Brain Health: Of course we can do better

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The Elliott family at a wedding, late 1950s

My great-grandfather Maurice Elliott died in 1944 after the uninsured barn on their farm burned to the ground. He left behind his widow and nine children.

Only as an adult did I come to know his death was a suicide. It wasn’t my grandmother or father who told me. For them, it was a deeply buried secret.

Of course we can do better! What’s holding us back?

We’ve evolved, but we can do much, much better

It’s not that anxiety, depression, despair and the ability to think clearly weren’t challenges in earlier generations. People just didn’t talk about brain health.  Winston Churchill led the British to victory in both World Wars, and in his personal life, battled depression. He named his dark moods “Black Dogs”. The times when he would be unable to get out of bed, had little energy, lost his appetite and couldn’t concentrate were private ones.

Compare that to today. We speak openly of post-traumatic-stress-disorder. Anxiety and depression are well understood, particularly as they affect youth. Dementia is a clearly-anticipated crisis with people my age doing Sudoku puzzles to stave off wolves at the gates of our memory.

We talk of brain health, not mental illness. This is all good. But there are times when I wonder if we’re responding in the best ways possible.

My husband and son were travelling together this September to Cincinnati, and tell the story of a woman traveller with a dog alongside on the plane as her medically-prescribed emotional support. This wasn’t a lapdog. This petite woman’s companion dog was a Great Dane!

Airlines are allowing a Noah’s Ark of animals onboard to support passengers: turkeys, roosters, dogs, cats, tortoises, pigs, miniature horses! I’m not making this up.

Reality check

In Canada, provinces deliver healthcare. It’s their biggest spend. When I was a provincial politician in Alberta, we spent more than 50% of our operating budget on healthcare. My constituents asked lots of questions about healthcare delivery and policies. Over half of their questions were about brain health. These same people had really good ideas on how we could do better.

In 2015, I hosted a town hall to explore these good ideas. We had the Alberta Children’s Hospital and the University of Calgary’s medical school in constituency. Plus local schools and community clinics. We invited experts and families dealing with these challenges on a daily basis.

We agreed, dementia care for seniors needs resources. And, we agreed, the mental health of younger people is a ticking bomb.

Child and youth mental health is an orphan in healthcare system

In this town hall, we went deep, laying bare the facts on child and youth brain health:

 

FACT: About 50% of all lifetime cases of mental illness begin by age 14 and about 90% begin by age 25.

FACT: Psychiatric illnesses, including schizophrenia, bipolar disorder, depression and anxiety are the major chronic diseases of young people. They account for roughly 40% of the medical burden for people aged 15-44 years.

FACT: Adolescents with psychiatric illness are at an enormously increased risk of suicide.

If mental health is the orphan of the medical system, child and youth mental health is the orphan within this orphan – the orphan’s orphan.

Young people are feeling more anxiety

Anxiety has now overtaken depression as the most common reason post-secondary students seek counseling.

What’s triggering these levels of acute anxiety, these feelings of overwhelm?

  1. Some psychologists and other practitioners attribute the spike to an increase in diagnosis of the disorder.

  2. Everyone talks about the role played by overly protective parents. ‘Helicopter parents’, as they are known, diminish their children’s opportunities to build much-needed resiliency.

  3. Social media is another named culprit. Kids have no safe places, no unconnected places when their cell phones are constantly in easy reach. Social media platforms encouraging people to compare themselves to their peers add to anxiety levels. And, we’ve all heard the horror stories of cyber-bullying.

We know better. Why aren’t we doing better?

In a rousing TEDxTalk, Dr. Glenda MacQueen assures us that we have the science available to look at someone’s brain in an MRI and diagnose whether or not that person is depressed.

With other health challenges—cancer, heart disease, kidney stones–we rely on diagnostic tools and trust the science.

How do we get to that same level of certainty and acceptance with brain health?

We fund more research. It’s exciting to see Bill Gates invest $50 million into the Dementia Discovery Fund, a private-public partnership to look at the causes of brain disease, not just the symptoms. The Fund’s researchers will look at novel ideas, like understanding our brain cells’ immune system.

And, we start diagnosing and treating brain health like other health conditions!

FullSizeRender2This is Dr. Barry Bultz, President of the Canadian Association of Psychosocial Oncology. This summer, while in for a routine mammogram, Barry and I had the chance to discuss his work.

Of course, cancer practitioners want to kill cancer cells! But that’s not all.

Treating the whole person

Barry spoke, compassionately, about how facing off against cancer forces people to deal with lingering issues, for example, relationships with their partners and families.

It’s trite to say that the cancer experience changes people, but Barry’s work emphasizes the less tangible emotional and social changes that go hand-in-hand with more visible changes to a person’s body.

Inherent in Barry’s approach is dignity—the ability to see the individual under the standard-issue blue smock that ties (often very poorly) in the back.

FullSizeRender2It made me grin to see this book on Barry’s desk. Man’s Search for Meaning by psychiatrist and Holocaust survivor Viktor Frankl.

I picked it up, and was surprised to see it was a signed copy. Frankl was one of Barry’s professors. Wow. Impressive.

