Make Things Well

  • Establish transition routines

    Establish transition routines

    To help yourself transition from work mode to home mode:

    • Create a routine or decompression time. Allow time for rejuvenation to recover from the emotional or physical exhaustion you may be feeling.
    • Listen to something that uplifts or relaxes you on the way home to help take your mind out of work.
    • Have a signal with your spouse or family member that indicates you need time before interacting with them. For example, thumbs down as you enter lets them know you had a difficult day and need a hug.
    • When you get home, take the dog — or just yourself — out for a walk.
    • Use meditative, grounding, or gratitude practices prior to reintegrating with your family.

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  • Substance use and violence in times of crisis

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    Substance use

    People use substances like alcohol, nicotine, cannabis, and other drugs for many reasons. Some use them for medical care, recreation, or religious traditions. Others use them to handle stress, pain, or trauma.

    During hard times, people may lose access to healthy coping methods like exercise or socializing. Some may start using alcohol and drugs. Others may increase their existing use.

    Disasters can reduce or cut off access to legal substances, pushing people toward unsafe alternatives. Hazardous events can also make it harder to get medical help or support.

    Substance use and mental health are connected. Stress caused by a crisis or hazardous event can potentially lead to anxiety, depression, and other issues. In-person support groups, doctors, and health care providers may be harder to access at these times. Ideally, virtual alternatives can be available or quickly mounted to bridge these gaps.

    Substance use is different for everyone and can be viewed on a spectrum with varying stages of benefits and harms. If you start to notice that a family member or friend is acting differently than before or is having problems in various aspects of their life, they may be struggling with substance use.

    Need help with substance use?

    Family and gender-based violence

    Hard times can lead to episodes of family and/or gender-based violence. Stress, financial hardship, and social isolation can make existing tensions worse. In some cases, substance use may also contribute to violent behaviour or make it harder for victims to seek help.

    Violence can take many forms, including physical, emotional, financial, and psychological abuse. It can happen in any relationship — between partners, family members, or caregivers. If you or someone you know is experiencing violence, support is available.

    Need help with family violence?

    Need help with gender-based violence?

  • Tips for problem solving

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    Why solve problems?

    Problem solving helps break complex problems into smaller, manageable steps. This makes it easier to decide how to create a plan of action and what to do first.

    This process can be stressful. If that happens to you, bring your mind to the present using the S.T.O.P. strategy:

    • S — Stop and take a moment to pause.
    • T — Take a few deep breaths or calm yourself with a grounding exercise.
    • O — Observe what’s happening around and inside of you.
    • P — Proceed mindfully. Ask yourself, “What can I do right now to help solve this problem?”

    Define the problem

    Indecision often happens when you don’t fully understand the situation. This is why it’s important to clearly define the problem when it occurs.

    • Break big problems into smaller parts. Be specific.
    • Focus on solving one part of the issue at a time.
    • Decide ownership! We often take on other people’s problems, so it’s important to ask ourselves: Is the bad thing happening to me, or is this someone else’s concern?

    Set a goal

    Once you understand the problem, decide what you want to happen. Setting a clear goal will help you figure out what steps you need to take to resolve your situation.

    Try to use the S.M.A.R.T. method:

    • S — Specific: What exactly will you do?
    • M — Measurable: How will you know when you are done?
    • A — Achievable: Can you really do this given your time and resources?
    • R — Relevant: Is this plan aligned with your bigger goals?
    • T — Timed: When will you finish?

    Brainstorm ideas

    Think of as many ways as possible to meet your goal. Don’t worry if an idea is good or bad or realistic or not — for now, just list everything that comes to mind.

    If this is difficult, think about trusted people in your life and imagine how they would go about this.

    Choose the best approach

    Work through your brainstormed ideas. For each one, ask yourself:

    • What are the pluses and minuses for this option?
    • How much time will this take?
    • What might happen if I do this?

    When you’re done, review your answers and pick the idea that seems most helpful.

    Put your plan into action

    Write down your selected steps to success. You are ready. Start working to solve your problem! 

    Resources

  • The power of scheduling positive activities

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    The activities you perform have a strong impact on your mood and how you feel. When you are feeling stressed and overwhelmed, it can seem hard — or even impossible — to do the things that bring joy and meaning to your life.

    However, engaging in enjoyable activities is a powerful way to boost your mood and make you feel better. Reflecting on the activities you already do and do not perform is a great step towards making a positive change.

    Low mood or high stress can lead you towards feeling less motivated and less able to engage in the activities you enjoy. This can further lower your mood, energy, and motivation — repeating the cycle.

    Activity monitoring involves tracking your daily activities and noticing how each one affects your mood. For example:

    1. You can use a calendar, a notes app on your phone, or a worksheet like this one to list all the activities you do during your day. After each activity, reflect on whether it improved or worsened your mood. Give it a score ranging from 1 (worst mood) to 10 (best mood).
    2. Track your activities for a full week to create a snapshot of your daily life. At the end of that week, take a close look at your records:
      • Which activities led you towards positive moods (6–10)?
      • Which activities led you towards negative moods (1–5)?
      • Were there any days with few or no activities that made you feel happy or gave you a sense of accomplishment? 
      • Can you see any gaps in your schedule where adding enjoyable activities might improve your moods?
      • Try to notice patterns in the data.
    3. Based on what you’ve just learned, plan a few short activities for your upcoming week to support your well-being and mood.
      • Choose activities that you find enjoyable and/or help you feel a sense of accomplishment and pride.
      • For example, if you observe that your Monday evenings are often gloomy, schedule 15 minutes of self-care, such as going for a walk, listening to music, or participating in a hobby you enjoy.
      • These scheduled activities don’t need to be lengthy — but they should be intentional, so you can build consistent engagement with positive experiences into your daily life.
    4. Stick to the schedule you’ve created for the new week. Pay attention to how the added positive activities make you feel. 
    5. Lastly, give yourself credit each time you follow your new schedule.

    Regularly participating in enjoyable and meaningful activities can boost your mood and overall well-being. In turn, this increase in energy and motivation can help you stay engaged with those activities.

  • Peer support

    Peer support

    Facilitating peer support and strong connections within your team is an effective way to mitigate adverse mental health outcomes.

    Ensure structures are in place for colleagues to provide social support to one another — such as having the opportunity to take regular breaks or developing structured peer support groups/programs.

    Additionally, leaders can encourage a supportive mental health culture to reduce fear of stigmatization and increase the likelihood of providers seeking support. Holding daily huddles to create a sense of belonging and building a sense of community through inclusion can be important steps to developing trust and safety within the team.


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  • Accept things as they are

    Accept things as they are

    It is challenging to acknowledge when a situation is hard, especially when you think it should be different. Here are some steps to help you accept things as they are and recognize when you are struggling to do this:

    1. Notice when you are trying to change or deny things that can’t be changed. This may lead to thoughts of despair or unfairness, or to feeling emotions such as anger and frustration.
    2. Remind yourself that “It is what it is,” and nothing can be done now. You may need to do this multiple times a day/hour/minute, depending on the situation and your mental state.
    3. While acknowledgment is important, so is allowing yourself to feel the emotions that come along with it, such as sadness and disappointment. These feelings are healthy.

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  • Practice self-compassion

    Illustration of a woman hugging her reflection in a mirror
    Illustration of a woman hugging her reflection in a mirror

    Practice self-compassion

    We are often our own harshest critics. We would not talk to our best friend the way we sometimes talk to ourselves.

    Begin to give yourself the same love, kindness, and support you would give to your best friend. Be fair to yourself. Recognize when things are hard and encourage yourself, just as you would your friend.


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  • Avoid information overload

    Avoid information overload

    Wanting to stay updated with current and notable events is expected. However, too much information can lead to you feeling negative, overwhelmed, and overstimulated.

    You can avoid some of these feelings by reducing the time and instances you check news and information sources to once or twice a day. Along with this, seeking out credible sources of information can also help you avoid misinformation and frustration.

    It is also a good idea to totally unplug and not look at your devices at least once a day, even briefly.


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  • Umbrella stretch

    Umbrella stretch

    Relieve stress-related tension by engaging in the following movement practice:

    1. Inhale and raise arms
    2. Interlock fingers
    3. Palms to the sky
    4. Vertical stretch
    5. Release fingers
    6. Exhale and lower arms

    Close your eyes and raise awareness to your heartbeat, breath, and surrounding sounds.

    Take a few moments to yourself and repeat as needed.


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  • Grounding stones

    Grounding stones

    You can self-soothe stress and anxiety using grounding stones. These smooth, coloured stones have historically been used as a means of stress relief and relaxation.

    • Place the stone between your index finger and thumb.
    • Gently move your thumb back and forth across the curve of the stone.
    • Pay attention to why you picked up the stone.
    • Accompany your steady breathing with positive thoughts and emotions.

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  • Boxed breathing

    Boxed breathing

    Boxed breathing, also known as four-square breathing, involves:

    • Inhaling for a count of four
    • Holding air in your lungs for a count of four
    • Exhaling for a count of four
    • Holding your lungs empty for a count of four before beginning anew

    It can help to visualize your breath travelling around the four edges of a square while breathing.

    ✳️ Learn more from Healthcare Salute


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  • Body scan

    Body scan

    The body scan is one of the most effective ways to begin a mindfulness meditation practice. The purpose is to tune in to your body — i.e., to reconnect to your physical self — and notice any sensations you’re feeling without judgment.

    • Sit quietly or lie down
    • Start at one end of your body and focus on each body part
    • Notice any areas of tension and then try to soften or relax them
    • Continue until you have mindfully scanned each part of your body

    ✳️ Learn more from Healthcare Salute


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  • T.I.P. skills

    T.I.P. skills

    When you are struggling to cope with intense emotions, you can use T.I.P. skills to calm these feelings. 

