Frequently Asked Questions

We accept psychology and neuropsychology referrals from all health professionals, community coordinators, agencies, insurers, lawyers and other organizations. Please download our referral form and fax it to our confidential fax number: 416 342-1968. You can also email it to us via SecureDocs, a secure encrypted portal. If you have any questions, please contact us.

Toronto Brain Health is a registered treatment provider with WSIB under the Community Mental Health Program. We are listed in the WSIB Psychologist Directory. The Community Mental Health Program is for all people with a WSIB claim who require psychological assessment or treatment, this includes individuals who have sustained a concussion or moderate to severe brain injury in the workplace or a psychological injury (e.g., workplace related PTSD, depression, anxiety or adjustment disorder following a physical injury).

Approval for psychological services is required by your WSIB case manager prior to proceeding with assessment and treatment.

Once approved, please schedule an initial intake call to get started. Once we determine that we are a good fit for your needs we can schedule your psychological assessment appointment with one of our psychologists. If you have any questions, please contact us.

For more information on why to see a neuropsychologist after sustaining a concussion at work, see our related blog.

Psychology and neuropsychology services are not covered under OHIP. Our therapy and assessment rates are set according to information and guidelines provided by the Ontario Psychological Association.

Most extended health insurance plans cover all or part of neuropsychology and psychology fees. Some plans allow direct billing for psychology services. We recommend that you review your individual plan as health benefits differ between providers. Fees which are not reimbursed can be claimed as medical expenses on your income tax return.

We work with service members, or their family members, of the Royal Canadian Mounted Police (RCMP) and Ontario Provincial Police (OPP). We assess and treat individuals who were psychologically and/or physically injured in the workplace under WSIB (e.g., PTSD, depression, anxiety, adjustment disorder, somatoform disorders, chronic pain, concussion, or moderate to severe brain injury).

Yes! We provide the following services by online appointment to individuals located throughout Ontario, Quebec, New Brunswick and Nova Scotia:

• Psychological consultations and assessments.
• Psychological and neuropsychological treatment.
• Neuropsychological evaluation – clinical interview only, cognitive testing requires in-person evaluation.

We can also provide phone sessions if needed and appropriate to your specific needs.

Yes. Our psychologists provide in-person appointments at our clinic. However, if you are sick or symptomatic with a virus, please change your in-person appointment to a virtual one or provide cancellation notice.

We have several psychologists for you to choose from. If you have someone specific in mind, then we will do our best to book you with this individual, if applicable, notify you of their wait time, or provide alternate psychologists at Toronto Brain Health with immediate or near future availabilities. We further work toward booking you with a psychologist who has experience and competency in the areas you would like help in.

If we do not have a psychologist who has the knowledge or experience to address the issues you are dealing with, we will let you know and may be able to provide resources to finding a more appropriate provider in the community.

Each psychologist’s bio is also listed on our website. Finally, you can schedule a free 15-minute call with a psychologist if you want to determine whether the fit is good. After you meet or start with a psychologist at Toronto Brain Health, if you are not happy with the fit, you can switch providers if another psychologist at our clinic has availability, or we can make recommendations for other providers in the community who may be able to meet your needs.

20 De Boers Drive, Suite 535
Toronto, ON, M3J 0H1

[Google Map]

Subway
We are a 3-minute walk from Sheppard West subway station.

Driving
Toronto Brain Health is located in the Domo Centre at 20 De Boers Drive. The closest intersection is Allen and Sheppard with nearby access to Highways 401 and 400.

Our office hours are as follows:

Monday 9a.m.–8p.m.

Tuesday 9a.m.–8p.m.

Wednesday 9a.m.–8p.m.

Thursday 9a.m.–6p.m.

Friday 9a.m.–6p.m.

Saturday Closed

Sunday Closed

Note: Office hours may change during civic and national holidays. Please contact us if you have any questions.

Yes. There is outdoor paid parking, and 6 levels of above-grade paid indoor parking.

If parking outdoors, proceed through the main entrance, enter the elevator to your right and exit on the fifth floor. Follow signs for suite 535.

If parking indoors, suite 535 is one floor above P6 however you can access the elevator from other indoor parking levels as well.

Yes. For wheelchair access from our parking facilities, proceed by elevator from the ground floor or parking levels P1 through P5.

For wheelchair access from the ground floor level, please proceed through the side entrance of the building (to the right of the main entrance if entering from outside). Take the ‘service elevator’ and exit on the fifth floor.

Yes! We provide the following services virtually via secure online client portal:

• Psychological consultations and assessments.
• Psychological and neuropsychological treatment.
• Neuropsychological evaluation – hybrid assessment options are available.

You can attend your virtual sessions via your preferred device (phone, tablet/iPad, laptop), access services from anywhere within Ontario, and save time by cutting out the commute or attending your appointment over a lunch break from work. We can also provide phone sessions if needed and appropriate to your specific needs.

