim of an apparent suicide (though authorities have not confirmed the cause of death). And Bennefield has been pondering that text exchange ever since.“Somebody actually asked me whether I thought this was a reach-out,” he says from Nashville. “You know: whether Wade was seeking some sort of reassurance that he had something to live for.” But that doesn’t square with the man he had seen at a taping just days earlier, ribbing staff at 102.5 The Game, cracking jokes at his own expense. While recording the inaugural episode of his weekly show and podcast “The Game Changer,” the 35-year-old had enthused about setting down roots in Nashville, where he’d just wound down his playing career. “Based on my conversations with him, based on the texts that I got hours before the fact,” he says, “my impression is this wasn’t a guy looking for a way out.”

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Can hitting the gym cure the blues?

By Julia Belluz - Wednesday, September 7, 2011 at 5:26 PM - 5 Comments

Meredith Farmer/Flickr

The Statement: “On antidepressants but still in a funk? Try hitting the gym. [A new study] has found that exercise is just as good as a second antidepressant in conquering the blues.”—Toronto Star, 08/25/2011

Our collective bafflement at the tragic deaths of NHL players Wade Belak and Rick Rypien, whom both reportedly committed suicide recently, and Derek Boogaard, who accidentally overdosed on booze and painkillers in May, had Science-ish wondering about the link between depression and sports. As the Globe and Mail’s André Picard penned rhetorically, “Surely a trio of tough guys dying at their own hand in a short period can’t be a coincidence, right?”

Indeed, the notion that athletes in peak physical condition could succumb to what Winston Churchill used to call the black dog doesn’t square with what we thought we knew. Besides the fact that jocks (unlike artists) aren’t typically associated with depression, the well-documented health benefits of playing sports don’t seem to align with the blues. There are the mood-boosting physiological effects of working out—it raises endorphin levels and reduces the stress hormone cortisol. There are intangible benefits, too: the increased self-esteem that comes with feeling and looking fit. Being athletic in our society is virtuous, and some have even linked too little physical activity to depressive moods.

So it seems easy to believe that exercise would inhibit depression.

Those who have wrestled the black dog may have been interested in the news stories last week about a new study that supposedly found the “treadmill can act as second antidepressant,” as the Toronto Star put it. That a jog could help treat depression—with fewer side-effects and costs than blockbuster antidepressants—sounded immediately appealing, especially when considering people tend to have poor adherence to antidepressants (the dropout rate within the first weeks of treatment can run as high as 40%), and even when they stick to their treatment, they often just don’t feel better. (A 2003 Cochrane review found only marginal differences between antidepressant medications and active placebos.)

Naturally, Science-ish was inclined to look at the evidence behind physical activity as a treatment for depression. The most recent Cochrane systematic review on the subject—”Exercise for depression“—examined randomized controlled trials in which exercise was compared to standard treatment, no treatment, or a placebo in adults with depression. Exercise, the investigators concluded, seemed to improve depressive symptoms in people—but the effects were statistically insignificant when only methodologically robust trials were considered.

The lead author on the study, Dr. Gillian Mead of the University of Edinburgh, told Science-ish, “There was also uncertainty about the optimum exercise prescription, which individual patients might benefit, how best to motivate people with depression to start to exercise, and how to optimize adherence.”

Dr. James Blumenthal (PhD), a leading researcher on exercise and depression at Duke University, weighed in, too. He has found that, while promising, there is no definitive link between exercise and depression. “Data are more limited in children, and most studies of adults have focused on aerobic exercise. But there is some—albeit limited—data supporting the potential value of anaerobic strength training,” he noted. Though, again, the exact dose of exercise needed to boost low moods is not yet known. (Duke research suggests 30 minutes three times each week for 16 weeks may be adequate).

As for the recent headline-grabbing study, “Exercise as an augmentation treatment for nonremitted major depressive disorder,” the researchers looked at people who had not responded to antidepressants, and split them into two groups: one went on a gentle exercise regime (walking ten minutes per day, for example) and the other took more vigorous aerobic exercise (a jog on the treadmill). All participants remained on antidepressants; but exercise—not another drug—was their co-treatment.