    T.I.P. stands for:

    • Temperature: Cold temperatures can help reduce our heart rate when we are feeling overwhelmed. Splash cool water on your face, take a cold shower, or go outside for a walk if the weather is chilly.
    • Intense exercise: Spend excess energy by engaging in an intense cardio exercise. This does not require a workout plan, just go for a run or do some jumping jacks.
    • Paced breathing: Take a deep breath in through your nose for four seconds and then breathe out through your mouth for six seconds.

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  • Half smile, willing hands

    Half smile, willing hands

    Stress can often lead to impacts on our bodies, but the reverse is also true: our bodies can have profound impacts on our minds.

    To help your body communicate to your brain that you are okay, practice the half smile, willing hands strategies. These strategies can help us regulate our systems and feel better in the moment.

    Half smile

    1. Relax the muscles in your face, starting with your forehead and moving down to your chin.
    2. Turn up the corner of your mouth very slightly to create a “half smile” reminiscent of the Mona Lisa’s.

    Willing hands

    1. Either sit comfortably, stand, or lie down for this exercise based on your preference.
    2. Ensure your muscles are fully relaxed.
    3. Place your hands palms up in your lap, if you are sitting, or find a comfortable position to hold them up while standing or laying down. Ensure your fingers are relaxed.

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  • Cold splash

    Cold splash

    Splashing cold water on your face from, say, a sink or a bowl has two main effects:

    1. Providing a controlled shock to your system, which helps shift your focus from what is distressing you.
    2. The cold water will help reduce your heart rate, making you feel calmer and less anxious.

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  • 5-4-3-2-1 grounding

    5-4-3-2-1 grounding

    Use the 5-4-3-2-1 grounding technique to mindfully take in the details of your surroundings using each of your senses.

    Notice:

    • Five things you see.
    • Four things you hear.
    • Three things you feel.
    • Two things you smell.
    • One thing you taste.

    Try to notice small details that your mind would usually tune out, such as distant sounds or the texture of an ordinary object.

    ✳️ Learn more from Healthcare Salute


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  • Practice S.T.O.P.

    Practice S.T.O.P.

    Starting to feel too much or too little? These are signs that you’re at risk of acting from either your survival brain (based on defensive instincts) or emotional brain (based on emotion), not from your learning brain (based on thought).

    At such times, practice the S.T.O.P. skill to connect with your learning brain:

    • S → Stop: Instead of acting out of a sense of overwhelm, take a moment to pause.
    • T → Take a step back: Do some deep breathing and/or grounding. Give yourself space to evaluate what is going on before acting.
    • OObserve: Notice what’s going on around you and inside of you.
    • PProceed mindfully: Ask yourself “What can I do that is most likely to help me effectively address this situation?” or “What choices might make this situation better or worse?” or “What actions will help me be successful?”

    ✳️ Learn more from Healthcare Salute


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  • Tame the thought monster

    Tame the thought monster

    Choose a thought that you find particularly bothersome.

    Label your thought as a thought: If you are thinking, “Bob is a jerk,” say to yourself, “I am having the thought that Bob is a jerk” or “I am telling myself the story that Bob is a jerk.”

    Appreciate what your mind is trying to do: Say to yourself, “I really get that you are trying to be of use. You are trying to keep me out of trouble and make sense of a difficult situation. Thanks.”

    Repeat your negative thought out loud: Say it with a silly voice, such as Eeyore from Winnie-the-Pooh.

    Notice when you are being “hooked” by the thought: Choose to become unhooked.

    Notice when you are “buying into” a judgmental or blaming thought: Ask yourself, have I bought into this thought before? Is this an old and familiar pattern? Will buying into this story lead to a more fulfilling life, or will it lead to more pain and suffering in the long run?

    ✳️ Learn more from Healthcare Salute


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  • Practice grounding

    Practice grounding

    Practice grounding by using a raisin or small candy, such as a jellybean, to centre yourself in the present. Keep a container of your preferred snack nearby to use this strategy when experiencing a stressor.

    1. Holding: Pick up a raisin and hold it in the palm of your hand.
    2. Sight: Pay attention to the raisin. What are some noticeable features? What colour is it?
    3. Smell: Bring the raisin to your nose. How would you describe the smell?
    4. Touch: Close your eyes. What does it feel like? Is it smooth, soft, bumpy, rough?
    5. Taste: Place the raisin on your tongue. Can you taste it? Chew slowly. What does it taste like now?
    6. Follow: As you swallow, pay attention to the feeling of the raisin passing down your throat. Is there an aftertaste? How does your body feel after this exercise?

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  • Hand-on-heart exercise

    Hand-on-heart exercise

    Take a deep breath in. On the exhale, place your right hand over your heart and your left hand on top.

    Next, breathing normally, notice:

    1. The sensation of your hands on your heart.
    2. The warmth flowing from your hands on your chest.
    3. The gentle pressure.

    Keeping your hands in place, send warmth, caring, and compassion into your chest. Spend a few more minutes here. There is no hurry and no limit to the amount of compassion you can send and receive. Practice compassion through this exercise whenever or wherever you are, including at work.

    ✳️ Learn more from Healthcare Salute


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  • G.I.V.E. C.A.R.E.

    Illustration of a woman hugging her reflection in a mirror

    G.I.V.E. C.A.R.E.

    At times, you can be your own worst critic. When you find yourself questioning your ability to bounce back, know that you can do something different, and it is okay if you make mistakes as you learn.

    Let’s get to a place where you’re going to:

    1. Learn something new.
    2. Practice it.
    3. Give yourself credit.

    Don’t forget to G.I.V.E. C.A.R.E. along the way:

    • G → Be gentle with yourself.
    • I → Take interest in why you might be feeling this way and whether you might be missing something that might change how you’re feeling.
    • V → Validate, recognize, and acknowledge your suffering. Be fair to yourself in understanding that you are not alone, and that suffering is part of being human.
    • E → Address yourself in an easy manner. Be kind, gentle, and fair with yourself, even if you’re unable to do things as you’d like right now.
    • C → Be curious about your options. What could really help you in this moment?
    • A → Acknowledge that change is hard and doing things differently is difficult.
    • R → Reflect on which of your options is most likely to help you get to where you want to be.
    • E → Encourage yourself to go through with the option that you’ve decided is best, even and especially when it’s hard.

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  • Practice during calm periods

    Practice during calm periods

    Use positive mental health support tools during calm periods to practice helpful skills. Having this repertoire of stress-relieving exercises at your fingertips will help to ensure that challenging moments will be more manageable.


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  • Take a pause

    Take a pause

    You may feel as though your time is better spent doing other, more “urgent” tasks, but your mental health is just as important. Whether you can spare five minutes, five hours, or five days, you can work towards having helpful mental health tools on hand regardless of time.

    Think about:

    • Why you are overwhelmed in this exact moment.
    • What has helped you in the past (e.g., bath, grounding, pets, exercise, breathing).
    • Who you can talk to about your experiences.

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  • Cope in the moment

    Illustration of a harried man sitting at his desk, overwhelmed by work tasks

    Cope in the moment

    If you are at work and experiencing stress or overwhelming emotions, it can be difficult to cope with them in the moment. Here are some strategies you can implement when at work:

    • Actively listen to what your colleague is saying to keep you in the present.
    • Clasp your hands tightly to use the sense of touch to ground yourself.
    • Affirm: Remind yourself you can do this. Recall successful results in the past.
    • Scan your environment and note key characteristics. Use your sense of touch to ground yourself.
    • Walk slowly: Take notice of each step as you walk from one area to the next to help yourself reduce intense emotions.

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  • Refill your own pitcher

    Refill your own pitcher

    The thing about clichés is that they’re most often true. Without your oxygen flow, it can feel like you’re suffocating. So put your own oxygen mask on first. Take care of yourself by using any of the following strategies:

    1. Take your dog (or just yourself) on a walk.
    2. Do boxed breathing.
    3. Have a safe space you can go to recentre and ground yourself.
    4. Splash cold water on your face.
    5. Use sensory stones.
    6. Call a loved one.

    What is your oxygen mask?


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  • The feelings machine

    The feelings machine

    Learning about the stress response cycle is an important step in helping people build their tool kit of positive mental health practices.

    The animation seen here can be used as a guideline.


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  • Building social connections

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    During and after a traumatic event, we need other people. Relationships are key to helping individuals and communities heal after something bad happens.

    • Social connections can reduce the impacts of trauma. They let us lean on others during our times of greatest need.
    • Strong relationships can bring people together, even those who feel alone or excluded.
    • Social connections take time and energy to build and maintain. 

    It’s worth investing in trusted relationships. When they are formed, those who have experienced trauma can feel supported and find hope for their future.

    How can I build social connections after trauma?

    • Look at your current relationships:
      • Think about the people who are already in your life.
      • This might include family, friends, co-workers, or neighbours.
      • Ask yourself: Can I turn to them for support?
    • Find community social supports:
      • Are there nearby groups and organizations you can join?
      • Look for clubs, groups, teams, committees, online forums, and more.
    • Connect with cultural and identity-based organizations:
      • Are any groups related to your culture, identity, or religion?
      • This might include family, friends, and others who share your values or beliefs.
    • Map out your social connections:
      • Write down or draw a diagram of the connections you have just identified.
      • Include people and groups from across your personal, community, and cultural areas.
    • Plan to connect:
      • Select one connection to reach out to first.
      • Make a plan to do that using the S.M.A.R.T. method: Specific, Measurable, Achievable, Relevant, and Timely.

    Example of a social connections map

    Example of a social connections map depicting a plan to connect with a friend from volunteer group
  • Moral challenges, moral distress, & moral injury

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    Sometimes you are exposed to situations that challenge your sense of right and wrong. These experiences can vary in how long they last and how intense they feel. They can stir up feelings that range from mild moral frustration to more serious moral injury.

