*The Trevor Project (2021) has estimated that more than 1.8 million LGBTQ youth between the ages of 13-24 seriously consider suicide each year in the US and at least one suicide attempt occurs every 45 seconds.
*Suicide is the second leading cause of death among 10–24 year-olds.
*LGBTQ youth are at significantly higher risk for suicide risk: more than four times as likely to attempt suicide and nearly three times more likely to consider suicide compared to cisgender/heterosexual youth.
*The increasing number of anti-LGBTQ legislation in the US has correlated with increasing rates of depression, anxiety, and suicide attempts. In 2023, over 520 anti-LGBTQ bills were introduced in state legislatures.
*In August 2023, the Canadian government issued a travel advisory warning for LGBTQ travelers coming to the US because of anti-LGBTQ legislation.
*Protective factors for LGBTQ youth suicide include:
*Having at least one accepting and affirming adult
*Experiencing high social support from family
*Living in an LGBTQ-supportive community
*Having safe spaces in school settings
As we reflect on the importance of Suicide Awareness month, it is vital that we turn our attention to minority populations that disproportionally are impacted by mental health outcomes. Suicide is the second leading cause of death among 10-24 year olds. LGBTQ+ youth are at significantly higher risk for suicide compared to cisgender, heterosexual youth. Queer youth are three times more likely to experience suicidal thoughts and four times as likely to attempt suicide. One key factor in this trend is ongoing minority stressors, including the surge of anti-LGBTQ+ legislation in the US. In 2023, over 520 anti-LGBTQ+ bills were introduced in state legislatures. In fact, in August 2023, the Canadian government issues a travel advisory warning for LGBTQ+ travelers coming to the US based on these laws. The Trevor Project, a US based LGBTQ+ advocacy group, estimates that more than 1.8 million LGBTQ+ youth between the ages of 13-24 seriously consider suicide each year and at least one suicide attempt occurs every 45 seconds.
To combat these rising suicide rates among queer youth, the Trevor project has identified key protective factors. LGBTQ+ youth have lower rates of suicide and improved mental health outcomes 1) when they have at least one accepting and affirming adult in their life, 2) when they have high social support from immediate family members, 3) when the live in LGBTQ-supportive communities, and 4) when they have safe spaces in school settings. In short, improving LGBTQ+ mental health and decreasing suicide rates requires family and community engagement. We all play a role in creating communities where all people feel safe and included.
Resources
*For LGBTQ youth experiencing suicidal ideation, the following resources are available:
*If you require emergency support or assistance, please reach out to the available support networks:
The National Suicide Hotline in the US (dial 988 in the US)
The Trevor Project (dial 866-488-7386 or text 678-678)
SAGE LGBT Elder Hotline (dial 877-360-5428 in the US)
The Trans Lifeline (dial 877-565-8860 in the US or dial 877-330-6366 in Canada)
Crisis Services Canada (dial 833-456-4566 or text 45645)
Kids Help Phone (dial 800-668-6868 – providing services in French/English/Arabic)
In Canada and the US, we offer specific services for youth struggling with their mental health. For more information, visit our therapy page or our child psychiatry page (US only).
World Suicide Prevention Day: Resources
We've put together a list of Suicide Prevention resources. We're here to support you.
Emergency/Crisis Support
Whatever you’re facing, you are not alone. If you’re currently in crisis, experiencing suicidal thoughts, or need immediate help, please seek support through the following channels:
CANADA
Call the national suicide helpline at 1.833.456.4566 or call 911.
We offer non-emergency traditional and alternative mental health therapies, including treatment resistant conditions that could contribute to suicidality. Click here to view our services and book an informational call with a health navigator.
Pride Month: Fostering Mental Health & Advocacy
Numinus Stands with the LGBTQ2+ Community
June 6th, 2023, the Human Rights Campaign (HRC), a leading LGBTQ+ advocacy group, declared a state of emergency for LGBTQ+ individuals in the United States due to a surge in anti-LGBTQ+ legislation, primarily targeting transgender Americans. In 2023 alone, legislators from 41 US states introduced more than 525 anti-LGBTQ+ bills, with 220 of them specifically aimed at transgender people. These bills encompass a wide range of measures, such as denying transgender students the right to participate in sports, restricting access to gender-affirming healthcare, and prohibiting transgender individuals from using certain bathrooms.
Statistics derived from the Trevor Project's 2023 National Survey on the Mental Health of LGBTQ Young People reveal alarming figures. Within the past year, nearly 50% of transmen, transwomen, and nonbinary/genderqueer youth aged 13-25 seriously contemplated suicide, while over 20% of transgender young individuals attempted suicide. The survey also uncovered that rates of suicidal ideation, suicide attempts, depression, and anxiety among LGBTQ+ youth are two-to-three times higher compared to cisgender, heterosexual peers. The adverse effects of anti-LGBTQ+ legislation directly impact the mental health of queer youth.