Yes. We have a few psychologists who are seeing clients in-person at our clinic. Not all psychologists are providing in-person services at this time. We require clients to wear a medical grade mask upon entering our clinic and during their in-person appointment. We can provide you with a mask if needed. Please see our COVID-19 update for our most recent in-person appointment guidelines.

Not every hit to the head results in a brain injury. If hitting your head was that dangerous, our toddler years would be pretty rough, and we would not survive as a human species. However, some hits do result in concussions. A concussion, also known as a mild traumatic brain injury, is an immediate and temporary alteration in brain functioning due to physical trauma.

A concussion can occur because of a hit to the head, or forces causing a sudden jolt to the head such as whiplash or blow to the body. Loss of consciousness is not necessary for a concussion to occur. In fact, only 10% of individuals who sustain a concussion lose consciousness. Up to a third of individuals experience post-traumatic amnesia, also known as a post-traumatic confusional state, which disrupts memory for events occurring shortly before or after injury. Loss of consciousness, post-traumatic amnesia, plus feeling dazed, disoriented, or ‘out of it’ are all examples of altered brain functioning which suggest that a concussion may have occurred (a physician, nurse practitioner or neuropsychologist are able to diagnose concussion).

For early diagnosis of concussion, see your physician or nurse practitioner, or if there are delays, attend a walk-in clinic. If you are experiencing severe symptoms such as severe headache, confusion, seizure, repeated vomiting and worsening in your symptoms, then a trip to the ER may be needed to ensure you did not sustain a more severe injury.

The content on this website is for informational and educational purposes only and is not intended to be a substitute for medical advice, diagnosis, or treatment.

Following a concussion, a brief period of rest is recommended for the first 24-48 hours, such as avoiding intensive work or pushing yourself cognitively or physically. Rest does not mean lying in a dark room with no stimulation and avoiding all activity. We now know that isolating yourself in a dark room is not helpful and can actually prolong your concussion symptoms.

After the brief rest period, gradually increase your activity levels while still taking it easy by staying just below your symptom threshold (e.g., onset or worsening of symptoms), taking breaks as needed to stay comfortable, and not pushing into and making your symptoms worse (Type A personalities beware!).

In fact, ignoring and pushing through your symptoms will not get you back to life faster. Instead, it could make your recovery take longer.

So, what does a Type A person with a concussion do?

Don’t beat yourself up. Take it easy, take breaks as you need, make room for some self-compassion, and gradually increase activities over time over the next couple of weeks. After the initial rest period, research has shown that light cardio exercise (e.g., walking) can help with recovery. But don’t push into your pain and symptoms. In the case of concussion, “no pain, no gain” does not apply.

The content on this website is for informational and educational purposes only and is not intended to be a substitute for medical advice, diagnosis, or treatment.

80% of people recover from concussion symptoms within 7-14 days of injury, with the average recovery period lasting 10 days. Although post-concussion symptoms may resolve within 2 weeks, we do not yet know how long it takes the brain to physically heal after a concussion. So, take care not to re-injure yourself in the weeks ahead, it could set you back in your recovery.

The following are risk factors for longer than expected recovery following concussion. The more risk factors you check off, the higher the chances for a prolonged recovery.

• Multiple moderate to severe physical symptoms and sensitivities following mild traumatic brain injury (concussion).
• Moderate to severe cognitive symptoms.
• Post-traumatic headaches and/or migraine that won’t quit.
• Symptoms of depression, anxiety, trauma or sustaining the injury within the context of a stressful period in your life or stressful circumstances.
• Pre-existing mental health history including anxiety, depression, trauma.
• Adverse childhood history or adverse life events pre-existing injury (adversity can wire the brain for chronic pain).
• Past history of concussion(s)

Being at risk for prolonged recovery following a concussion does not mean that there is nothing you can do to change your outcome. If you have checked off several of the above risk items, you may benefit from targeted treatment to reduce your recovery time.

The short answer is yes.

The longer answer is, it depends. They don’t have to. There is a lot we have learned over the past several years about who is at risk for prolonged concussion recovery, what the barriers are to recovery and how to effectively target barriers to concussion recovery in treatment.

Although symptoms experienced immediately or shortly after injury can be directly related to brain injury, over time the brain heals and persistent symptoms can be maintained by many other factors, known as barriers to recovery.

Barriers to recovery following concussion can include depression, anxiety, avoidance of triggers (e.g., sound, lights, screens, physical or cognitive exertion), sleep problems, fatigue, pain (e.g., headaches), focusing on your symptoms, over exertion and experience of repeated setbacks in symptoms, and misinformation by well meaning family and health professionals. These factors can further interact to escalate each other (e.g., anxiety can fuel pain circuits in the brain) and maintain or even worsen symptoms.

Fortunately, neuropsychologists knowledgeable in concussion management can treat most barriers to recovery and get you on the right track to feeling like yourself again.