    Understanding moral challenges

    • A moral challenge might cause moral frustration, such as worrying about the state of the world. Usually, this feeling does not affect you too deeply or last for very long.
    • Moral distress can bring up emotions like anger, sadness, and guilt, although it rarely has a lasting negative effect. Being lied to or having something stolen might cause moral distress.
    • A potentially psychologically traumatic experience can be a singular event or an ongoing situation. It is a rare but intense violation of your deeply held moral beliefs. Many PPTEs are high-stakes scenarios that can create long-standing challenges in how you see yourself or other people.

    Types of potentially psychologically traumatic experiences

    PPTEs can happen in different ways, such as:

    • Transgressions of the self involve doing (or not doing) something you think is right.
    • Transgressions of others happen when someone else’s actions or inactions go against your morals.
    • Betrayals occur when people or institutions you trust let you down.

    Examples of potentially psychologically traumatic experiences

    Things that might be considered PPTEs include:

    • Seeing something harmful or immoral happen and being unable to stop it.
    • Experiencing misconduct from a trusted person or institution.
    • Feeling unsupported by leadership after a major event that went against your beliefs.
    • Carrying out orders you believe are immoral. 
    • Feeling like you should have done something to prevent someone’s death or injury.
    • Witnessing suffering in others caused by actions that were committed by you or someone else.

    Signs of moral injury

    After a PPTE, you might notice changes in your emotions, behaviours, and social life — perhaps even your beliefs. These could include:

    • Feeling exhausted or disconnected from your work and the people around you.
    • Feelings of shame, guilt, anger, or hopelessness.
    • A sense of betrayal or injustice.
    • Loss of purpose or sense of identity.
    • Having difficulty concentrating.
    • Losing trust in yourself or others.
    • Isolating or feeling cut off.
    • Blaming yourself.
    • Struggling with your spiritual or existential beliefs.
    • Self-sabotaging, self-harming behaviours, like using alcohol or drugs to cope.

    What can help?

    If this sounds familiar and you think you are experiencing a moral injury, here are some steps you can take:

    • Write down your thoughts and reflect on the values that matter to you.
    • Talk to people you trust, like colleagues, family members, spiritual advisors, peer supporters or your friends.
    • Seek help from a mental health professional.
    • Learn more about moral injury within your community (e.g., first response, health care, military).

    Resources

    If you are interested in learning more about moral injury — particularly among essential service workers — you can read: 

  • Cultural considerations

    This page is for you if:

    • You feel different parts of your identity (professional, personal, racial, gender, etc.) are in conflict with one another 
    • You feel you need to ignore, forget, or drop important parts of your identity in parts of your life (e.g., be someone else at work)

    Can you bring your whole self to work?

    Human beings are incredibly complex. We all have multiple aspects to our identities that contribute to how we see ourselves and the world around us. 

    Your identity — for example, being Black, gay, Muslim, non-binary, autistic, deaf, or living with chronic pain — is who you are. 

    It may not be possible for you to leave these parts of yourself behind when you go to work. There are many parts of your identity that cannot be switched off, including:

    • Race and ethnicity
    • Sexual orientation
    • Gender identity
    • Age
    • Religion
    • Ability
    • Neurodiversity
    • Health status

    It can be stressful to feel that you should or must put these intersecting, multi-faceted aspects of your identity aside when your experience of the world is rooted in them. This may be particularly true during personal, societal, or global crises that bring awareness to particular parts of your identity — for example, increased awareness of the Black Lives Matter movement or the disproportionate impact of the COVID-19 pandemic on Black and racialized communities.

    Navigating these experiences in high-stress or unsupportive environments can lead to personal challenges including:

    • Difficulty reconciling conflicting roles and responsibilities
    • Conflict or confusion within your values, or between your values and the values of others
    • Feeling shame or hiding important parts of yourself in certain settings
    • Feelings of anger, injustice, or betrayal (towards yourself, an important other, and/or society)
    • Feeling powerless or at the mercy of society’s views and assumptions about you
    • Compassion fatigue
    • Feeling misunderstood, unseen, and/or underappreciated

    How do different cultures experience mental health?

    Apart from these stressors, there are cultural and social differences to how we all experience mental health.

    • Different cultures and communities can experience trauma differently. What might be traumatic for someone from one culture may not be for someone else from a different culture.
    • Different cultures and communities can experience mental health symptoms differently. For example, people from some cultures are more likely than others to describe physical symptoms (e.g., stomach aches, feeling heavy or weighted, cardiac-related issues, etc.) when discussing their mental health.
    • Different cultures and communities can differ in beliefs, values, and ideas around mental health. In some cultures, seeking mental health help is considered acceptable. In others, it may be discouraged or even considered shameful.
    • Different cultures and communities can have different ideas and ideals around healing the mind, body, and spirit. Therapeutic practices can vary greatly across cultures.

    For people who grew up in a different culture but now live and work in a predominantly white Western community, it can be difficult to adapt to the fixed perspective through which that community views mental health. In addition, people who grew up within Western culture and work in the same environment may disagree with how societal views have evolved over time.

    Activities

    Connect

    No one else has ever lived through your exact experiences. An important part of honouring your own complex identity can involve connecting with others who share or have shared some of its parts. 

    Seek out others who have part or parts of your identity in common. Connect over the nuanced ways those parts inform your overall experience of the world.

    Identify your hats

    Take some time to think about the parts of your identity that are most important to you. Write them out in a list. Next, indicate which, if any, are in conflict with your current place in the world. For each of these conflicts, jot down a few examples of ways that you already are (or could be) engaging with and expressing these parts of yourself.

    Writing prompt

    What were you taught about mental health growing up? How, if at all, have your views changed over the course of your lifetime?

  • Lifestyle factors

    This page is for you if:

    • You have trouble falling asleep or getting restful sleep during the night
    • You are looking for strategies to boost your brain health and increase the effectiveness of your coping strategies
    • You want to learn about how taking care of your body can improve your ability to tolerate mental stress and help with emotional regulation

    Sleep

    Sleep is a state of unconsciousness in which the body is at rest in response to external stimuli, but very much active and responsive to internal stimuli. It is thought to play a restorative role for both the body and brain. It gives your brain cells a chance to shut down and repair themselves. 

    Your quality of sleep and rest impacts all areas of your health and wellness. This is because the brain controls all aspects of your body, including:

    • Physical health: Sleep heals and repairs cells, increases immune system functioning, and balances hormones.
    • Mental health: Quality of sleep can influence mood and impact emotion regulation abilities.
    • Productivity: If you lack adequate sleep you may take longer to finish tasks, be more likely to make mistakes, and have slower reaction times.
    • Consolidating memory: Your ability to learn and store new information is dependent on good quality sleep.

    People who experience high stress and/or trauma often notice an impact on their sleep habits. For example, sleep disturbances impact 70–91 percent of individuals diagnosed with PTSD. 

    These problems include:

    • Difficulties falling asleep due to racing thoughts. Feeling like your mind cannot settle
    • Less restful sleep
    • Difficulty staying asleep
    • Upsetting dreams or nightmares

    Insufficient or low-quality sleep can be impactful during the daytime hours when you are awake, including:

    • Reduced ability to learn or solve problems
    • Difficulty making decisions and concentrating
    • Reduced ability to regulate emotions and manage stress
    • Low mood and increased irritability

    Because many of the consequences of poor sleep overlap with symptoms of posttraumatic stress, they often perpetuate and exacerbate one another. For example, many people who experience symptoms of trauma will notice high levels of stress, making it difficult to relax, wind down, and achieve restful sleep. In turn, this can decrease their ability to cope with daytime stressors.

    Nutrition

    It’s also important to nourish the brain. Food is essential to grow new brain cells, transmit important nutrients and chemicals, provide fuel for your nervous system, and help protect you from disease. 

    Nutrition is an important part of a healthy and fit brain.

    A healthy diet is good for your body and your mind. This includes fresh fruits and vegetables, lean proteins, whole grains, nuts, seeds, spices, and herbs. 

    A nutritious diet is important for people who have experienced high stress or trauma. Its benefits include:

    • Increased mood and emotional health
    • Improved cognition and decreased risk of cognitive decline
    • Increased sense of control
    • Increased energy and motivation

    Nacamulli, M. (2016 June 21). How the food you eat affects your brain – Mia Nacamulli. [Video]. TED-Ed. How the food you eat affects your brain – Mia Nacamulli – YouTube

    Movement

    Physical activity is a vital part of any healthy lifestyle. Regular exercise has many benefits that can minimize symptoms of stress and PTSI, including:

    • Improved mood: Exercise increases dopamine and serotonin, the chemicals in the brain that make you feel good
    • Improved cognition: Exercise stimulates growth of new brain cells and reduces harmful chemicals in the brain
    • Improved sleep and restfulness
    • Increased feelings of strength and self-esteem
    • An outlet for intense emotions (e.g., anger or anxiety)
    • Stronger mind-body connection
    • An opportunity to set goals and develop new healthier routines
    • Opportunities to connect with others and form a community around a shared interest or hobby
    • Reduced stress and increased opportunities for play and fun

    There are many lifestyle factors that can impact your ability to tolerate stress and recover after traumatic experiences. 

    This resource is not an extensive list. Remember: everything that affects you and your body also affects your mental health.

    Activities

    Progressive muscle relaxation

    This technique teaches you how to relax your muscles through a two-step process. 

    First, tense a particular muscle group in your body, such as your biceps or fists, for about three seconds. 

    Next, gradually release the tension and notice how those muscles feel when relaxed.