We are currently facing an unprecedented mental health crisis within the LGBTQ2+ community. Without decisive and meaningful action, the social and political climate in the United States will continue to jeopardize the health and well-being of queer individuals. As a queer healthcare provider myself, I am devastated and appalled by the ongoing threats to the basic rights of queer people in our country. This Pride Season, it is my hope that mental health providers and organizations will reflect on how we can further advocate for and support the LGBTQ2+ community. Mere symbolic gestures, such as flying flags or posting on social media, will not suffice. We require fundamental and structural changes that permeate every aspect of mental healthcare, including the creation of affirming patient-care spaces and the elevation of queer voices in decision-making processes within institutions. The choices we make today will have a direct impact on the mental health outcomes of LGBTQ2+ individuals for generations to come.
At Numinus, we are committed to fostering a safe and inclusive environment for the LGBTQ2+ community. We prioritize creating a space where individuals of all gender identities and sexual orientations feel respected, affirmed, and free from discrimination. We strive to ensure that our services are accessible, sensitive, and tailored to meet the diverse needs of the LGBTQ2+ community. To our LGBTQ2+ clients and fellow providers, please know that you are seen, valid, and indispensable. Each of you brings unique contributions to this world that no one else can replicate, and together, we collectively enhance the beauty of this world.
LGBTQ+ Mental Health Resources
If you require emergency support or assistance, please reach out to the available support networks:
The National Suicide Hotline in the US (dial 988 in the US)
The Trevor Project (dial 866-488-7386 or text 678-678)
SAGE LGBT Elder Hotline (dial 877-360-5428 in the US)
The Trans Lifeline (dial 877-565-8860 in the US or dial 877-330-6366 in Canada)
Crisis Services Canada (dial 833-456-4566 or text 45645)
Kids Help Phone (dial 800-668-6868 – providing services in French/English/Arabic)
Fully Present: How Ketamine-Assisted Therapy Helped One Woman Out of Depression
By Greg Ferenstein
Michelle* lived with constant anxiety that she would explode during an argument and enter into a months-long depressive episode. She’d tried so many strategies to manage her mental health, from group discussions to cognitive behavioral therapy, but nothing seemed to work well.
“Most of the therapy I’ve done just kind of muted my symptoms mostly, but I am still walking around with heavy, heavy depression and really terrible anxiety.”
Depressive episodes would socially paralyze her.
“I wouldn’t feel like I had any energy to do anything. I’d isolate myself,” she says. “I'm not social. I don't function besides what I absolutely have to function for.”
She could work but that was about it.
Unfortunately, the most effective solutions for her had intolerable side effects. The generic version of Zoloft, Sertraline, managed her major mood swings but came with “horrible” sweats that left her “drenched” in the middle of the night. Perhaps worse, it severed her emotions.
“It made me not care at all,” Michelle recalls. “I just kind of didn't feel anything.”
After her doctors recommended trying a higher dose, she went looking for something else. Her friends said good things about ketamine, a dissociative psychedelic that is known to help people confront painful topics and manage a range of mental health conditions, including depression.
Michelle was nervous. She had some not-so-positive experiences with psychedelics when she was younger. Even though it was years ago, she didn’t like the idea of losing control of her mind.
The therapists at Numinus made her feel more at ease with their Emotion-Focused Ketamine-Assisted Psychotherapy, which pairs intensive emotional management and trained mental health professionals with multiple rounds of in-person ketamine sessions.
The Ketamine Experience
The psychedelic portions of ketamine treatment typically last an hour and many people report hazy dreams representing unprocessed challenges.
After years of therapy, Michelle believed she knew the source of what she might encounter: being abandoned by her mother as an adolescent and subsequent years in-and-out of near homelessness.
Instead, her most healing psychedelic experiences were simple and pleasant experiences.
She remembers telling her husband, “Maybe this is what it feels like to feel normal.”
The simple absence of anxiety was profound. After one session, she burst into tears.
“I just started crying and crying and crying,” she recalls. “I really felt like it helped me release those emotions, and relieve some of that pain and all of the struggle that I had when I was a child with my family.”
During another psychedelic experience, Michelle set an intention and drifted into a meditative state, daydreaming of swimming. Usually, when water was involved in Michelle’s dreams, it was a nightmare drowning sensation. This watery dream, though, was superbly healing.
“I have been a hyper-vigilant person, always looking for the next thing to crumble in my life,” she says. “But with ketamine, just to even have that feeling that I'm okay—and that I'm happy—was huge for me.”
Introspection, fewer explosions, less depression
In the three months since Michelle had her first ketamine treatment with Numinus, she has learned to better manage her emotional triggers.
One example stands out. Because of their shared traumatizing past, her family has had a tendency to set her off. But the last time they had a fight, Michelle recalls being able to remove herself from the argument, sensing that she was about to explode, and embrace her feelings without becoming overwhelmed by them.
“It's getting easier for me to recognize, even in conversation.”
She feels more in touch with her emotions, and if things start feeling really bad, she can discuss her emotions openly in a way that defuses the situation.