After the four-month trial, more people on the higher ‘dose’ of exercise experienced remission of symptoms than the gentle exercisers, but more of those on the brisk routine dropped out of the trial. Dr. Mead observed, “The difference between the two doses of exercise was not statistically significant. So while these data are not inconsistent with the literature that suggests that exercise is of benefit for depression, further research is still needed to answer important questions about how effective exercise might be.”

Still, in her systematic review, Dr. Mead and her co-authors did suggest physicians consider prescribing exercise for depressed patients. “It would be reasonable for doctors to give them the same advice that they would give healthy people about the long-term benefits of exercise. And also say that exercise may have short-term beneficial effects on mood,” she said. “As you know, there is a vast, robust literature on the benefits of exercise in the general population.”

So will we see doctors prescribe exercise for depression anytime soon? “Possibly,” said Dr. Blumenthal, “especially physicians who feel comfortable recommending exercise for their patients. However, if physicians don’t normally prescribe exercise—and many don’t—they will likely continue to prescribe what they usually do: antidepressants.”

Science-ish is a joint project of Maclean’s, The Medical Post, and the McMaster Health Forum. Julia Belluz is the associate editor at The Medical Post. Got a tip? Seen something that’s Science-ish? Message her at julia.belluz@medicalpost.rogers.com or on Twitter @juliaoftoronto

Women with depression at increased risk of stroke

By macleans.ca - Friday, August 12, 2011 at 2:20 PM - 0 Comments

Women with a history of depression have a 29 per cent increased risk of suffering a stroke, according to a report in the BBC. The new study looked at over 80,000 women aged 54 to 79, and found that depressed women were more likely to be single, smokers, and less physically active, as well as being slightly younger with a higher body mass index. They also suffered from conditions like high blood pressure, heart disease and diabetes. Depression seems to stop some women from curbing other medical problems, taking their medications and following a healthy lifestyle, they said.

BBC News

People who hate long weekends

By Rebecca Eckler - Thursday, July 28, 2011 at 3:55 PM - 30 Comments

Getty Images; Photo Illustration by Lauren Cattermole

Though the condition isn’t in any medical book, it could unofficially be called the “Long Weekend Blues,” or, perhaps, LWAD (Long Weekend Affective Disorder). Many people, it turns out, do not look forward to long weekends. In fact, they dread them.

As a 37-year-old Vancouver lawyer says, “Every long weekend feels to me like everyone else has big, unusual fun plans. I dread it. It’s a reminder that my life is a little slow or empty or something. The last long weekend, there was a truck of people dressed up with brass instruments having the time of their lives. As I watched them drive by, I was like, ‘Where are all you people going and how come I don’t know about it?’ It just feels like a long weekend is one big party I had no idea about.”

Another woman, 41, from Toronto, says long weekends depress her because she ends up doing chores; she also feels like she’s missing out on some sort of party, which makes her feel lonely. “I just try and get ahead for the week, making my lunches, doing groceries, going to the dry cleaner. Long weekends aren’t attached to anything meaningful except maybe some dead queen.” Still, she jokes, “They should call it ‘No Suicide Long Weekends.’ ” She adds, “I get really sad because my daughter is all grown up and isn’t around and all my friends seem to go visit their families. One of my friends said, ‘We’re going to visit my in-laws so my husband can fix their roof.’ They weren’t looking forward to it, but on my end I thought, ‘That’s nice that you have something to do.’ Not that I would want to fix their roof either. But what was I going to do? Buy another book?”