    You can start from your toes and work your way up to your forehead. This exercise will lower overall tension and stress levels and help you relax. It can also improve sleep and reduce physical problems such as stomach aches and headaches.

    Practice sleep hygiene

    Create a bedtime routine that you complete each night before sleeping. It might include a final check of your phone or email, cuddle time with a pet or loved one, brushing your teeth, a meditation or breathing exercise, reading, or anything else you like to do before bed. 

    Complete the routine in the same order at the same time each night. The repetitions will cue your body that it is time to wind down and relax, which can help improve your sleep.

    Writing prompt

    Write your responses to these questions:

    • What do you fuel your body with? What kinds of food, substances, movement, and/or rest are you giving to yourself? 
    • How do you feel after you give yourself those things? 
    • What kinds of fuel would you like to give your body? Why, and how so? 
    • What is getting in the way of giving yourself the things you want?
  • Moral injury

    This page is for you if:

    • You struggle to cope with having to make difficult decisions
    • You feel let down or even betrayed by others whom you expected to do the right thing and/or protect you
    • You struggle to make sense of things you’ve done, things that have been done to you, and what’s happening in the world

    What is moral injury?

    Like posttraumatic stress, moral injury (MI) is a type of stress response that follows a morally distressing situation. It feels like an injury to your moral compass.

    Morally distressing situations, also known as morally injurious events, arise when you feel your morals are being violated. They make you question right and wrong and challenge your faith in the goodness of yourself, others, or the world. 

    Not everyone who experiences trauma goes on to develop posttraumatic stress disorder (PTSD). Similarly, moral violations and moral pain do not always mean you will develop a moral injury.

    Moral pain exists on a spectrum. On one end there are common moral challenges and resulting moral frustrations. (For example, you may experience guilt if you call in sick or feel angry when a request for time off is denied.) At the other end of the spectrum there are more severe moral violations, including morally injurious events that result in moral injury.

    What’s considered a morally injurious event?

    Morally injurious events can be grouped into two kinds of situations.

    Perpetration

    Perpetration events occur when you do something that violates your morals by:

    • Commission (e.g., doing something that hurts someone else)
    • Omission (e.g., not doing something that helps someone else)
    • Failing to prevent a perceived immoral act (e.g., not doing something that prevents harm to someone else)

    Betrayal

    Betrayal events occur when your morals are violated by someone or something you trust, like a family member or close friend or a powerful institution or organization.

    What are the symptoms of a moral injury?

    A moral injury can result in symptoms across multiple domains of your mental well-being. You may experience:

    Emotional changes

    • Guilt 
    • Shame
    • Anger
    • Hopelessness
    • Anxiety

    Cognitive changes

    • Loss of trust in yourself or others
    • Existential crises (e.g., questioning your purpose and/or the meaning of life)
    • Spiritual questioning or doubts (e.g., querying your faith in a higher power)
    • A difference in the ways you evaluate the integrity of yourself or others
    • Feeling like the world is an unsafe or unjust place

    Behavioural changes

    • Social withdrawal, isolation, or disengagement
    • Self-harm

    Activities

    Create a responsibility pie chart

    Use this technique if you experience emotions like guilt, shame, or anger about who to blame for a challenging event or situation.

    1. Make a list of all possible factors that contributed to the challenging situation, even if you think they are only one percent responsible.
    2. Roughly estimate the percentage of responsibility you can assign to each possible factor.
    1. Assign yourself the remaining percentage once you have listed all other factors.
    2. Draw a pie chart with each factor claiming its appropriate size of slice.
    3. Now that you see the full picture of all contributing factors, is there as much blame left for yourself as you initially thought?

    Connect with gratitude

    Gratitude can counteract many of the negative emotions we experience. Take five minutes each day to identify three things you feel grateful for.

    Writing prompts

    1. Process a difficult decision you’ve had to make. Include the internal struggle, your own feelings of responsibility, and how your decision impacted the way you feel about yourself and others.
    2. Similar to the responsibility pie chart described above, write a short letter describing the challenging event or situation and all the factors that contributed to it. Pay attention to which factors were in your control and which ones were not.
    3. Morally challenging situations can lead to feelings of shame, worthlessness, or a loss of trust in yourself. To challenge some of those feelings, make a list of things you like about yourself. Put simply, what about you makes you feel worthy, valued, and proud?
  • Social relationships after trauma

    This page is for you if:

    • You feel distant, misunderstood, rejected, or excluded by others
    • You have difficulty engaging in healthy social interactions and maintaining relationships (e.g., setting boundaries, resolving conflicts)
    • You have difficulty understanding the motivations, thoughts, and feelings of others
    • You feel emotionally numb, have low empathy for others, or reduced interest in social interactions

    Trauma and social relationships

    Stress and trauma deeply affect our mental well-being and can significantly impact our relationships with others. This can include affecting the way we think, feel, and behave in relationships. 

    It is very common for people who have experienced trauma to notice changes or challenges in their relationships, including difficulties with:

    • Intimacy and trust
    • Sex drive
    • Communication
    • Avoiding people, places, or conversations
    • Attachment (e.g., feeling overdependent, detached, or overprotective of others)

    Several kinds of relationships can be impacted after stressful or traumatic experiences. These can include your professional relationships with:

    • Superiors
    • Mentees
    • Teammates and colleagues

    As well as relationships outside of work, including:

    • Partners
    • Children
    • Parents and family members
    • Friends
    • Pets
    • Strangers

    How does trauma affect your social relationships?

    Trauma can impact your relationships and social life in multiple ways.

    Impacts of traumaSymptoms
    Thoughts
    • How you think about yourself, your body, or your value (e.g., negative self-image)
    • How deserving you feel of love, affection, or praise from others
    • How much you feel you can trust and rely on yourself or others
    • Your beliefs about how safe or fair the world is
    • How you understand the thoughts and feelings of other people
    • Your ability to concentrate during interactions with others or resolve conflict
    Feelings
    • You’re easily startled and hypervigilant, meaning always on edge or worried that something bad will happen
    • It’s difficult for you to unwind or feel relaxed
    • You have a loss of interest in the people, places, or activities you used to enjoy
    • You feel emotionally numb, meaning empty or hollow
    • You find it difficult to experience sympathy or empathy for other people, even your closest loved ones
    • You’re easily irritated or impatient, even about things you used to be able to (or think you should be able to) tolerate
    Behaviours
    • You have difficulty sleeping, which can lead to excessive tiredness and fatigue
    • You have angry outbursts or a “short fuse” with those closest to you
    • You withdraw socially and isolate yourself
    • You avoid people or places that you used to spend time around
    • You have increased conflict with those closest to you
    • You engage in other (potentially unhelpful) coping strategies, such as self-harm and substance use

    If you have experienced trauma and developed one or a combination of these symptoms, you may become caught in a cycle of:

    1. Increased irritability or discomfort around others
    2. Withdrawing, pushing others away, or even noticing others pull away from you
    3. Feeling disconnected, abandoned, and/or unworthy — which may further increase your irritability or discomfort around others

    Tips for family and friends

    Social support is extremely important to recovery from trauma. You can share these tips with your family and friends.

    1. Help your loved one create routines. Structure and predictable schedules can restore a sense of stability and security to someone who has experienced trauma. Create routines that involve having your loved one help with groceries or housework (e.g., maintaining regular times for meals).
    2. Speak to your loved one about the future and make plans. This can help counteract the common feeling among people who have experienced trauma that their future is limited.
    3. Help your loved one remember their strengths. Encourage them to believe they are capable of recovery. Remind them of their strengths, positive qualities, and successes.
    4. Help your loved one identify and manage triggers. Ask your loved one about helpful things they’ve done in the past to respond to a trigger — as well as whatever things they tried that didn’t help them. Then come up with a joint game plan for how you will respond together in the future.
    5. Ask your loved one directly how you can help. For example, you can ask: “What can I do to help you right now?” Ask if a timeout or change of scenery will be useful.
    6. Be a good listener. Don’t push a person who has experienced trauma to talk about it. If they choose to share, listen without expectations or judgments. Make it clear that you’re interested and that you care, but don’t worry about giving advice. It’s the act of listening attentively — not what you say — that is most helpful to your loved one.
    7. Educate yourself about trauma and posttraumatic stress injury (PTSI). The more you know about trauma’s symptoms, effects, and treatment options, the better equipped you’ll be to help your loved one, understand what they are going through, and keep things in perspective.
    8. Accept (and expect) mixed feelings. As you support your loved one, be prepared for a complicated mix of feelings — including anger or frustration. Remember to tend to your own emotions while supporting your loved one.

    Strategies for social relationships after experiencing trauma

    Pace yourself

    Don’t expect too much from yourself too soon. Take social breaks even when you are feeling good. Allow yourself more downtime — or “you” time — than you typically would.

    Identify your triggers

    Pay attention to your mind and body. Notice when something feels good or bad. When someone or something upsets you, don’t judge that person or your emotional response. Instead, get curious. Ask yourself if you’re upset about the current moment or if you’re reacting to a reminder of a past stressful situation.

    Ask for help

    Often, others want to help us,  but they don’t know how. Think about the ways those close to you could make you feel cared for and supported. Share this information with them.

    Write a letter

    Write a letter — which you don’t have to send — to your loved ones expressing your gratitude for their impact on your life. In the first half of the letter, write about the positive ways that they made you feel supported before you experienced trauma. In the second half, describe the ways you would like them to better support you now that you have.

  • The impact of trauma on cognition and problem solving

    This page is for you if:

    • You have unexpected reactions to reminders of past stressful situations (e.g., feeling afraid if you see someone cough)
    • Your body instinctively reacts in real-life situations without your explicit thought or intention — for instance, feeling like your body is on high alert for danger when you are out with friends or family
    • You have increased difficulty understanding or remembering things that people say to you

    Layers of the brain

    While the brain is a complex organ, it can be broken down into three layers: survival brain, emotional brain, and learning brain.