Her relationship with her husband has improved and she is no longer burdened with extended bouts of depression. She’s made incredible progress, but Michelle still struggles with explosive episodes and depression. So, she continues to go in for occasional ketamine treatments.
But she no longer needs antidepressants.
“It has really, really, honestly been the only thing that has helped me feel normal without taking a pill every single day.”
*Michelle is a pseudonym. Some quotes edited for clarity
About the author
Greg Ferenstein is the founder of Frederick Research, a mental health innovation consulting firm. His research has been widely covered in leading publications, including the New York Times, The Brookings Institute and The Washington Post.
His field investigations in mental health have been supported by respected technology companies, from Google.org to Lyft and his public policy papers have influenced bills at the U.S. federal and state level.
Prior to founding Frederick Research, he taught statistics for journalists at the University of Texas and received a Masters in Mathematical Behavioral Sciences.
Healing My Worth: How Ketamine-Assisted Therapy Helped One Woman Out of Depression
By Greg Ferenstein
Sarah* couldn’t understand why she felt such debilitating depression. On paper, she seemed to be doing everything right. She practiced yoga, ate well, and was raising two well-adjusted children. Her supportive family and healthy lifestyle helped her overcome a difficult cancer treatment, yet she was consumed by dark ruminating.
“I find myself constantly apologizing to everyone,” she recalls, of the crippling self-doubt that led to serious suicidal ideation.
Intuitively, she knew people loved her, but couldn’t stop her reaction to apologize as never being good enough for her family. Sometimes, the mere gentle embrace of her husband would send her into a sobbing fit.
“My kids were scared when I got really suicidal,” she admits.
Traditional therapy and medications had been somewhat helpful. One of the anti-depressants that she tried, specifically, Zoloft, took the edge off of otherwise brutal, constant rumination.
“I was more stable—I was much more approachable.” With Zoloft and talk therapy, Sarah’s relationships were more manageable. She could work, raise her kids, and not break down crying around her husband.
But, eventually, the trade-offs from Zoloft, and anti-depressants generally became too much. First, Sarah’s cancer medications interacted poorly with Zoloft.
Second, it strained relations with her husband in unexpected places like the bedroom. “There’s kind of a sexual dampening effect.”
Her husband wanted to be desired physically, but as an emotional ‘zombie’, Sarah just couldn’t feel it.
“I wasn’t filling that need for him because I wasn’t feeling it within myself,” she recalls. “I wanted to feel well, but I also wanted to feel everything.”
Eventually, Sarah’s therapist proposed a relatively new psychedelic pharmaceutical treatment, ketamine, a widely used surgical general anesthesia known to have potent antidepressant effects. In the dreamlike state of this powerful analgesic, patients can often process memories that are too painful to deal with normally.
Sarah’s initial ketamine treatments were positive, but they did not seem to alleviate her issue, nor did they help her understand the source of the depression.
So, she decided to try a new ketamine provider, Novamind, a growing mental healthcare company specializing in psychedelic-assisted therapy. Having treated thousands of patients using various ketamine therapies, Novamind was uniquely equipped to address Sarah’s challenging situation. In her case, Novamind providers used Emotion-Focused Ketamine-Assisted Psychotherapy or “EF-KAP”. EF-KAP is a special type of ketamine-assisted psychotherapy that focuses on helping patients learn to identify, cope with, and transform emotions related to their mental health condition. It is based on principles found in Emotion-Focused Therapy, an approach to psychotherapy that clinical research has shown is very effective.
A transformational visualization
Initially, Sarah remembers feeling “terrified” of psychedelics. Her fears ran the whole gamut of disaster scenarios, from suffering a hypothetical permanent psychosis to simply not ‘returning’ to her normal psychological state of being able to care for her family.
“I’m kind of a control freak,” she says.
But, she was desperate and willing to trust in the confidence of her mental health team.
Under Novamind’s care, Sarah recalls the trip that transformed her mental health. Sitting in a comfortable chair and dimly lit room, a ketamine IV was placed in her arm and she drifted off into a state that felt like the semi-conscious awareness of waking up from a long sleep.
In her dream, a building stood out in the middle of a big, cosmopolitan city. She peered in and could empathize with the hundreds of families seen through the windows. Soon, she witnessed the glow of different family members dissolving from what looked like divorce. But, it wasn’t a sad occasion, as each person floated into another room with a new, loving family unit.
To Sarah, this was a revelation: as the child of a difficult divorce, she realized how the scars of feeling unloved during her parents’ separation never fully healed. But, in her psychedelic vision, she understood separation as a natural part of life.
“My energy can now leave and go flow elsewhere.” Sarah did not have to take the scars of being unloved from her childhood into her role as a mother. “I equated trying to be perfect with getting love.”
She says that she could choose to accept the unconditional love of her husband and children, even if she is imperfect.
No more apologizing or suicidal thoughts
Sarah recalls feeling unusually pleasant in the days after the experience. Her first assignment was to ditch her knee-jerk reaction to apologize—and it worked.
She was determined to be “more mindful every time I wanted to say ‘sorry’.” Instead, she knew, “I could just show up and be enough.”