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Male depression expected to increase, experts say

By macleans.ca - Tuesday, March 1, 2011 at 1:57 PM - 37 Comments

The number of men with depression is expected to rise due to large-scale changes in Western society, the BBC reports. According to an article in the British Journal of Psychiatry, economic and social changes are quickly destroying traditional sources of male self-esteem, and men are expected to struggle with the shift away from traditional gender roles. The men’s health forum said male identity is closely connected to employment. Traditionally “male” jobs like manufacturing and pysical labour are disappearing, and as women are now more likely to go to university, the number of households where the main breadwinner is expected to rise. “Women are almost twice as likely to develop major depressive disorder in their lifetime as men, but we believe this difference may well change in the coming decades,” said one of the authors, Dr. Boadie Dunlop of the Emory University School of Medicine.

BBC News

High anxiety

By Julia Belluz - Thursday, November 18, 2010 at 11:40 AM - 0 Comments

Ting Hoo/Getty Images

By the time Victoria Ciciretto left her family’s home in Kleinburg, Ont., to live and study at the University of Toronto, the 18-year-old was already a seasoned world traveller. “I’d gone away for a month in Europe for summer school in Grade 10,” she says. “I took a Grade 12 course in Greece,” she adds. “And the year before last, I studied English in England.”

Presumably, moving 40 km away from home would be easy, but instead the arts and science student was filled with anxiety. “For my first week, I was like, ‘Oh my god, why would people say this is the most amazing time of your life?’ ”

She was nervous about living in a dorm, about classes and homework, about what major to choose and if she would make friends. There was a reason she could handle summers overseas, but was scared of university. “I had really good friends with me when I went travelling,” she says. “When I went to university, I didn’t know anybody.”

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Newsmakers

By macleans.ca - Friday, October 15, 2010 at 8:00 AM - 0 Comments

The prince gets down
Prince Charles, donning a red bindi, charmed locals with a charmingly poor dancing form while visiting the northern Indian city of Jodhpur during India’s Commonwealth Games. After some cajoling, he began to follow the movements of the elderly farmers, and began to smile as he twirled about.

And long may you run
Omemee, Ont., a wide spot on the highway between Lindsay and Peterborough, is the early childhood home of rock icon Neil Young. It’s also the site of Youngtown, a museum packed to the rafters with rock memorabilia of every sort, and a tribute to the Young family, including Neil’s late father, storied sportswriter and author Scott Young. Last week Neil and his older brother, Bob, visited the museum for the first time since it opened in 2008. “The hour-long visit was simply an awesome experience for this writer,” museum founder and collector in chief, Trevor Hosier, wrote on Youngtown’s Facebook page, “and I’m glad to report that we passed the audition.”

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Working ourselves sick

By Kate Lunau - Thursday, May 6, 2010 at 8:00 AM - 12 Comments

Getty Images

Dr. Diana Fernandez, an epidemiologist at the University of Rochester Medical Center, spent two years studying what she calls a “typical American workplace” and its health effects on employees. Her findings were stark: pressures at work are linked to cardiovascular disease, depression, anxiety, and self-reported poor health, she noted in a recent study of one U.S. company, and chronic job stress is strongly associated with being overweight or obese. What some would call the company’s most important assets—its workers—were in very poor shape.

These employees didn’t lack the resources to eat well and exercise, her findings suggest; most were middle-aged, married, and highly educated, making more than $60,000 a year. They’d worked at the company an average of almost 22 years. Still, about three-quarters of the 2,782 subjects were overweight or obese. Job strain had a lot to do with it. “People didn’t want to be perceived as working less than others,” so they’d spend long hours at their desks, she says, eating up time that could be spent relaxing at home, or getting some exercise at the gym. In especially stressful times, they told her, they also turned to junk food. Anecdotally, “when the next round of layoffs came, the first thing that disappeared from the vending machine were the brownies,” she says. When employees got home, more than 65 per cent of them watched two hours or more of television a day.

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Science-reporting smell test of the week

By Colby Cosh - Tuesday, May 4, 2010 at 2:26 PM - 80 Comments

Here’s the lede of a science story from Saturday’s Winnipeg Free Press:

WINNIPEG — Depression and substance abuse plague about half of American women who reported having an abortion, according to a new University of Manitoba study.