    Survival brain

    This is the oldest part of the brain. It asks the question, “Am I safe?”

    The survival layer is responsible for:

    • Taking in information from your environment
    • Coordinating reflexive, defensive behaviours during times of threat
    • Activating your instincts to protect yourself when you don’t have time to think before acting

    Emotional brain

    This middle layer of the brain is your feeling centre. It can ask the question, “Am I fearful or sad?”

    The emotional layer is responsible for:

    • Emotional learning
    • Storing memories
    • Controlling the release of hormones

    Because emotions and memories are connected in this way, your brain can be unintentionally trained to respond with big emotions to anything that triggers a particular memory. 

    If you experienced overwhelming fear, sadness, or shame during a traumatic event, then you may be likelier to keep experiencing those emotions whenever you are reminded of that event, even well after it has passed.

    Learning brain

    The highest layer of the brain asks the question, “What can I learn from this?”

    The learning brain is involved with:

    • Cognition
    • Problem solving
    • Decision making
    • Attention
    • Learning new skills
    • Adapting to your environment

    Stress and trauma can keep you in your survival brain. Your body’s energy and attention are instinctually put on the defensive while you try to answer the question, “Am I safe?” 

    This situation makes it difficult for incoming information to move up towards your learning brain. You might find yourself struggling with cognition and problem solving as you make decisions that guide your behaviours.

    Stress can feel like a boulder that you are trying to drag out of a swamp. Its weight can cause you to slip backwards. 

    The more stress you carry, the easier it is for you to stay in your survival brain. You can remain in a state of increased vigilance and threat detection — far away from the solid environment of your learning brain, where you can think, plan, and solve problems.

    Stress and the learning brain

    Stress, trauma, and PTSD can negatively impact four core areas of cognition within the learning brain.

    Memory

    • The ability to remember and use information for tasks such as calculation or reasoning
    • Changes in memory are one of the most common symptoms of PTSD
    Cognitive effects of stressImpacts
    Reliving traumatic events through intrusive memories or flashbacksSome people who have experienced trauma describe intrusive memories as movies that play on repeat in the back of their minds.
    Memory loss, gaps, or total amnesiaForgetting the timeline of a traumatic event or entire portions of a traumatic memory.
    Deficits in short-term memoryForgetting the name of someone you just met or where you parked your car earlier.
    Deficits in multitasking or being able to keep multiple thoughts in mind at onceDifficulty holding an address in mind while listening to directions to your destination.

    Cognitive flexibility

    • The ability to hold and switch between different tasks, concepts, or activities and their corresponding behaviours
    • Trauma makes it difficult to access this function because your resources are consumed by your survival brain
    Cognitive effects of stressImpacts
    Reduced ability to acquire and integrate new information at a fast paceDifficulty understanding the gist of a five-minute phone conversation compared to having the same information in an email you can reread.
    Reduced ability to solve problems creativelyGetting “stuck” when solutions are not clear-cut.
    Challenged to quickly adjust responses to changing conditionsFeeling unable to carry on with your day if something unplanned comes up.
    Increase in impulsive behavioursUnintentionally expressing frustration when it may not be productive to your situation.

    Concentration

    • The ability to focus and maintain a single thought process while ignoring distractions
    • People diagnosed with PTSD may struggle to sustain their attention because they are hypervigilant and constantly scanning their surroundings for threats
    Cognitive effects of stressImpacts
    Reduced ability to generate, direct, and maintain alertness so you can correctly process informationDifficulty focusing on or extracting important details from conversations with others.
    Reduced ability to sustain your attention for prolonged periods of timeDifficulty focusing on reading an article or watching a TV show.
    Increase in zoning outFeeling withdrawn or daydreaming throughout the day, whether at work, home, or out with friends.
    Increase in impulsive thinkingMaking decisions quickly without thinking through potential outcomes or consequences.

    Decision making

    • The ability to consider multiple factors and use logic and reasoning when making decisions
    • Good decision making requires several high-level processes (e.g., attention, memory, emotion regulation) that can be impacted by trauma
    Cognitive effects of stressImpacts
    Distrusting your sense of right and wrongFeeling conflicted by what you instinctively want to do versus what is expected of you.
    Making decisions based on emotion rather than logicLetting feelings of guilt result in avoiding making decisions altogether.
    Difficulty recalling important information that could aid decision-makingForgetting about somebody’s offer to help after starting a task on your own.
    An inability to evaluate and incorporate all relevant information given a focus on threat detection or safetyFocusing mainly on negative details of a situation when deciding a course of action.

    These cognitive changes can be incredibly taxing for those who have experienced trauma. However, it is important to remember that the brain is malleable. We can often recover from cognitive challenges.

    Activities

    Problem solving

    When you have a complex problem, break it into the following chunks to make it more manageable:

    • First, define the problem
    • Second, define the goal or goals
    • Third, brainstorm all possible solutions
    • Finally, evaluate each solution and select the best one

    S.T.O.P.

    Practice the S.T.O.P. skill to connect with your learning brain:

    • S — Stop: Notice when you’re acting from either your survival brain or emotional brain, not your learning brain.
    • T — Take a step back: It can be hard to make a decision when you’re in the heat of a moment. Give yourself space to properly evaluate what is going on.
    • O — Observe: Notice what’s going on both around and inside of you.
    • P — Proceed thoughtfully: Ask yourself questions like, “What do I want from this situation?” or “What are my goals?” or “What choice might make this situation better or worse?” or “What action will allow for success?”

    Writing prompts

    Think of a challenging situation you recently experienced and describe it from the perspective of each of your brain’s three layers:

    1. Survival brain
    2. Emotional brain
    3. Learning brain
  • The impact of trauma on the body

    This page is for you if:

    • You experience familiar physical sensations in circumstances that you associate with previously stressful situations
    • You feel withdrawn or disconnected from your surroundings and like you lack control of your actions or emotions

    The body’s stress response

    The human body is designed to respond to stressful situations. Your body’s hormone control centre, called the hypothalamic-pituitary-adrenal (HPA) axis, regulates hormones including cortisol.

    The HPA axis releases cortisol when a physical or psychological stressor is present to trigger your body’s defensive mechanism. This includes the fight-or-flight response, which acts on multiple systems inside you.

    Typically, your body signals the HPA axis to stop releasing cortisol when the stressor is dealt with and your stress response can safely end. 

    However, chronic or extreme stress can lead to disruptions in the HPA axis that impair your body’s ability to return to a calm state.

    Trauma, especially when it is severe or prolonged, can cause your body to remain stuck in defence mode. This results in symptoms like:

    • Increased heart rate, blood pressure, hormone levels, and inflammation
    • Increased threat detection, including being jumpy, easily startled, or on edge
    • Feeling hypervigilant or needing to scan your environment for danger
    • Irritability
    • Difficulty relaxing or falling asleep
    • Shaking or crying
    • Feelings of restlessness, tingling, or numbness

    The Window of Tolerance

    The Window of Tolerance is the optimal zone of arousal in which you can function and cope most effectively. Every person’s window is different.

    When you are within your own Window of Tolerance, you can:

    • Think more clearly
    • Process information better
    • Concentrate better
    • Make more informed decisions

    Chronic stress or trauma can make your window become much narrower, meaning it becomes easier for you to get pushed into a state of over-arousal or under-arousal.

    Survival responses

    Hyperarousal

    Over-arousal, also known as hyperarousal, activates the body’s fight-or-flight response to stress. This involves aggression, shortness of breath, increased heart rate, and increased shakiness or muscle tension.

    Hyperaroused responses include:

    • Cry for help: When your body detects a threatening situation and instinctively becomes prepared to defend itself
    • Fight: When you’re angry or irritated and you engage in impulsive and/or aggressive behaviours
    • Flight: When you feel denial or anxiety. This stress may cause you to evade, omit, or sabotage to escape a stressful situation

    Hypoarousal

    Under-arousal, also known as hypoarousal, can involve feeling numb or withdrawn from your surroundings, feeling detached from your body or environment or as though things around you aren’t real, or feeling not in control of your body’s movements.

    Hypoaroused responses include:

    • Freeze: This involves feeling emotionally detached or withdrawn from your environment
    • Submit: This involves surrendering to the consequences of a stressful situation when your body feels too overwhelmed to fight or flee

    Dissociation

    Dissociation is a disconnection or detachment between your active mind and your thoughts, memories, feelings, actions, or sense of self. It most often occurs during a state of under-arousal. 

    Dissociation is a way that your body copes with overwhelming thoughts, feelings, or memories — either by shutting down, “numbing out,” or disconnecting completely from your surroundings. 

    Its symptoms range from subtle to extreme. They include:

    • Disengagement (not paying attention or spacing out)
    • Emotional numbing
    • Memory disturbances (e.g., gaps)
    • Depersonalization (feeling outside of your body or as if it does not belong to you)
    • Derealisation (feeling like things around you are unreal or distorted)
    • Identity dissociation (feeling like a different person from yourself)

    Activities

    Square breathing

    Connecting to your breath can help you move back inside your Window of Tolerance during times of stress.

    Box breathing, also known as four-square breathing, involves inhaling to a count of four, holding air in your lungs for a count of four, exhaling at the same pace, and then holding your lungs empty for a count of four before starting over. 

    It can help to visualize your breath travelling around the sides of a square while you are breathing.

    Grounding 5-4-3-2-1

    Use this countdown technique to mindfully take in details of your surroundings. Notice:

    • Five things you can see
    • Four things you can hear
    • Three things you can feel
    • Two things you can smell
    • One thing you can taste

    Try to notice small details that your mind would usually tune out, such as distant sounds or the texture of an ordinary object.