Soon, relations at home improved. Before the therapy, Sarah had become physically estranged from her husband, who had stopped being affectionate for fear of triggering a depressive episode. But, now, he could embrace her with a loving hug. It was the little things like this that gave her more confidence and began the road to repairing intimacy in her marriage.
Initiating intimacy ran both ways: now that she felt a fuller and more intense range of emotions, Sarah is comfortable in her body. She is less judgmental about her weight and image. In the bedroom, she enjoys connecting and is less likely to cover under the sheets.
“Years of eating disorders and body dysmorphia, and body shame had prevented me, for a long time, from really being present in my body.”
Sarah still has shaky days, but is staying vigilant in her practice of mindfulness. She finally believes, at her core, “I’m worth being here”.
Exploring the nuances of what worked
Sarah was no stranger to psychedelics; she’d experimented liberally years ago with LSD and psilocybin, both of which are known to have antidepressant properties in therapeutic settings. And, she had come to Novamind recently for ketamine treatments.
So, what was different about this particular transformation experience?
Novamind’s Dr. Stephen Thayer, who oversaw her care, credits two things in particular to the healing process.
First, Sarah was instructed how to ‘recall’ her psychedelic experience in her everyday life as a method of integrating the insights she learned while on ketamine. During challenging times, Sarah takes a moment to breathe and mindfully reflect on these insights, allowing her to emerge fortified and less self-critical. Dr. Thayer describes this process as following breadcrumbs back to insights first encountered during the ketamine experience.
Second, both Dr. Thayer and Sarah credit the unobtrusive talk therapy during the trip with a trusted counselor.
In many ketamine infusion clinics, clients go through the experience without supportive psychotherapy.
Sarah’s case is a fascinating example of why this kind of support may be crucial to the healing process. Ordinarily, she admits, anxiety would get the best of her and she would feel the need to do anything else but sit with her difficult emotions. That guidance involved open-ended questions, invitations to be curious, and reminders that she was safe. Being invited to describe the visualizations mid-trip helped uncover the meaning of the dream-like state and gave her the courage to dive deeper into the experience.
For Sarah, it made all the difference.
*’Sarah’ is a pseudonym. Some quotes edited for clarity.
About the author
Greg Ferenstein is the founder of Frederick Research, a mental health innovation consulting firm. His research has been widely covered in leading publications, including the New York Times, The Brookings Institute and The Washington Post.
His field investigations in mental health have been supported by respected technology companies, from Google.org to Lyft and his public policy papers have influenced bills at the U.S. federal and state level.
Prior to founding Frederick Research, he taught statistics for journalists at the University of Texas and received a Masters in Mathematical Behavioral Sciences.
Julie Andrews: "Therapy Saved My Life"
Depression, more common than either cancer or heart disease, is the leading cause of ill health & disability worldwide, yet 50% of people with depression don't get treatment.
1 in 4 people will face mental illness at least once in their lifetime, but why do governments only invest 3% of their health budgets in mental health?
Going to a therapist or psychiatrist should be as normal as going to your family doc when you have the flu. Even though it's getting better, the stigma is still out there. So, you can imagine how pleased we were to hear about this conversation on The Late Show with Stephen Colbert:
"Colbert asked Andrews about the decision to discuss her history with therapy in Home Work. Andrews' first stint in therapy took place after her separation from her first husband, when "my head was so full of clutter and garbage." Mike Nichols, who she admired for being clear-headed, was going to therapy and so she gave it a try. As for why she shared this with readers, Andrews replied, "The truth is, why not, if it helps anybody else have the same idea? These days, there's no harm in sharing it, I think everybody knows the good work it can do."
We need to talk more about our mental health. We get this message from society that asking for help is weak, but maybe society needs some therapy. Therapy is cool, psychiatry is rad, and working on your mental health is a sign of strength, not weakness. It's showing up for ourselves so we can be there for the other people in our lives too.
Mallory Talks Ketamine on the Latest Episode of Diagnosis Explained
Did you know that anti-depressant medications only help 3-5/10 people?
And did you know that our very own Psychiatric Provider, Mallory Danielson, PA-C, has a popular and super informative podcast called Diagnosis Explained? 🙂 On the latest episode, we get to learn about ketamine and esketamine (Spravato) and how it can start helping your depression within only a few hours!
“When you look at mental health in our society, we are in crisis mode,” said Christena Huntsman Durham, of the Huntsman Foundation. “I think each one of us deals with mental health, either personally or in our family. It’s time that we take the stigma away.”
- 40% of Utah’s depressed youth age 12-17 did not receive treatment for depression
- Over 50% of Utah adults with mental illness did not receive mental health treatment or counseling.
- Suicide was the leading cause of death for Utahns ages 10 to 24 in 2017
Huntsman Foundation CEO: It's past time to change stigmas and misconceptions surrounding mental illness. “We need to do better by you, and particularly, that third group that’s most important—who all too often live in silence because they are afraid that somebody is going to find out that they have something they never bargained for, something they never asked for; who suffer all too often in silence."