Psychological healing was Frankl’s passion, too. His brutal experiences in the concentration camps taught Frankl how people can hold onto their dignity, even in the most hellish conditions:

We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of the human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

There is hope

Two generations ago, my great-grandfather lived in a community where mental illness was not talked about. He must have suffered, and in silence. That was a time when cancer was also talked about in whispers, was not disclosed and was treated with harsh drugs and brutal surgeries.

Today, thankfully, we’re not afraid to talk about brain health and to advocate for better research, diagnosis, treatment and policies. We’ve chosen a better attitude, one that may even impress the likes of Viktor Frankl.

This gives me hope.

I have to admit though, I’m still a wee bit anxious about a Great Dane poking its head out from under my airplane seat!

Donna Kennedy-Glans, November 16, 2017

 

 

 


7 thoughts on “Brain Health: Of course we can do better

  1. fabulous post Donna. i am not positive this will reach you – however i have just read without stopping your article on brain health and as a psychotherapist, i couldnt agree more. your visit and information about Dr. Barry Bultz is heartwarming and encouraging…fascinating to know he was a student of FRankl. i would love to talk with him someday.

    there was a great article in the Walrus in October – Jagged Little Pills – about adolescent mental health. perhaps you have read it.

    thanks for the inspiration and thoughts.

    Sandra Hayes-Gardiner

    1. Yes, with the recent suicide of George Gosbee this week, we’re all reeling. This blog was invited by Jennifer Beatty, with Minds over Matter Mental Health Society. Jennifer was at the Varsity Constituency town hall I refer to in the blog, and followed up to ask me to write a blog on brain health. We’ve been going back and forth on key messages over the past few weeks and this blog was just ready.

  2. Re-posted from Facebook. Worth sharing?

    Frank Penkala: Another interesting post Donna. Can science look into the mind? From a practical treatment perspective I wonder if governments need to be careful not to over emphasize brain health research spending at the cost of psychosocial therapies which may have more immediate benefits. In his darkest hours Frankl surely did not think in scientific terms in his search for meaning. Isn’t it possible that therapies ought to extend through a spectrum, some derived from pure science to some based on wildly artistic characteristics? Our faith in science alone to provide solutions may be a bit misplaced.

    Donna Kennedy-Glans: Valid points Frank Penkala. Thank you. Just seems like the Great Dane under the airplane seat is a tad misguided.

    Donna Kennedy-Glans: Frank, your question has had me thinking all night. A good thing. What Frankl says to me, when I read him and reflect, is no matter how bad your situation, even if you are diagnosed with an incurable disease, you have the ability to choose your response. There is power in that. I speak to a lot of people in Yemen about that right now. With cancer, as a society (not just individuals) we are saying, yes we know cancer kills, but by the time my grandchildren are my age, I want this damn disease to be eradicated and I think we can do it! So we fundraise, and demand more research and better, more humane treatment. And we’ve had success. My question, then, is why haven’t we done the same with mental illness, brain health? Why don’t we push as hard, respond with the same sense of hope and drive? Demand better. No, we can’t afford to do everything – give every teen a brain scan, give every anxious person a lap dog for the plane. But we seem to be stuck in not expecting more, when we do have some better tools, ideas, visions of what is possible. There are people, like Dr. Glenda MacQueen who tell us what’s possible. Why aren’t we choosing to either believe her (and people like her) or choosing to act with greater clarity and optimism about the potential? Mental health is harmful to so many people, and not just the people who have the illnesses themselves.

    Frank Penkala: Donna, as someone surviving colon cancer (T3N1, dx Dec 2013, surgery Jan 2014, chemo complete Sept 2014, survivor badge due Sept 2019) I heartily support the efforts at increasing and improving cancer research. As a member of the Calgary Jung Society since 2008, along with Dr. MacQueen’s colleague Dr. Chris Wilkes (Psychiatrist AND Jungian Analyst), I have experienced the benefits and learned of the limitations of science based courses of treatment as the only recourse to serious illness and disease. Who do Clinical / Behavioural Psychologists tend to consult when they get stuck / complexed / confused? It often is a Jungian Analyst, trained in unconventional methods to tap into the unconscious, who provides the relief and healing. Guess whose services are NOT covered by Alberta Health Services? As programming vp for the society, I had the unique privilege of hosting author and Jungian Analyst Guy Corneau as a speaker here in Calgary. Guy taught us about surviving, about approaching illness in the most aggressive ways possible; about never giving up or giving in. Guy had faced down and survived Stage IV (terminal) cancer, metastasized throughout major organs, and had been given a decidedly short time frame to get his affairs in order. The formula for survival? “Try everything that resonates for you”; “Pile On” the therapies; experiment with all your heart — it is your life; and, do not accept “expert” advice that you are defeated. This approach certainly did not exclude conventional treatments including surgery and chemotherapy. In Guy’s case (and in mine) it did not exclude holistic, naturopathic, dietary, fitness, spiritual, and psychological options either. Many of these supplementary factors are, shall we say, less than grounded in scientific principals. In mental health care, as in cancer treatment, we have so many possible choices. We need to integrate and accept the non-clinical possibilities as well as the scientifically “proven” modalities. It is about “AND”. As Frankl taught: even in our darkest hours we have the choice to pick up the cello, and play for the guards.

    https://jungcalgarydotcom.wordpress.com/2012/03/

    https://www.afterlife.co/us/memorial-montreal-guy-corneau-559606

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