The study, published in the current issue of the Canadian Journal of Psychology, suggests there’s an association between mental disorders and abortion…

Eager to investigate this shocking headline claim—the Edmonton Journal, picking up the story, literally gave it the headline “Depression or drug abuse found in half of women who aborted”—I set out to find the study. This presented something of a problem, since there has not been a “Canadian Journal of Psychology” since 1993. I spent a little while rifling through Canadian Psychology and the Canadian Journal of Experimental Psychology until a helpful reader on Twitter clued me in. Yes, you guessed it: it can be found in the Canadian Journal of Psychiatry. First place I should have looked, really.

That’s an understandable mistake. It’s a bit more of a problem that the first sentence of the article—an article that includes a warning from the lead author to the effect that it is “important the study is not misinterpreted”—is totally false. Because of, y’know, misinterpretation.

The paper, entitled “Associations Between Abortion, Mental Disorders, and Suicidal Behaviour in a Nationally Representative Sample”, does what it says on the tin: the data are taken from interviews with a demographically representative subset of the U.S.’s National Comorbidity Survey Replication project. It is hard to know what numbers the reporter added or multiplied or pulled out of a hat to reach the conclusion that “Depression and substance abuse plague about half of American women who reported having an abortion.” (I spoke to the lead author of the study, and she can’t figure it out either.) But a good guess would be that she looked at this section from the article’s main chart—

—and simply added together the estimated lifetime incidence of depression among women who had had an abortion (29.3%) and the lifetime incidence of substance-use disorders (24.6%). It will probably have occurred to you that there might be some overlap there between depression and substance abuse, which go together like poached eggs and hollandaise. You don’t need a Ph.D. to know that the depression group is likely to contain almost all of the women in the substance-abuse group.

And this naïve math (which is hardly attributable to a failure to grasp hyper-advanced statistics) is compounded by the wording of the offending sentence, which doesn’t say that “some percentage of abortion recipients have, at some point before or after getting an abortion, experienced depression or substance abuse or both.” It uses present tense, unjustifiably implying that all the women in question are plagued by both problems now.

This mess is already being picked up, “carelessly” garbled even further, and circulated around the globe by pro-lifers, despite the personal entreaties of the scientist who helped the newspaper with its reporting and the many, many methodological and interpretive caveats in the original study. This kind of thing is exactly why a lot of scientists hate talking to reporters. Nor does it make sincere research into therapeutic abortion any easier. The UM study can’t be used to attribute psychiatric morbidity to abortion, but it could be used by fair-minded pro-lifers (let’s assume for the sake of argument that there were some) to raise questions about abortion’s place in our society and argue for a research program.

Oh, I know: we’re a hundred years away from that kind of discussion being possible. But the inadvertent propagation of urban legends only pushes that day further into the future.

Depressed girls gone wild?

By Colby Cosh - Wednesday, November 25, 2009 at 2:39 AM - 38 Comments

I realize nobody has all that much interest in being strictly fair to insurance companies, but I’m sort of horrified by the way the Nathalie Blanchard story is being handled in the press and electronic media. The evidence for the notion that Ms. Blanchard lost her long-term disability benefits “over Facebook photos” appears to amount entirely to “She says she was told that’s what happened.” Now, she could be quite right. Manulife admits it does use Facebook to investigate disability claims, as anyone would expect them to do. Here’s a news flash for particularly naïve children and desert-dwelling stylites: an insurance company following up a suspicion of a false claim uses every kind of evidence it can scrape up. Its hirelings will quiz your neighbours, co-workers, and friends! They will rummage through your garbage! They will engage in photo and video surveillance! They’ll Google you until the cows come home!

In short, this is, like this spring’s “Craigslist killer” news story, a narrative to which the supposed cynosure of attention really has no special relevance. At all. It would be nice if news organizations could get together, run one last banner headline announcing that THE INTERNET EXISTS, and be done with these trumped-up technology angles for all time.