Everything You Need to Know About Cannabis and Mental Health
“We’re just at the beginning,” Dr. Claude Cyr told Dr. Joe on episode 10 of the Numinus podcast. He was talking about what we know about the potential positive and negative impact of cannabis on mental health.
Dr. Claude Cyr is a family physician who has been practicing medicine for over twenty years. He judiciously prescribes medical cannabis to his patients.
In 2015, the Prime Minister of Canada, Justin Trudeau, announced his intention to legalize cannabis. One year later, Claude founded Doctors for Responsible Access to bring the medical community into the conversation on legalization.
Now with the end of prohibition in Canada and in a few states in the US, the doors have opened for researchers. We’re just at the beginning of understanding the potential uses and misuses of cannabis.
But what exactly do we currently know about cannabis and its impact on mental health? In episode 10 of the Numinus podcast, Dr. Cyr shares with Joe his reservations and hopes for cannabis and its potential treatment for mental illness.
Let’s dive in.
Note: If you would like a more in-depth discussion of medical cannabis, Dr. Cyr will be running a one-day training on cannabis and mental health for healthcare professionals at the Numinus clinic on November 29th, 2019 called “Cannabis Safety – a primer for health professionals.”
The Current State of the Science on Cannabis
“We know about one percent of what the therapeutic potential of cannabis is.”
Dr. Cyr told Joe that when he was attending medical school in the 1980s, we didn’t even know that the endocannabinoid system even existed.
Now we know that there are over a hundred cannabinoids in cannabis. Only two of which have been adequately researched: CBD and THC. And there are probably a dozen or so cannabinoid receptors. Only one of those has been studied to a significant degree: CB-1. These receptors are found all over the body: in the brain, the liver, the lungs, the kidneys, etc. So why is that important?
By isolating and synthesizing each individual cannabinoid, and we can study the interaction they have on each receptor. We can also combine them in different concentrations and see if that also has a particular effect. The possibilities are endless.
Anxiety
Many people with anxiety self-medicate using cannabis. Dr. Cyr said, in short, that this was a bad idea. A short period of euphoria is followed by a depressed mood, elevated anxiety, and withdrawal symptoms. Also, people who self-medicate using cannabis use strains with too much THC and not enough CBD.
However, according to Dr. Cyr there is a possibility that cannabis may be very beneficial for people with anxiety. We just need more studies in order to determine which strain and which dose would have the most benefit.
Depression
Two studies came out a couple of years ago. One study followed people with depression who self-medicated, and another followed people with depression whose cannabis use was prescribed and monitored by physicians.
The outcomes were unfavourable for those who self-medicated. However, patients who were monitored by a medical professional fared better.
One possible explanation for this difference in outcomes is that, according to Dr. Cyr, those who self-medicate tend to consume far too much THC (sometime up to a hundred times the dose that is necessary) and not enough CBD.
Interactions with Antidepressants
At small therapeutic doses of THC, the interactions in the liver have not been shown to be significant, Claude told Joe. However, no studies have been done at much higher doses.
PTSD
“When cannabis is used in palliative care, it does have a tendency to make people forget. What we call aversive memory extinction.”
Dr. Cyr told Joe that the average dose of cannabis used by veterans in Canada is “two to three grams a day.” It is an extremely popular form of self-medication for those that suffer from PTSD. And there might be good reason for that.
“When cannabis is used in palliative care, it does have a tendency to make people forget. What we call aversive memory extinction,” Dr. Cyr said. For example, if patients undergoing chemotherapy are using cannabis before, during, or after treatment, “it’ll help prevent that memory from sticking,” he continued. According to Dr. Cyr, preventing those memories from being hard-wired can be beneficial in certain circumstances.
But is it effective long term? “If you look at certain studies, sometimes the outcomes are worse. If you look at other studies, patients claim that it makes them feel better than all the other medications that they have been using up to date,” Dr. Cyr said.
But again, Dr. Cyr said that there is a lot more research that has to be done.
The Risk of Psychosis
“That’s a huge risk right now.”
Studies have shown that there is a threshold of THC concentration where the risk of psychosis increases significantly. Dr. Cyr warned that people can very easily take “a huge dose of THC in a very short period, which was something probably more difficult to do 30 years ago.”
Two studies were done this year with just over 10,000 students, 4,000 in Montreal and 6,000 in Finland. They examined the link between psychosis and cannabis consumption. The researchers found that the risk for developing psychosis is extremely high in teenagers who had premorbid conditions and had consumed cannabis. But the risk also increases in those without premorbid conditions, just to a lesser degree.
Dr. Cyr warned that teenagers need to be extra careful. “Even if you have no predisposition to schizophrenia, if you start consuming cannabis as a teenager, you may become schizophrenic. And that would never have been your trajectory in life.”
Dr. Cyr added that it is probably dose related, as in a high concentration of THC will likely increase that risk. However, including a higher concentration of CBD may help reduce that risk, but more research is needed to confirm this.