    Body scan

    The body scan is one of the most effective ways to begin a mindfulness meditation practice. Its purpose is to tune in to your body — i.e., to connect to your physical self — and notice without judgment any sensations you are feeling.

    • Sit quietly or lie down
    • Start at one end of your body and focus on each body part
    • Notice any areas of tension and then try to soften or relax them
    • Continue until you have mindfully scanned each part of your body

    Writing prompts

    1. Make a list of people, places, or things that can push you out of your Window of Tolerance. Try ranking them in order of most impactful to least. Next, write a similar list of the people, places, or things that help bring you back inside your window during times of stress.
    2. The next time you notice you are feeling stressed, take a moment to write down what you’re experiencing in your body. Consider each body part. Notice where you feel tension, shakiness, or numbness. Describe the sensations in as much detail as you can.
  • The impact of trauma on mood and emotions

    This page is for you if:

    • You’ve noticed it is hard to let go of negative emotions, leading to a persistent low mood
    • You’re stuck in cycles of negative thinking that lead to feelings of hopelessness, guilt, or blame
    • You find it hard to control fear-based feelings like stress and anxiety and would rather focus on the emotions that keep you calm and relaxed

    What is mood?

    Mood is a temporary state of mind, or simply how you feel in a given moment.

    Moods can feel good, bad, or neutral. They are generally more stable and less intense than emotions. Those tend to be stronger, more specific, and shorter in duration.

    Working together, your moods and emotions have a profound impact across your life.

    Your moods can influence:

    • How you think, feel, and behave
    • Your interest in daily activities
    • How you develop and maintain relationships
    • How you make decisions
    • How you view the world (e.g., positively or negatively)

    Trauma, posttraumatic stress injury, and emotions

    Several negative emotions are associated with stress, trauma, and PTSI. They include:

    • Fear and/or anxiety
    • Sadness and/or depression
    • Irritability and/or anger
    • Guilt and/or shame
    • Hopelessness

    These emotions can feel overwhelming, especially after an experience of significant stress or trauma. They can lead to unhelpful changes in your thinking, as well as negative feelings that can impact you, your environment, and others around you.

    Negative emotionsUnhelpful changes in thinkingExamples
    Guilt or shameNegative self-talk or doubt“I am stupid” and/or “I cannot do anything right”
    Distorted blameBlaming yourself for things you can’t control
    Fear or angerDifficulty trusting othersNot believing your colleagues, authority figures, or loved ones
    Detachment from or disinterest in othersDifficulty relating to your colleagues, authority figures, or loved ones
    Difficulty managing negative emotionsUnwanted feelings of fear, anger, horror, etc.
    Sadness or hopelessnessExaggerated negative expectations of yourself or the world“I will never be happy again” and/or “The world is unsafe”
    Decreased participation in activitiesLow energy levels and/or motivation. Loss of pleasure in activities you previously enjoyed
    Difficulty experiencing positive emotionsReduced ability to feel love and happiness leads to feelings of guilt and shame instead

    PTSD and depression

    PTSD and depression often happen at the same time because of the impacts that stress and trauma can have on mood.

    Everyone has low moods or periods of  “feeling blue” from time to time. However, depression is more intense and lasts longer. It has a large negative impact on your life.

    Many symptoms of PTSD and depression overlap, including:

    • Feeling detached from loved ones
    • Difficulty experiencing positive emotions
    • Decreased motivation to engage in regularly enjoyed activities

    Low mood and the brain

    Chemicals in your brain influence how you think, feel, and act. Two important ones that impact your mood are serotonin and dopamine. Negative mood states often occur when these chemicals are released in low levels.

    Boosting these brain chemicals can help you shift towards a more positive state of mind. There are several things you can try to help increase your brain’s output of serotonin and dopamine, including:

    • Physical activity
    • Goal setting
    • Eating nutrient-rich foods
    • Trying something new
    • Spending time in nature

    Incorporating one (or many) of these habits into your daily routines may help improve your mood over time.

    Thinking traps

    Everybody experiences unhelpful thinking styles, also called thinking traps. These can match (and often worsen) your low mood states.

    Thinking traps are especially common for people experiencing depression, anxiety, and PTSI. They have the power to impact how you interpret the world and the conclusions you come to.

    Identifying when you’re falling into a thinking trap can be the first step to getting out of it. Increasing your self-awareness can help you escape negative thought cycles and decrease the gloomy mood states that often accompany them.

    Some of the most common thinking traps include:

    Thinking trapDefinitionExampleCounter thought
    CatastrophizingExpecting the worst-case scenario to happen, no matter how unlikely it might be in reality.“I’m going to make a fool of myself at the gym. Everyone will laugh at me. I won’t be able to survive the embarrassment.”“I may feel embarrassed, but others at the gym have probably felt that too. They will not judge me. I can ask someone for help if I need it.”
    Mental filteringSolely focusing on negative events while dismissing positive or neutral information.“Everyone hated my presentation. A lot of people looked engaged and gave me compliments afterwards, but one person seemed bored with the whole thing.”“I should be proud that I demonstrated a high capability of doing my job.”
    All-or-nothing thinkingSeeing things in extremes or as black-or-white options. There’s either all good or all bad — and nothing in between.“I planned to eat only healthy foods, but then I had a piece of chocolate cake. Now my diet is ruined!”“Mistakes happen, but they do not mean I am a failure.”
    LabellingAttaching critical or absolute labels to yourself or others based on behaviours or reactions to a specific situation.“That went wrong. I’m a failure.”“I failed that time, but I will learn and do better in the future.”
    Magnification and minimizationMagnifying the positive attributes of others while minimizing your own.“Everyone else is so competent and put together. They do not want to hear about my struggles.”“I deserve to talk about my struggles. Talking about how I’m feeling may help someone else.”
    Shoulding and mustingPlacing undue pressure on yourself to meet unrealistic expectations.“I must pick up as many additional shifts as possible or else I will let my co-workers down.”“My value as a co-worker is not conditional on picking up additional shifts. I need to take care of myself first so I can be the best version of myself for others.”
    PersonalizationAssuming personal blame for everything that goes wrong in your life.“My kid got in trouble at school today because I didn’t spend enough time with him. It happened because I work so much.”“My child might have made a mistake, but I am not in control of his behaviour and can only talk to him about it.”
    Emotional reasoningInterpreting a situation based on your emotions in the moment.“I feel really anxious on this plane ride. Something bad is about to happen.”“Feelings are not facts. I have flown many times before, and nothing bad has ever happened. I can accept my feelings of anxiety without believing something awful will happen.”

    Activities

    Naming emotions

    Often, labelling a negative emotion can help you feel better. Naming an emotion is a skillful technique that requires paying attention to how you feel, understanding what you feel, and using language to communicate it — even if only to yourself.

    The next time you notice a strong feeling, pause and label the emotion you are experiencing. Be as specific as possible.

    In 1982, Dr. Gloria Willcox created The Feeling Wheel as a tool to help people identify and talk about their emotions. It still works today! You can use it to help assess your own condition.

    (For an interactive version of the model, try The Emotion Wheel app by All The Feelz.)

    Increase motivation

    Use checklists and goal setting to track your short- and long-term accomplishments. Reward yourself for every win, no matter how big or small.

    “Scheduled” emotional release

    Put a fixed amount of time in your schedule — typically no more than 30 minutes — to check in with your emotions. Let yourself cry or yell privately if you need to. 

    If you’re experiencing negative emotions, physical exercise can help relieve anxiety by reducing stress and tension in your muscles.

    Grounding

    Use your senses — sight, taste, touch, smell, and sound — to get out of your feelings and into your body. Cycle through each sense and pick out things you notice using each one (five things you can see, four things you can hear, three things you can feel, etc.). Alternatively, you can do a short activity that engages your senses, like holding ice in your hands or walking barefoot on grass.

    Self love

    Do one small thing that makes you happy every day to remind yourself that you deserve to feel good.

    Writing prompts

    Identify your emotions

    How have your moods and emotions been impacted by stress and trauma? Consider the feelings of guilt, shame, anger, and fear. What does each one mean to you? When do you encounter these feelings? How do you experience them?

    Challenge negative thoughts

    Write down the negative thoughts you have about yourself. Using the table above, try to identify any thinking traps you may have fallen into. Then write down why each thought might be untrue.

  • Introduction to trauma, PTSD, and stigma

    This page is for you if:

    • You’ve been in a distressing situation or situations where you might have felt trapped, out of control, or helpless
    • Important parts of your life are still affected by that event or events, such as your mood, relationships, and/or work
    • You’ve felt alone in these feelings and/or wondered if others have felt the same

    What is trauma?

    Psychological trauma refers to the emotional consequences of living through a highly stressful situation or traumatic event.

    There is no strict definition for traumatic events, but they’re usually situations in which you experience strong feelings of distress, fear, loss of control, or being trapped.

    Traumatic events can be:

    • Things that happen to you.
    • Things you see and/or hear happen to someone else.

    They can be one-time events (like an assault) or long-term patterns (like abuse or repeated exposure to danger).

    What are the consequences of trauma?

    Psychological trauma is just like physical injury: it can result in symptoms that vary in severity, intensity, and duration.

    Emotional symptomsPhysical symptomsCognitive symptomsBehavioural symptoms
    Numbness and/or detachment

    Fear and/or anxiety

    Guilt and/or shame

    Anger and/or irritability

    Sadness and/or hopelessness

    Difficulty experiencing positive emotions
    Fatigue and/or exhaustion

    Nausea, digestive problems, or changes in appetite

    Difficulty sleeping

    Increased heart rate, startle response, and/or feeling “on edge”

    Increased muscle tension
    Difficulty concentrating and/or making decisions

    Intrusive thoughts and/or memories relating to trauma

    Changes in the way you think about yourself, others, and/or the world

    Difficulty trusting yourself and/or others
    Social withdrawal

    Disengagement from your typical responsibilities and activities

    Increase in unhelpful coping strategies, such as avoidance and alcohol or substance use

    Although these symptoms can be hard to live with, they are normal responses to traumatic events. When you have a physical injury like a broken ankle, you notice the bruising, swelling, and pain. These indicators, while unpleasant, signal that your body has begun to heal.