Anyway, since we don’t know what other evidence Manulife’s investigation turned up, and they are bound not to tell us, it seems inappropriate for the headlines and the secondary commentary on the story to take Blanchard’s version as the gospel. Which is exactly what everybody is doing, even though Manulife may have had a dozen other reasons for cancelling the claim.

I’m not suggesting, mind you, that they necessarily do. An insurer makes decisions like this with hypothetical litigation in mind. That’s not necessarily conducive to clear thinking: it’s conducive to thinking like a juror, which may well be the diametrical opposite. It would not be surprising if some excitable junior associate had been shown Blanchard’s Facebook pictures of fun in the sun and thought “Well, well, well. These will be awfully hard to for her to explain to a jury.” You would have to be an idiot to think that such pictures are, in themselves, good evidence that Blanchard is not depressed. And, unfortunately, the world is full of idiots.

The key question for an insurer, however, is not whether Blanchard has depression, but whether she is making bona fide efforts to return to her job. Her duty isn’t to stop being ill, but to do what she can to get as well as she can and start earning her paycheques again. There are plenty of seriously depressed people who still manage to drag their butts out of bed and punch the clock most days. Blanchard’s statements to the CBC leave me wondering a little about her self-understanding, and since thousands of bloggers and editors apparently have no trouble questioning Manulife’s credibility, I feel quite licensed to wonder.

She says, for instance, “that on her doctor’s advice, she tried to have fun, including nights out at her local bar with friends and short getaways to sun destinations, as a way to forget her problems.” I suppose that a physician treating depression would recommend, in a general way, that his patient should try to get exercise, seek pleasant new experiences, maintain strong social networks, etc., etc. On the other hand, I can’t see any doctor having a display of travel brochures on the wall of his office, or publishing a guide to Eastern Townships nightlife. Again, pictures of Blanchard at a bar cannot possibly demonstrate that she is not depressed. But they could show that she was defying a doctor’s advice concerning the safe use of psychiatric medication, or the consumption of alcohol itself, if she were at risk of co-morbidity from substance-abuse problems.

Blanchard also says, by the way, that she “doesn’t understand how Manulife accessed her photos because her Facebook profile is locked and only people she approves can look at what she posts.” I hope that since this interview, someone has taken her aside and gently explained the Sherlockian maxim that “when you have eliminated the impossible, whatever remains, however improbable, must be the truth.” In this case, the compelling conclusion is that somebody Blanchard trusted snitched on her to the insurer, perhaps in a spasm of dudgeon over her insurance-subsidized lifestyle. It happens. In fact, it was known to happen before there was such a thing as Facebook.

A family mystery

By Aaron Wherry - Tuesday, August 11, 2009 at 11:19 AM - 21 Comments

Last month, Lawrence Martin wrote about Stephen Harper’s grandfather and the possibility that Harris Harper had taken his own life. Harris Harper’s son now steps forward to dispute that version of events in a lengthy response.

On Monday, the police got a credible report that a person matching his description had spent Saturday night (and maybe even Sunday night) at the Saint John Salvation Army Hostel. Three or four weeks later, the police distributed missing-person flyers throughout Canada and the United States – I helped stuff the envelopes – and there were several reports of sightings but none could be verified. Another distribution of missing-person flyers was carried out the next year with the same results.

After a year, there was a petition filed with the courts to have him declared dead, but it was pointed out that at that time, there was more evidence suggesting he was still alive, possibly a victim of amnesia. This, however, was never proved nor disproved.

Leading economist warns of possible Depression

By Aaron Wherry - Tuesday, December 16, 2008 at 11:35 AM - 19 Comments

A few more points from the Prime Minister’s obviously satirical interview with ATV.

1. Asked if a Depression could be in the offing, the Prime Minister responded, “It could be.” This new projection comes three months to the day after he assured Canadians that if we were going to experience a Recession, “we probably would have had it by now” and just over two months after he told Canadians the stock market was rife with “great buying opportunities.”