So do we stop all teenagers from consuming cannabis? Dr. Cyr says no. “We may have to put up with a certain amount of risk.” Dr. Cyr added, “but if we can prevent the high risk teenagers from consuming early, promoting the importance of CBD, and therefore reduce the harm collectively, I think that’s something that’s more realistic than just saying, ‘Just say no.’”
Addiction
“If it causes euphoria, if it releases dopamine, it’s addictive.”
However, Dr. Cyr adds, when compared to other drugs like cocaine or nicotine, the rate of addiction is much lower. The addiction rate with cannabis is around 9%, compared to cocaine, which is around 20%, and nicotine, which is around 30%.
The problem is that in “young people addiction is much higher than in adults,” which Dr. Cyr said is around 16%. He warns that “there is something with the teenage brain and cannabis, which is different than the adult brain and cannabis.”
Cognitive Functioning
“People who consume cannabis containing only THC, have trouble with memory, attention span, and concentration,” Dr. Cyr said. However, the good news is that after around 30 days of abstinence, most of these symptoms gradually go away. But Dr. Cyr warned that problems with attention may persist for longer.
Motivation
This is a controversial issue according to Dr. Cyr.
He said that some scientists and doctors believe that while under the influence of cannabis complex tasks might become more difficult to perform since it has an impact on executive functioning. “So [cannabis users] might stop doing complicated things like studying for example because it requires too much mental effort,” he told Dr. Joe.
Sleep
Cannabis is a very popular sleep aid. However, does it produce restful sleep? Dr. Cyr says it depends. According to some, it does, but there hasn’t been a lot of studies. Dr. Cyr also added that “CBD may cause insomnia.”
For his patients, if they haven’t responded to any other medication, he would prescribe synthetic THC. In some of his patients, it finally permitted them to sleep. But Dr. Cyr only prescribes cannabis as a form of last line of defence.
Some doctors argue that cannabis is safer than other sleep-aids like valium and that they rather prescribe it as a first line of defence for people suffering from insomnia.
. . . . .
There is so much more to be discovered about cannabis, whether about its positive or negative effects. And according to Dr. Cyr, we’re at the very beginning. With the end of prohibition in Canada, doors for researchers have been wide opened. So for now, we’ll have to wait, and perhaps we might have to wait awhile.
“We’ll talk in 5 to 10 years,” Dr. Cyr told Dr. Joe.
And we’ll be listening.
Episode 13: Lawyer Well-being with Yan Besner and Bree Buchanan
“Across the board, we noticed that we have a moment here. The data is in. It’s
undeniable. We cannot just sit here and fail to take action and let these studies go on
a shelf somewhere because we know that lawyers, law students, and judges are
In this episode of the Numinus podcast, Dr. Joe focuses on well-being in the legal profession. Working in law is one of the most demanding and stressful jobs in the world: tight deadlines, long hours, a hyper-competitive culture, and the weight of supporting demanding clients. In 2016, a study showed that lawyers and law students suffer from substance abuse, depression, anxiety, and stress in far greater numbers than the general population.
In the first half the podcast, Joe speaks with Yan Besner, a partner at Osler, a national law firm. Yan is recognized as one of the best real estate lawyers in Canada.
Joe and Yan discussed:
Yan’s struggle with depression, anxiety, and stress as a young lawyer
The therapies that helped him recover
How he maintains his mental health these days
How the culture in law firms is slowly changing to support mental health
In the second half of the podcast, Joe speaks with Bree Buchanan, co-chair of the National Task Force on Lawyer Wellbeing. Bree is leading a cultural transformation that will help promote mental health in the legal profession.
Joe and Bree discussed:
The 2016 study showing that lawyers and law students disproportionately suffer from substance abuse, anxiety, depression, and stress
How lawyers can cope with these problems
Her personal struggles with substance abuse, anxiety, and depression
How her work in this space aligns with her life purpose
If you would like to find out more about Bree and the work she is doing, check out the National Task Force on Lawyer Wellbeing’s site here.
Here are some highlights of the conversation with Yan:
3:16 Can you tell us what you do? And how did you into this line of work?
3:44 You’re a champion of mental health at Osler. How did your interest in lawyers’ well-being develop for you?
[…]
Well-being, mental health, balance is something that is near and dear to me simply because, like many, when I started out in private practice, I struggled with it. A lot of hours, a lot of pressure. You may have been someone, at least me, who may have excelled in school, but then you’re in a high performing, high achieving work environment with everyone who finished first, second, third in their class, and with leading minds in their respective fields who excel at speeds and rhythms and who juggle schedules and who are satisfying demands both external and internal, both with family.
That can be both motivating and awe-inspiring and you want to emulate that and you want to be like them. But can, at times, be quite overwhelming. Anyone who comes in even keeled in terms of their mood will see and recognize that.
I’m programmed a little bit differently, having done quite a bit of self-awareness and soul searching over my time. I’m someone who traditionally, whether I was programmed by this or whether this was my environment or I was born this way, but I do know I’m someone who has traditionally suffered from irrational guilt and excessive anxiety. So facing a challenge as daunting as private practice and the demands that come with it, my reaction would be to feel a little bit of anxiety and the levels can depend.