    Recovering from psychological trauma takes time and effort. When the nature of a traumatic event is particularly severe or long lasting, your symptoms may take longer to heal. You may develop a posttraumatic stress injury (PTSI).

    What is PTSD?

    Posttraumatic stress disorder (PTSD) is a diagnosable mental health condition that may develop in those who have experienced a traumatic event or events. 

    Not everyone who goes through trauma will develop PTSD, and there’s no way to know for certain who will. However, these factors can make you more vulnerable:

    • The traumatic event included a threat to your safety
    • You experienced intense helplessness and/or fear during the event
    • You have feelings of guilt, shame, or responsibility about the event and/or its outcomes
    • More stressful experiences followed the original event
    • You received inadequate social support after the event

    Many people who live through trauma go on to experience posttraumatic stress. You may never get a diagnosis of PTSD. You may continue to function from day to day while enduring some or all of these symptoms:

    • Nightmares, flashbacks, and/or intrusive memories
    • Feeling unable to connect with yourself, others, and/or the world around you
    • Feeling unable to have positive emotions like joy, pleasure, and/or love
    • High irritability and/or angry outbursts
    • Increased tension, fear, and/or hypervigilance
    • Anxiety and/or worry about your future

    A note about terms: We use the term posttraumatic stress disorder (PTSD) to refer to the diagnosable mental health condition. We use the term posttraumatic stress injury (PTSI) to refer to the psychological hurt you may experience after a traumatic event.

    The impact of stigma

    Stigma refers to a societal disapproval or misunderstanding. It can include shaming and/or blaming people who live with a mental illness.

    Stigma can be harmful to someone who has experienced trauma, with impacts including:

    • Feelings of fear or shame
    • Withdrawal and/or hiding from support systems
    • Attempts to suppress, ignore, or avoid painful symptoms

    Activities

    Share your stress with a loved one

    It can be hard to bear the weight of your stress on your own. Ask a loved one to take time to listen without having to offer advice or try to solve your problems for you.

    Identify your triggers

    Make a list of the people, places, situations, and/or memories that you struggle to cope with. This list might include a person who reminds you of someone you’ve lost or a location where your stress gets agitated.

    Writing prompts

    Letter to a loved one

    Write a letter to a loved one (which you may or may not send) about the traumatic event you experienced and how it has impacted you since.

    Next, pretend you are the person receiving that letter and write a reply to yourself. Respond how you would if someone you love had been through the event instead of you.

    Listing

    Write down the unhelpful thoughts you’ve had about yourself since the traumatic event. Next, for each item on the list, write one or two pieces of counter evidence. For example, if one of your unhelpful thoughts is “I’m not good enough,” then write down two ways or times when you’ve felt useful or important to counter it.

  • The “big four” helpful actions to take

    A side profile silhouette of two overlapping human heads, one in dark blue and purple tones facing left, and one in light blue and yellow tones facing right. The watercolour effect creates a gradient blend between the two profiles, suggesting duality or mental health concepts
    💚 Goal setting💚 Visualization💚 Self-talk💚 Tactical breathing
    Specific: your behaviour

    Measurable: see progress

    Attainable: challenging and realistic

    Relevant: want it or need it

    Time-bound: set finish time
    Be calm and relaxed

    Use all senses

    See positive mental images

    Keep it simple

    Use movement
    Become aware of self-talk

    Stop the negative messages

    Replace with positive

    Practice thought stopping:
    I can do this”;
    I am trained and ready”;
    I will focus on what I can do
    Rule of four:
    Inhale to count of four;
    exhale for count of four;
    practice for four minutes

    Breathe into the diaphragm

    If you are concerned about signs of poor or declining mental health in yourself or a buddy, get it checked out.

    Resources include:

    • Buddies
    • Mental health team
    • Chaplains
    • Leaders/supervisors
    • Crisis or help lines
    • Community mental health services
    • Family doctor
  • ASPR: Disaster Behavioral Help

    Contactaspr.hhs.gov/behavioral-health
    InformationResources and guidance for stress management after disasters from the Administration for Strategic Preparedness & Response (ASPR).
    LocationInternational: 🇺🇸 United States
    Type of resourceResource hub
    Type of supportPsychosocial emergency preparedness
    Target demographicHealth care providers and public safety personnel
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English
  • SAMSHA: A guide to managing stress for disaster responders and first responders

    Contactstore.samhsa.gov/sites/default/files/pep22-01-01-003.pdf
    InformationA downloadable booklet about stress management published by the Substance Abuse and Mental Health Services Administration (SAMHSA).
    LocationInternational: 🇺🇸 United States
    Type of resourceOnline service
    Type of supportPsychosocial emergency preparedness
    Target demographicPublic safety personnel
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English
  • CDC: Emergency preparedness and response

    Contactemergency.cdc.gov/coping
    InformationFrom the US Centers for Disease Control and Prevention (CDC), mental health information to prepare for and recover from a disaster.
    LocationInternational: 🇺🇸 United States
    Type of resourceOnline service
    Type of supportPsychosocial emergency preparedness
    Target demographicGeneral population
    Serves adults (18+)Yes
    Serves children (0–12)Yes
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English, 🇪🇸 Spanish
  • SAMHSA: Warning signs and risk factors for emotional distress

    Contactsamhsa.gov/find-help/disaster-distress-helpline/warning-signs-risk-factors
    InformationCoping tips for traumatic events and disasters from the Substance Abuse and Mental Health Services Administration (SAMHSA).
    LocationInternational: 🇺🇸 United States
    Type of resourceOnline service
    Type of supportPsychosocial emergency preparedness
    Target demographicGeneral population
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English
  • Skills for Psychological Recovery (SPR) Manual

    Contactptsd.va.gov/professional/treat/type/skills_psych_recovery_manual.asp
    InformationSPR aims to help survivors gain skills to manage distress and cope with post-disaster stress.
    LocationInternational: 🇺🇸 United States
    Type of resourceOnline service
    Type of supportPsychosocial emergency preparedness
    Target demographicMental health providers
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English
  • KidsHealth: Coping with a natural disaster

    Contactkidshealth.org.nz/coping-natural-disaster
    InformationInformation for parents on how to help their children recover after natural disasters.
    LocationInternational: 🇳🇿 New Zealand
    Type of resourceOnline service
    Type of supportPsychosocial emergency preparedness
    Target demographicGeneral population
    Serves adults (18+)
    Serves children (0–12)Yes
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English
  • All Sorts: Tips for coping after a natural disaster

    Contactallsorts.org.nz/tips-for-coping-after-a-natural-disaster
    InformationResources, information, and tips for coping with natural disasters.
    LocationInternational: 🇳🇿 New Zealand
    Type of resourceOnline service
    Type of supportPsychosocial emergency preparedness
    Target demographicGeneral population
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English
  • Get Ready: Mental Wellbeing

    Contactgetready.govt.nz/emergency/mental-wellbeing
    InformationMental health tools and resources for before and after disaster.
    LocationInternational: 🇳🇿 New Zealand
    Type of resourceResource hub
    Type of supportPsychosocial emergency preparedness
    Target demographicGeneral population
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🇸🇦 Arabic, Easy read, 🍁 English,
    🇼🇸 Gagana Samoa, 🇮🇳 Hindi, 🇯🇵 Japanese, 🇹🇴 Lea Faka-Tonga, 🤟 New Zealand Sign Language, 🇮🇳 Punjabi, 🇨🇰 Reo Kuki Airani, 🇨🇳 Simplified Chinese, 🇪🇸 Spanish, 🇵🇭 Tagalog, 🇳🇿 Te Reo Māori, 🇨🇳 Traditional Chinese, 🇳🇺 Vagahau Niue
  • Black Dog Institute: National Emergency Worker Support Service

    Contactblackdoginstitute.org.au/education-services/national-emergency-worker-support-service/
    InformationFree mental health check, providing insights and recommendations to support PSP.
    LocationInternational: 🇦🇺 Australia
    Type of resourceOnline service
    Type of supportWellness support
    Target demographicPublic safety personnel
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English
  • Phoenix Australia: Responder Assist

    Contactphoenixaustralia.org/responder-assist
    InformationMental health information, resources, and training for emergency workers and those who support them.
    LocationInternational: 🇦🇺 Australia
    Type of resourceOnline service
    Type of supportWellness support
    Target demographicPublic safety personnel and their families
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves familiesYes
    Language(s) spoken🍁 English
  • PAHO: Mental Health and Psychosocial Support in Emergencies

    Contactpaho.org/en/topics/mental-health-and-psychosocial-support-emergencies-mhpss
    InformationFrom Pan American Health Organization (PAHO), a plan of action for mental health and psychosocial support during emergencies.
    LocationInternational: Americas
    Type of resourceInformation
    Type of supportPsychosocial emergency preparedness
    Target demographicGovernments, non-governmental organizations, civil society groups
    Serves adults (18+)This resource is for mental health systems. It is not a resource for individuals.
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Languages spoken🍁 English, 🇪🇸 Spanish
  • Headspace: Natural Disaster Mental Health

    Contactheadspace.org.au/our-impact/campaigns/mental-health-after-natural-disaster
    InformationMental health information for during and after a flood or bushfire.
    LocationInternational: 🇦🇺 Australia
    Type of resourceOnline service
    Type of supportPsychosocial emergency preparedness
    Target demographicGeneral population
    Serves adults (18+)Yes
    Serves children (0–12)Yes
    Serves youth (13–17)Yes
    Serves familiesYes
    Language(s) spoken🍁 English
  • Australian Psychological Society

    Contactpsychology.org.au/for-the-public/psychology-topics/disasters
    InformationInformation for preparing for disasters and for looking after mental health and well-being after experiencing a natural disaster.
    LocationInternational: 🇦🇺 Australia
    Type of resourceOnline service
    Type of supportWellness support
    Target demographicGeneral population
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English
  • Beyond Blue: Natural Disasters

    Contactbeyondblue.org.au/mental-health/natural-disasters
    InformationMental health information for those who have experienced a natural disaster.
    LocationInternational: 🇦🇺 Australia
    Type of resourceOnline service
    Type of supportWellness support
    Target demographicGeneral population
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English
  • Australian Red Cross

    Contactredcross.org.au/emergencies
    InformationProvides tips for coping with a crisis, including looking after yourself and returning home.
    LocationInternational: 🇦🇺 Australia
    Type of resourceOnline service
    Type of supportWellness support
    Target demographicGeneral population
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English
  • Responses to trauma

    An abstract painting with swirling green, yellow, and blue colours, creating a dreamlike and ethereal atmosphere
    🔈 Press play to listen to this content.