Non-rhetorical question: Would you let this man manage your personal finances? Continue…

Doctors need medical attention too

By Cathy Gulli - Friday, December 5, 2008 at 6:30 PM - 4 Comments

Last spring we put together the popular “How healthy are you?” package. One of the most stunning trends we reported on showed that people under 25 have, by far, the highest rates of psychological problems compared to any other age group, according to data gathered by Scienta Health.

A new study in BMC Medical Education shows that med students are no exception. Researchers at ABC Regional Medical School in Brazil have found that 38 per cent of the 481 students they examined had at least 10 depressive symptoms. It was most dire among females.

Last week at the Canadian Family Physicians Forum in Toronto, experts from the College of Family Physicians of Canada spoke about the stress many medical residents face before they even start working. A report showed that more than a third of med students say their debt load after school will be over $80,000. Family docs, as it happens, earn 33 per cent less than other medical specialists. 

And then there are all the stresses of actually working in our overstretched medical system, which we wrote about last January.

So who’s taking care of our doctors?

Grey skies are gonna get even darker. Put on an angry scowl!

By selley - Thursday, November 20, 2008 at 2:17 PM - 4 Comments

Everybody hold hands
Fear not, Canada. As soon as we’re back in the black, our politicians will go back to hating each other.

“Glittering through [the] bleakness” of recession, deficit and abandoned election promises, the Toronto Star’s James Travers also espies Stephen Harper’s “commitment to suspend the politics of division in favour of partnership.” It’s nothing less than a “seismic shift,” he enthuses, as evidenced most compellingly by his recent meeting with the premiers. And with the opposition parties in no position to trigger another election, Travers expects a new, congenial tranquility to descend over Ottawa. We’ll all be living in abject penury, of course, but you can’t have everything.

The Globe and Mail’s Lawrence Martin believes yesterday’s Throne Speech arrived safely at the midway point between “timidity” and “rash action.” And, like Travers, he detects unusually low activity in the Prime Minister’s Van Loan lobe, the part of the brain that regulates hyper-partisan blather. “The economic crisis has focused his mind,” he suggests; “he is a more mature leader. … He understands the country better.” And as such, Martin believes he now “realizes the necessary response [to the crisis] is consensus-building at home and abroad.” However, as if sensing Canada’s collective skepticism, Martin hastens to add “it’s by no means certain” that this new conciliatory tone will take hold throughout Ottawa.

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The brain-gut connection

By Cathy Gulli - Thursday, November 6, 2008 at 12:00 AM - 10 Comments

In the coming year, a team of researchers from Canada and the U.S. will begin a study to determine the best way to treat the worst gut problems, including severe diarrhea, gas, bloating, nausea and “chronic constipation where you have excruciating cramps [that feel] like labour pain,” says Brenda Toner, a psychologist and co-head of social equity and health research at the Centre for Mental Health and Addiction, who is leading the investigation. But they won’t be looking at antacids, laxatives or enemas. The most effective remedies may be ones normally prescribed for mental illness: antidepressants or talk therapy, or both. “What I’ve been trying to do is put the mind and the body back together,” says Toner, who heads the women’s mental health department at the University of Toronto.

This surprising study is the latest research acknowledging the connection between anxiety or depression and gastrointestinal problems. “Most of us, when we’re under stress, respond with a GI symptom,” says Toner, up to 70 per cent of people, in fact. Think about how sick to your stomach you felt before that big meeting or when you were worried about someone you love. Gut discomfort is one of the biggest reasons people miss school or work, second only to the common cold. And for people whose pain is persistent, which is typical because many GI disorders are chronic, the psychological impact can be devastating. “The brain-gut interaction is a prominent one,” says Nicholas Diamant, a gastroenterologist and professor of medicine at the University of Toronto, who is working with Toner on the study. “There are a lot of things about gut symptoms that impact patients in a mental way,” he explains, which “will not only affect their mood but also their behaviours—whether they go to work or out to socialize.”