It’s only later on in life–I’m approaching 40–that you realize that’s just how I react. It doesn’t mean that I’m scared of the challenge or I’m not willing to deal with. But when you’re in your early twenties and all you want to do to please, satisfy, and accomplish, both for yourself and for those you are working for, it’s hard to kind of filter it through and stay focused.
Through the last 15 years of my practice, yes, you become a little bit more seasoned and you know what to expect when something huge comes in, you react differently. But being more aware of triggers of why you feel what you feel and what you can do to make yourself feel better is something that over the course of my career, I’ve become a lot more aware of. I’ve become a lot more proactive in responding to those triggers that would either be negative in terms of my reaction to big work projects, tough deadlines, a testy client.
[…]
I just don’t want people to go through the same stressors that I went through because I now have the benefit of the information and benefit of hindsight and perspective that maybe someone who has just finished school doesn’t necessarily have.
7:30 Do you feel comfortable talking about what you actually went through?
9:33 How did you get back on track?
Part of it was the demands of the profession and part of it is my programming. And that’s not something that you know how you’ll going to react until you’re faced with it. And in going to therapy weekly and having proper inward reflection and discussions about why I react, how I react, why I feel what I feel, what are triggers to certain of my feelings, that helped me become a lot more aware. Then with the therapist, you get tools. I’m sure this is something that you assist your clients with as well is how to cope.
[…]
The awareness lessens the blow.
[…]
What I really appreciated about therapy was the objectivity of it and the perspective. Going into it, I thought, ‘Well, this person is not going to care about me. So how are they going to be able to give me the proper advice?’ But it was quite the opposite.
I think they are very invested and coming at it from a place without bias. I was able to see things a lot clearer when it came my personal relationships, my family, and, quite frankly, my job and how to attack those challenges and how to deal with different people within my workplace and how to deal with my work tasks.
14:14 For many people there is this fear that these kinds of feelings are irreversible. ‘I’ll never be able to handle the emotional demands of my job.’ Yet you came out the other side and are now an award winning lawyer.
17:41 I do appreciate the nuance. Anxiety or depression is not a moment that you triumph over and that you never have to think about again. We need to maintain a certain amount of mental fitness. So it is possible to be in that dark place and then come out of it. Your story is very inspiring.
20:09You mentioned that it is not always obvious for lawyers to be vulnerable. It is part of the culture of the profession to not come forward.
Can you tell us about the culture and why it is a part of the culture? And what do you think we can do about it?
[…]
We have to talk about this stuff more. It has to become more of a way of being as much as, ‘Did you get this done on time?’ Because no one is going to get it done on time if they’re not in the proper state to do it.
[…]
25:09I have a lot of respect for the leadership you’re taking in this space. How can people keep in touch with you?
* * *
Here are some highlights of the conversation with Bree:
26:35 Tell us what you do.
28:00 What exactly is the National Task Force on Lawyer Wellbeing?
We’re a rogue band of individuals who really care passionately about lawyer wellbeing.
[…]
Helping lawyers who are already experiencing depression, anxiety, substance use disorders and helping them overcome and deal with them and go into recovery for those impairments. And it’s also looking to support lawyers who are really not thriving in their profession and just have a sort of general malaise in their life and are not happy. We have something to offer everybody in the profession.
Those of us who work on this on a national level came together a couple of years ago, commandeered an empty conference room at the American Bar Association because we were all already there wearing the chair of this or the commissioner of that. We were already in one location.
And the reason we got together on that day in August of 2016 is two big reports had just been published that made it so clear and undeniable that the state of lawyer well-being was dire. Prior to this we didn’t really have good studies or statistics. We certainly had anecdotal evidence of what had gone on.
[…]
One study showed incredibly rates of alcohol abuse, substance abuse, high, high rates of depression and anxiety disproportionate to the general population. The same year a study was done and published of law students across the United States.
[…]
What we saw very clearly was that these issues are starting in law school. If you compare these rates of impairments in law students with people in the general population, you can start to see that there’s something about the experience of entering into the legal profession that has almost a pathologising effect.
Anxiety goes up, substance abuse goes up, depression goes up. One of the most of concerning things out of these two studies that we saw that really turned things on its head is that the younger the lawyer, the greater the rate of impairment, regardless of what type it was. We used to think that the people who did the work the longest would have the higher rate of problems.
[…]
All of those of us who are coming from different parts of the law, the lawyer assistance programs, the people who regulate the profession, the bar counsel, the disciplinary folks. Across the board, we noticed that we have a moment here. We have an opportunity because the data is in. It’s undeniable. We cannot just sit here and fail to take action and let these studies go on a shelf somewhere because we know that lawyers, law students, and judges are suffering.
How does that impact society in general? When you have people attending to the judicial system and our system of laws and our access to justice who are not doing well in their work, it affects all members of society.