    What is psychological trauma? 

    Psychological trauma refers to lasting emotional impacts of living through or learning about a distressing event. These events, known as traumatic events, can be singular (e.g., assault) or repetitive (e.g., abuse), and while some people are more likely to experience a traumatic event, these may happen to anyone, regardless of profession or background.  

    Importantly, if you are having trouble managing your emotions, reactions, or day-to-day life following traumatic events, please seek support.  

    Common impacts following a traumatic event include: 

    • Muscle tension
    • Low mood
    • Feeling “out of control” of your actions or emotions
    • Increased irritability or anger
    • Memory difficulties (e.g., gaps, loss)
    • Disinterest in activities you used to enjoy
    • Short-term memory challenges (e.g., forgetting where you parked your car)
    • New difficulties controlling negative patterns of thinking (e.g., feeling hopeless)
    • Difficulty with concentration and decision making
    • Increased intensity or frequency of fear responses (e.g., more easily startled)
    • Changes in how you think about yourself, other people or the world around you
    • Recurring thoughts, memories, or dreams about the traumatic event
    • Difficulties with sleep (e.g., falling asleep, staying asleep, waking up in the middle of the night)
    • Withdrawing or disconnection from your surroundings

    Other impacts of psychological trauma that aren’t talked about as often include:  

    • Dissociation, which is a way to “numb out” when things get overwhelming, through disconnection from our surroundings, and can occur either through depersonalization or derealization. 
    • Depersonalization: Feeling as though your body does not belong to you, or as though you are “outside” of your body. 
    • Derealization: Feeling as though things around you are unreal or strange (e.g., as though you’re in a movie).

    Guilt, which are feelings of having done something “bad” or “wrong” following the traumatic event. Often, these feelings may show up as thinking about past events and thinking that you or someone else “could have” or “should have” done something differently. Sometimes people may even feel guilty that they survived an event that another person did not. This is known as survivor guilt, and can lead to feelings of negativity about ourselves, or even thoughts about whether we “deserved” to survive compared to those who lost their lives.  

    Shame is the feeling that part of me is “wrong” or “broken,” and can be a very challenging emotion to navigate following traumatic events. These events may make us feel like the way we reacted means something bigger about who we are as people, or even as though the traumatic event that happened was somehow their fault. Shame is a negative feedback loop that can stop us from wanting to seek help because we may feel like we do not “deserve” to live a stable, healthy life.   

    Moral injury is a type of stress response that occurs after a morally distressing experience, where we feel that our own deeply held morals have been violated in some way. Symptoms can include psychological, social, behavioural, and spiritual changes that might impact how we see ourselves or other people.  

    A chart titled “Moral stressors and outcomes” depicts a triangular area divided into sections based on event frequency (y-axis, labeled from rare to constant) and degree of psychological, social, and spiritual harm and impairment (x-axis, labeled from very little to extreme). The chart also includes population prevalence (labeled from high to low on the right side of the triangle). The triangular space is divided into four labeled zones: “Moral frustration” at the bottom-left, “Moral distress” to its right, “Moral stressors” above these areas, and “Morally injurious events” at the top-right

    Moral stressors and our associated moral reactions exist on a spectrum. Moral challenges may prompt feelings of moral frustration but do not lead to any lasting impairment, such as worries about “the state of the world.” Moral distress brings up moral emotions and causes short-term increases in distress levels. Experiences such as being lied to or stolen from might induce moral distress, but they are unlikely to leave lasting impacts. On the far end of this spectrum are morally injurious events, which cause moral injury. 

    Vicarious traumatization, also called secondary traumatization, is something that can be especially challenging for individuals who work or volunteer in public safety, military, and healthcare settings, due to their more frequent exposure to victims of traumatic events and violent acts. This can occur when we hear about or witness events that have occurred but do not have direct impacts on us as individuals. The symptoms that occur following vicarious trauma are similar to that of experiencing a traumatic event personally.  

    Having trouble coping with your behaviours, emotions, or social changes following a traumatic event? This may be a normal reaction to witnessing, experiencing or hearing about traumatic situations that people go through. However, if this is causing you a lot of distress or getting in the way of how you would like to live your life, it may be important to seek support. 

    Supports can include: 

    • Peer support  
    • Talking with family or friends 
    • Religious or spiritual leaders 
    • Mental health professionals  

    Self-driven activities that may help reduce distress include: 

    • Identifying people, places or situations that trigger your stress responses in order to increase your awareness and cope ahead
    • Labelling your emotions as you notice them rather than avoiding them 
    • Boxed breathing
    • Progressive muscle relaxation
    • Setting boundaries with yourself and with other people
  • Moral injury & posttraumatic stress

    A minimalist illustration of a person standing in a doorway, casting a long shadow. The person appears to be contemplating or looking into the distance, and the background is a light teal colour

    What is moral injury?

    Moral injury is the potential outcome of witnessing an event that goes against ones moral beliefs, or participating in the act oneself. Moral injury can also be caused by feeling betrayed by someone you trusted, like a coworker, supervisor, or workplace.

    It often results in intense feelings of guilt, shame, disgust, and anger.

    What is posttraumatic stress?

    Posttraumatic stress (PTS) is a response to traumatic events that one has personally experienced, has learned about happening to a loved one, or has been exposed to. This could include actual or threatened death, serious injury, or sexual violence.

    PTS symptoms can include:

    • Reliving the event repeatedly in your mind
    • Having nightmares
    • Avoiding family and friends
    • Having trouble sleeping
    • Losing interest in enjoyable activities
    • Avoiding places and people that remind you of the event

    Some people with PTS also experience dissociation. This means that they feel disconnected from themselves, or feel like things happening around them are unreal or unfamiliar.

    Though most people who experience a traumatic event will have a strong reaction, many will recover over time. Experiencing trauma doesn’t mean you will develop PTS.

    A stylized illustration of a person with dark hair in a bun, holding their head with both hands, surrounded by swirling lines and abstract shapes. The background is a mix of blues and greens, suggesting a sense of confusion or overwhelm
  • Managing reactions to stress

    An illustration of a person with pink hair and a yellow shirt, holding their head in frustration. The background is filled with scribbles and chaotic lines, conveying a sense of stress or anxiety
    🔈 Press play to listen to this content.

    Coping strategies are activities or exercises that can be used to manage stress, reduce unpleasant emotions, and help improve your mood. They can be internally directed activities or outward behaviours. They can be individual or social.

    Engaging in coping strategies is one way to help maintain mental and emotional well-being. It can be hard to find the energy and time to do this. However, coping strategies do not need to be big or elaborate. Having a few easily accessible, go-to tools can be very helpful.

    Here are some coping strategies you can begin to put in place right away:

    • Set and keep routines that help with work-life balance. Focus on a healthy diet, enough sleep, exercise, and time with friends and family.
    • Set small goals for yourself. These will give you a sense of accomplishment, and signal that you are taking care of yourself.
      • Find a sheet to assist with setting small, manageable goals here.
    • Pick up a hobby that gives you pleasure. Set a goal to engage in this hobby regularly.
    • Practice deep breathing. Inhale for four counts, exhale for four counts, practice for four minutes. Deep breathing sends oxygen to the brain and helps relax the body.
      • Find several deep breathing exercises to try here.
    • Positive self-talk. Redirect negative thoughts by reframing them.
      • Learn more about reframing and positive self-talk here.
    • Visualization and sensory grounding. Pay attention to your five senses and visualize positive images. For example, imagine the sounds, smells, and sights of a calming scene.
      • Find a guided audio visualization here, and sensory grounding instructions here.
    • Self-care. Go for a walk, engage with your religion/spirituality, journal, read a book, take a nap or bath, listen to music. Do something that feels good!
    • Self-compassion. Show yourself the same kindness you would to a friend who is struggling.
      • Find guided self-compassion exercises here.
    • Mental Health Continuum Model (MHCM). This tool helps identify your current mental health status and provides relevant resources.
  • 9-8-8: Suicide Crisis Helpline

    ContactCall or text: 9-8-8
    Online: 988.ca
    Information“You deserve to be heard. We’re here to listen. A safe space to talk, 24 hours a day, every day of the year.”
    LocationNational
    Type of resourceTelephone (call or text), online service
    Type of supportCrisis support
    Target populationGeneral population
    Serves adults (18+)Yes
    Serves children (0–12)
    Serves youth (13–17)
    Serves families
    Language(s) spoken🍁 English, ⚜️ French