The physical pain is real and dogged. “On bad days it feels, literally, like somebody has taken a knife and stabbed it in my lower left side and is dragging it across my stomach,” says Jeffrey Roberts, 47, who has suffered from irritable bowel syndrome since he was a teenager. The symptoms fluctuate between diarrhea, constipation, nausea and cramps. Roberts, who lives in Toronto, is also lactose intolerant and was diagnosed with Crohn’s disease on his 40th birthday. The gut discomfort has forced him to reschedule a family trip to Disney World and cancel an Italian romantic getaway with his wife.

One of the most famous victim of eviscerating GI pain was Kurt Cobain, who hauntingly foreshadowed his own death when describing how gut symptoms sent him into a downward spiral: “It had been building up for so many years that I was suicidal. You know, waking up starving, forcing myself to eat, barfing it back up . . . just crying at times, ‘Urgh, I’m in pain all the time.’ ”

On top of the physical distress, Roberts says he and others like him suffer mental and emotional symptoms. (Cobain’s proof.) Anxiety and depression begin to creep in. “You worry that people see you as a hypochondriac,” he says, “as if it’s all in my head.” Some sufferers feel hopeless, which is a common reaction to chronic pain. Even the practical aspects of living with a major gut problem—always needing to know there’s a bathroom nearby, for example—can wear people down. ‘‘I don’t know anything that is more distressing for a patient,” says Diamant, a senior scientist at Toronto Western Research Institute, “than to fill their pants full of poop at the grocery store.”

The body, of course, reacts to stress in all kinds of ways. The cardiac system may respond with a hastened heartbeat; the vascular and nervous systems may cause a migraine headache. “But the gut seems to be the one [system] that’s more sensitive,” says William Paterson, a neurogastroenterologist and research chair at Queen’s University in Kingston, Ont. The gut includes everything from the salivary glands, the pharynx and esophagus to the stomach, intestines and anus, plus organs like the liver and pancreas. It’s huge and complex. “There are more nerves in the wall of the gut than there are in the spinal cord,” says Paterson, past president of the Canadian Association of Gastroenterology. It’s so responsive that scientists often refer to the gut as the “little” or “second” brain.

Megapundit: The Royal Bananadian Mounted Police

By selley - Wednesday, October 29, 2008 at 2:37 PM - 4 Comments

Must-reads: Ian Mulgrew on the Robert Dziekanski fiasco.

Canadian justice
Shameless cops, creepy hockey coaches and random urban gunfire. What a country.

The Vancouver Sun‘s Ian Mulgrew believes the RCMP may have blood on its hands in the death of 21-year-old motorcyclist Orion Hutchinson, who was struck and killed Saturday night by an off-duty RCMP officer who happened to be inebriated, and who happened to have been one of the four officers who so professionally dealt with Robert Dziekanski at the Vancouver airport. Those officers “have had a horrible cloud over their heads and their careers” while the RCMP dithers over what to do with them, he argues, and it’s not tough to imagine that stress leading to “self-destructive judgements.” As for the RCMP’s refusal to name the officer, on grounds he hasn’t yet been charged in either Dziekanski’s or Hutchinson’s death, Mulgrew says he can’t believe they “have the audacity to pull a stunt like this.” It really is staggering, the third-world depths to which the RCMP is capable of sinking.

The Globe and Mail‘s Christie Blatchford and the Toronto Star‘s Rosie DiManno report on yesterday’s developments from the David Frost trial, where a 28-year-old woman testified as to the various acts of depravity Frost forced her and his players to perform. DiManno’s is a little more in-depth when it comes to the legalese, but you won’t want to read either piece with a full stomach. (Interestingly, we note the Star seems to have reversed course and is now only identifying the female witnesses by their first names, just like the Globe.)