[…]
We decided that we were going to use this opportunity to nothing short of create a movement to change the legal culture and how it takes care of its own, how it treats the lawyers and law students who come into this profession. To institute a culture change and a real shift in how that work is done.
We knew would not be easy.
So the first thing that we did is started bringing in the other leaders of their profession, other stakeholders who have an interest in this and bring them to the table. So we started having conference calls every couple of weeks and broke into work groups. And started looking at each of the stakeholders within the profession. What do they need to do to bring about a culture change within their area?
And we all got together to find out, what are some recommendations for the entire legal profession and recommendations for each stakeholder–judges, legal educators, law schools, the people who regulate and manage the profession, the legal employers?
[…]
At this point in time, it really is a movement.
36:35 Why do you think this work has been so well received?
39:53 You mention that the doors are being opened. Are there any other signs that you’re having an impact?
41:40 What impression did you get from Yan Besner’s story?
It sounds par for the course for what lawyers are experiencing. There is an uncertainty. It’s part of the profession. High stress is part of the profession. That’s never going to change. High stakes. We’re dealing with people with the most urgent issues, sometimes of their entire life that has landed in our laps and we’re being look to to fix that. That’s not going to change about the law profession.
[…]
How do we build up the lawyers so that they can endure this inevitable chronic stress, uncertainty, and difficulties that are part of the profession?
[…]
It’s around resilience. Thinking of it through that lens. How do we improve the resilience of lawyers to be able to deal with the inherent adversities and setbacks of practice and life? Giving them tools to be able to do this like meditation, mindfulness is an automatic go to out of my toolkit for my personal life, but also something that I try to teach lawyers as well. There are practices around gratitude, positivity, a variety of skill sets that can lift one up to be able to better endure what is thrown at us on a daily basis.
45:08 Yan spoke about when he was younger he was reluctant to go to talk to somebody about what he’s going through. That was an important finding in one of the 2016 studies that young lawyers don’t make themselves vulnerable in that way.
I was wondering if you heard of that kind of story as well.
49:53 I’m curious to hear how lawyers of the legal profession respond when you expose yourself like that.
51:56 Are there still people who think that you’re just weak and it’s not necessarily mental illness?
I believe that there are. And people engage in defence mechanisms. Play old tapes and are not comfortable with that self revelatory experience and don’t think there’s a place in a CLE program.
And I’ve gotten beyond that. I know that when I am saying my story that there are people who are going to be uncomfortable. And I’m okay with that. I get up there knowing that I’m not going to please everybody in the room. But my mission is that if I can get up there and reduce the suffering of someone in the room and maybe even save a life down the road somewhere, my discomfort and the passing discomfort of someone in the room because they had to listen to my story, is well worth it.
53:26 If you’re up for it, how did you get into your difficulties with substances and how did you get yourself out?
I’ll give the short version because we don’t have all that much time [laughs]. To sum all of it up, I had a very uncomfortable and painful childhood. And I, like so many people do when they experience that, found pretty quickly that substances medicated that pain and discomfort.
So in high school, it was alcohol. And undergraduate, it was marijuana. I went to law school, and I said, ‘I better leave aside the illegal drugs.’ So I turned to what is so sanctioned in law schools and the legal profession which is alcohol in copious amounts. I had an anxiety disorder by the time I finished my first year of law school. The go to to deal with that was to drink, and drink a lot.
Fast forward through my profession, I got to do a lot of really cool things. I got to work and represent victims of domestic violence and really threw myself into some tough, tough areas of the law that brought up stuff for myself. I didn’t take care of myself in the best ways. And I continued with that quick easy fix, go-to of alcohol. They say it works, until it doesn’t. And a lot of times it made me feel better.
But it is insidious and over time, you pour enough alcohol onto somebody who is genetically predisposed because of family history to develop an alcohol use disorder, that starts to change the brain, the actual brain chemistry. That’s what happened with me.
It goes from something you choose to something you don’t really have a choice over. It took me a long time to get there, but I definitely got to that point. Through all of that, I’m self-medicating anxiety, I’m self-medicating depression and covering all of that up.
And at one point, in my 40’s, it all started–it was like a game of Jenga–it all just came crumbling down. I lost my marriage. I lost my job. And boy, when a lawyer loses their job, it really gets their attention. It’s terrible, but it’s the truth.
At that juncture, which was my low point. Some other people need to get to the point where they also lose their house. Losing a marriage and losing my job was my bottom. And then I started looking for a way to find my way out.
I did that through getting into really regular therapy, getting on also the right medication, getting into a mutual support group that supported my recovery, and also getting into a community of meditators. That really helped save my life as much as anything else, developing a meditation practice. So I could get real with myself and stabilize my mind. I spent some time out of work, putting myself back together again. Then I was truly blessed to get a job here at the Lawyers Assistance Program. So for the past 8 years I live and breathe recovery. It’s an amazingly blessed life and one I could never have imagined with those dark days in 2009 and 2010.
57:36 Thank you for sharing. Could you tell us about some of the specific changes that you’re trying to create on the ground for the profession?
1:01:40 Is there anything else you want to speak about?
