Major depressive disorder or clinical depression is a serious mood disorder that involves a cluster of the following symptoms, occurring most of the day, nearly every day for at least 2 weeks:

• persistent depressed moods

• loss of interest or pleasure

• reduced or increased appetite or unintended weight loss or gain

• sleeping too little or too much

• poor concentration or distractibility

• low energy

• moving, thinking, or speaking more slowly than usual

• restlessness or agitation

• feelings of worthlessness or excessive guilt

• suicidal thoughts or wishes*

*If you or someone you know is in crisis and considering suicide, please phone the 24 hour crisis line 1-800-SUICIDE (1-800-784-2433), call 911, or go to the nearest emergency room.

Generalized anxiety disorder (GAD) is characterized by excessive anxiety and uncontrollable worry about a wide range of topics that occurs more often than not, for at least the last six months. GAD tends to be chronic and people often describe being “lifelong” worriers.

Topics of worry may include concerns about the future, work, finances, relationships, as well as health and safety of onseself and loved ones.

Associated symptoms include:

o restlessness or feeling “keyed up” or on edge

o being easily fatigued

o difficulty concentrating or mind “going blank”

o irritability

o muscle tension

o sleep disturbance

Panic disorder involves sudden, unexpected panic attacks that may include the following symptoms:

o shortness of breath

o racing heart

o hot flushes or chills

o feelings of unreality or depersonalization

o dizziness or feeling faint

o trembling or shaking

o chest tightness

o choking sensation or lump in throat

o numbness or tingling

During a panic attack, people often experience anxious thoughts such as fear of dying, having a heart attack, losing control, or “going crazy.” Due to these thoughts, people can become fearful of panic attacks and avoid situations or places thought to trigger panic attacks, which can lead to agoraphobia, a fear or avoidance of places or situations where escape might be difficult or embarrassing.

Social anxiety involves marked anxiety and fear about situations that may expose one to possible judgement or evaluation by others, such as during social interactions, being observed, or performing in front of others. As a result, social situations are avoided, which may lead to social isolation, or they are endured with significant distress.

Social situations that may be avoided include: meeting new people, conversing with others, eating or drinking in front of others, public speaking, speaking up in meetings, etc.

Obsessive compulsive disorder is characterized by one or both of the following:

o obsessions: recurrent or persistent, unwanted thoughts, images or urges cvbnm,mnav bv cause significant anxiety or distress

o compulsions or rituals: repetitive behaviours or mental acts an individual feels driven to perform to reduce distress or to prevent a dreaded outcome or situation

The obsessions and compulsions are time consuming and are disruptive to daily functioning.

Posttraumatic stress disorder (PTSD) involves difficulty recovering after experiencing or witnessing a traumatic event, or learning that a traumatic event has happened to a close friend or family member. Traumatic events may include actual or threatened death, serious physical injury, sexual violence, or exposure to details of aversive events.

Not everyone develops PTSD after a traumatic experience, and stress related reactions tend to improve with time. PTSD is suspected if the following symptoms persist for one month or more after the trauma:

o reexperiencing the event: distressing and intrusive flashbacks, memories, nightmares

o avoidance of reminders of the traumatic event: internal (thoughts, feelings, memories), external (places, people, conversations, objects)

o changes in physical arousal and reactivity: irritable behaviour and angry outburst, reckless or self-destructive behaviour, hypervigilance, pronounced startle response, concentration difficulties, sleep disturbance

o changes in cognition or mood: inability to remember an important aspect of the traumatic event, persistent and exaggerated negative beliefs about oneself, others or the world, persistent negative emotional states (e.g., fear, horror, anger, guilt, shame), persistent inability to experience positive emotions, diminished interest or participation in significant activities, feelings of detachment from others

Insomnia involves difficulty falling asleep, staying asleep or waking too early. The sleep disturbance occurs at least three nights per week, despite adequate opportunity to sleep, and is present for at least three months. Insomnia can occur singly or alongside another medical or mental health condition.

The following are examples of health-related concerns that may cause significant distress or negatively affect daily functioning:

• excessive worries or anxiety about health and wellbeing

• fear or anxiety about getting sick

• difficulty adjusting to a chronic illness

• difficulty managing chronic or persistent pain

• difficulty making health-related lifestyle changes

• distress related to a new medical diagnosis

The path to parenthood can be a time of optimism and joy but also can present significant life changes, existential crises, and challenges to our mental health. We provide emotional support for people navigating various phases of this journey:

• trying to conceive and/or navigating fertility treatments

• pregnancy loss or miscarriage

• during pregnancy

• after childbirth

Stress is a part of everyday living and its successful navigation can promote healthy growth and resilience. However, chronic stress and incomplete stress recovery can impact cognitive, emotional, physical, and social functioning.

Promoting stress resilience involves understanding stress triggers, symptoms and reactions, and learning adaptive coping skills.

Common signs and symptoms of stress include:

• feeling tense, restless, on edge

• feeling irritable

• feeling tired most of the time

• concentration difficulty

• uncontrollable worry

• increased muscle tension

• inability to fall asleep or stay asleep

• loss of appetite or overeating

• drinking too much caffeine or alcohol

• smoking more than usual

Due to the non-specific nature of some of these symptoms, prior to concluding that a symptom you have is stress-related, especially if it is a new symptom, please consult your doctor.