Continue…

When your mother’s a narcissist

By Julia McKinnell - Friday, October 24, 2008 at 12:00 AM - 0 Comments

“If I called my mother and told her I was feeling fat, she’d go, ‘Oh my God, talk about feeling fat!’ ” confides 44-year-old Chantal, a Toronto artist and single mother of a teenage son. Chantal says it’s pointless trying to have a heart-to-heart with her self-absorbed mother. “She can’t hear you. With a narcissistic parent, everything is about them. If I said I’m on a diet, she’d say ‘I’m on a diet,’ then go on and on about how fat she is. She’ll tell you how she’s eliminated sugar almost, but not hear anything I was saying.”

When psychotherapist Dr. Karyl McBride counsels the daughters of narcissistic mothers, she starts by giving them a questionnaire. Questions No. 1 and No. 2: “When you discuss your life issues with your mother, does she divert the conversation to talk about herself?” “When you discuss your feelings with your mother, does she try to top the feelings with her own?”

Maternal narcissism is a far more widespread, devastating disorder than most people realize, says McBride, who confesses that she, too, felt “unmothered” growing up and looked but could never find a book that dealt with mothers who are not maternal, or a daughter’s feelings of frustration, even hatred.

“It’s very rare for a woman to come into therapy and say, ‘Hello, I’m the daughter of a narcissist.’ Usually, they come in with depression or low self-esteem or [are] exhausted from trying to achieve, achieve, achieve,” says McBride. “Good girls aren’t supposed to hate their mothers so they don’t talk about their feelings.” Still, after 17 years of specializing in treating daughters of narcissists, McBride easily spots the symptoms: “over-sensitivity, self-consciousness, indecisiveness, inability to succeed in relationships.”

In her new self-help book, Healing the Daughters of Narcissistic Mothers: Will I Ever Be Good Enough?, McBride stresses that “recovery is not about changing mom. It’s about your own internal work.” Chantal’s Toronto therapist warned her not to confront or accuse her mother of being a narcissist. “I was told she wouldn’t get it. No, I’ve never tried to talk to her about it.” McBride agrees: “If mother is a full-blown narcissist, it’s not going to do any good to confront her.”

A Very Timely Cartoon

By Jaime Weinman - Monday, September 29, 2008 at 2:48 PM - 7 Comments

In 1933, Walter Lantz made a cartoon starring Oswald the Lucky Rabbit called “Confidence,” where the Depression causes harm to Oswald and his barnyard friends, and so Oswald goes to Franklin Delano Roosevelt to get a lesson — in song! — about the only thing that can cure the Depression.

For some reason, I’ve been thinking about this cartoon a lot.

Here is a link to the cartoon (embedding disabled).

The Depression stuff starts at 2:21, and FDR appears at 5:00. BTW, Tex Avery was one of the animators.

Or if you want a less upbeat take on financial crisis, there’s always Bob and June Wheeler from Night Court.

Prescription: Turn that frown upside-down

By Lianne George - Friday, August 22, 2008 at 4:19 PM - 0 Comments

Researchers are now saying that some of women’s greatest health challenges can be remedied with one thing: happiness. Simple enough, right?

A team of researchers at Ben-Gurion University of the Negev, Israel, questioned 255 women with breast cancer about their well-being and their levels of happiness, optimism, anxiety and depression before they were diagnosed. They studied them against 367 healthy control subjects. The study, published in the journal BMC Cancer, concluded that those with a positive outlook on life were better protected against the disease. Continue…

Anti-love drugs?

By Cathy Gulli - Friday, June 6, 2008 at 4:28 PM - 0 Comments

Depression is a tyrant. A woman I spoke with recently described her experience with it as feeling like she had been rolled up in a thick, black carpet and cut off from the world.

For her, antidepressant drugs, of which she tried many, helped. They work for a lot of people.

But these meds may have a negative impact too. This is the worst I’ve heard: antidepressant drugs may make it harder for people to fall in love. 

The hypothesis is put forth by The Nature of Love blogger, Helen Fisher, in a 2007 booked called What is your Dangerous Idea? 

Incidentally, she runs what appears to be a dating service website. 

And yes, I know, this idea is more than a year old—but come on, it’s interesting.