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Rising Anxiety Disorder Rates in Black Canadian: Understanding the Challenges and Pathways to Treatment

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Anxiety disorders are among the most common mental health conditions worldwide. In Canada, the prevalence of these disorders has significantly increased over the past decade. As of 2022, over 5 million Canadians aged 15 and older met the diagnostic criteria for mood disorders, including anxiety disorders. The COVID-19 pandemic exacerbated this issue, with large increases in anxiety symptoms reported between 2020 and 2021, particularly among women and young people. A 2022 study also noted a lower proportion of Black people living with anxiety disorders compared to other racialized and non-racialized groups, except for Filipino, Chinese, and South Asian groups.

Conversely, a study by Kogan and colleagues in 2022 found that close to 30% of Black participants reported clinically significant anxiety symptoms, with higher rates among young people and men. The study also highlighted a link between anxiety and exposure to racism, including racial microaggressions and discrimination.

In my private psychotherapy practice and previous work with the Substance Abuse Program for African Canadian and Caribbean Youth (SAPACCY) at CAMH, I have observed a growing number of Black individuals presenting with various anxiety disorders. These include social anxiety, generalized anxiety, and panic disorders. Assessing these disorders can be challenging due to societal and cultural factors that influence the willingness and ability of Black individuals to disclose their psychological distress.

Understanding Anxiety

Anxiety and fear are natural emotions regulated by our limbic system, essential for survival. Fear is the reaction to a real and imminent threat, such as an approaching car, while anxiety is the reaction to an anticipated threat, like the fear of being hit by a car. Both emotions activate the fight-flight-freeze response. When fear and anxiety intensify, they can lead to panic or anxiety attacks. Though often used interchangeably, these terms differ. Anxiety attacks arise from identifiable threats, whereas panic attacks are typically spontaneous, with no direct stimulus and more severe psychological and physical symptoms.

Anxiety disorders, including phobias, are characterized by excessive and uncontrollable worry or fear, co-occurring with other symptoms. The Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) lists 11 anxiety disorders, with social anxiety disorder and generalized anxiety disorder being the most common. Symptoms include excessive worry, muscle tension, sleep disturbances, and difficulty concentrating. These disorders are associated with chronic diseases like hypertension and kidney disease, due to the endocrine system’s prolonged stress response, and often co-occur with substance use disorders.

Causes of Anxiety Disorders

Anxiety disorders can affect anyone, but certain genetic, psychological, and emotional factors increase susceptibility. Genetic predisposition plays a significant role, as anxiety disorders often run in families. The largest genome-wide association study (GWAS) on anxiety traits linked various genetic variants to an increased risk of anxiety disorders. These genes are associated with the hypothalamic-pituitary-adrenal (HPA) axis, which regulates stress response.

Psychologically, individuals with anxiety disorders struggle with distress intolerance, an inability to manage unpleasant emotions healthily. Distress intolerance can be exacerbated by psychosocial factors like adverse childhood experiences, neighborhood violence, racial discrimination, and frequent relocations.

Anxiety Disorders in Black Individuals

Black individuals across the African Diaspora frequently face challenges in receiving adequate mental health care. Anxiety and panic attacks can lead to intense, dysregulated presentations, often misinterpreted as aggression due to racial bias and negrophobia. This misperception can result in poor treatment and unjustified use of restraints.

Cultural idioms of distress also play a role. Black patients may describe anxiety using terms like “my spirit isn’t right” or “I’m just in my head a lot,” which clinicians might overlook. Alexithymia, the inability to describe or identify emotions, is prevalent among many Black men, who are often socialized to suppress emotions other than anger. This emotional repression can lead to panic disorder and other health issues.

Treatment for Anxiety Disorders

The goal of treatment is to help patients regulate their anxiety and regain balance. Treatment may involve psychotropic medications, such as antidepressants, and possibly antipsychotics or mood stabilizers. Alternative treatments like Chamomile are also being explored.

Traditional psychotherapy, or talk therapy, helps patients explore triggers, develop new thinking patterns, and adopt healthy coping mechanisms like breathing exercises. For those with alexithymia, therapy focuses on identifying and confronting distressing emotions. Alternative therapies may include prayer, nature walks, and community gatherings.

Anxiety disorders can be overwhelming, but there is hope. Recognizing symptoms, understanding underlying factors, and seeking appropriate treatment are crucial steps toward recovery. It is essential to learn and practice healthy coping mechanisms before anxiety symptoms become severe. By confronting and managing our emotions, we can prevent anxiety from controlling our lives.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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