Neuropsychological treatment at Toronto Brain Health may include the following:

• Education and guidance to resolve symptoms more quickly.
• Biopsychosocial approaches to the treatment of chronic pain and physical symptoms (e.g., headaches, light and sound sensitivities), in conjunction with physiotherapy and neurology at other clinics or programs.
• Treatment of anxiety, depression, irritability, trauma, sleep problems, symptom preoccupation, low stress tolerance.
• Cognitive exertion training and cognitive rehabilitation , if indicated.
• Return to work or school readiness determination, a return plan, and guidance through the process.
• Many of our psychologists provide services under the WSIB Community Mental Health Program, insurer benefit plans and auto insurance for motor vehicle accidents.

Due to the large number of potential causes of ABI, the symptoms vary from person to person depending on the location and extent of injury to the brain, and several other factors that can affect recovery. Cognitive changes can be widespread and severe across many thinking abilities or specific and mild. Some cognitive symptoms are also more common than others due to the vulnerability of their supporting brain networks, for instance proximity to bony structures, blood vessels or sensitivity to oxygen deprivation.

Memory difficulties are the most common cognitive symptoms following an ABI. Memory changes can range from a greater frequency in misplacing important items, like keys, wallet and glasses or in forgetting the details of conversations, to severe memory impairment such as forgetting entire conversations, recent events or what happened a few minutes ago. Executive functions, also often affected by ABI, are made up of a diverse set of cognitive abilities including reasoning, mental flexibility, organization, problem solving, multi-tasking, prioritizing, planning, sustaining attention, goal attainment, as well as motivation, impulse-control (not doing or saying the first thing that comes to mind), judgment, social appropriateness, self-awareness and empathy. Other potential cognitive challenges can include slowed mental speed, difficulties interpreting visual information, and speaking or understanding language. Cognitive challenges further interact, such that difficulties in one area (e.g., organization) can create challenges in other areas (e.g., learning and recalling new information, planning, goal attainment).

An ABI is a major life event. It is normal to feel sad, down, angry, anxious and/or worried about what happened to you and what it means for your future. Adjusting to the changes you are experiencing as well as future uncertainties can be difficult to cope with. Many people describe their lives as “who I was before ABI” and “who I am after ABI”. The change to self-image, which may be due to changed employment status, physical abilities, and family and social roles, can be significant and have a negative effect on self-esteem. Many people benefit from supportive therapy to process these changes, the loss of their old life and to develop a new sense of identity and purpose.

Psychological disorders are common following an ABI. The most common conditions include depression, anxiety and anger. Often when psychological conditions are diagnosed, there is a pre-existing history of issues or risk factors (such as family history), but this is not always the case. Damage to certain brain structures resulting from ABI can also reduce emotional control which can exacerbate anxiety, anger and the ability to cope with day-to-day stressors. People who have experienced an episode of depression before ABI are at a greater risk following ABI of becoming depressed. Other risk factor for depression often experienced by individuals following ABI include reduced social contact, sense of purpose, meaning and engagement in activities they once enjoyed. Depending on how the ABI happened, a subset of people go on to develop post-traumatic stress disorder. Fortunately, cognitive behavioural therapy approaches have proven effectiveness with the above psychological conditions. As people with ABI may also have cognitive symptoms that interfere with traditional therapy administration (e.g., changes in memory, attention span), in many cases we may be able to adapt therapy to enhance treatment benefit.

This is one of the most common questions asked following an ABI and one of the most difficult questions to answer, which can be very frustrating in planning your future. Many factors influence recovery. These can include the location and extent of brain injury, complications, the responsible medical condition(s) causing cognitive and/or emotional symptoms, the severity and nature of symptoms early on in recovery, age, intelligence and educational attainment, motivation, family and social support, availability of comprehensive brain injury rehabilitation, psychological health, continued mental and physical activity, alcohol or drug use, sleep and nutrition.

The content on this website is for informational and educational purposes only and is not intended to be a substitute for medical advice, diagnosis, or treatment.

The type of injury, resulting symptoms, degree of recovery, in combination with your motivation, the nature of your job, flexibility at work and support of your employer can determine whether returning to work will be successful. Being aware of your challenges and learning strategies to effectively compensate, can also determine whether you will sink or swim at work.

The content on this website is for informational and educational purposes only and is not intended to be a substitute for medical advice, diagnosis, or treatment.

Neuropsychological assessment involves an examination of the brain and behaviour. Your performance on a variety of paper-pencil and computer tests provides a cognitive profile and information about the integrity of your brain function. Cognitive testing can take several hours to complete depending on the reason for referral. For many conditions, objective cognitive tests are more sensitive in detecting brain dysfunction or changes than current neuroimaging methods.

Thinking abilities tested can include attention, IQ and academic abilities, processing speed, learning and memory, language skills, visuoperceptual abilities, motor coordination, and executive functions, such as problem-solving, planning, reasoning, impulse control, and working memory (the ability to hold and manipulate information in mind). Psychological psychometric testing is also completed.

All psychometric scores are compared to normative datasets. Normative datasets can control for the effects of age, education, gender, and neurological or psychological conditions on test scores. In addition to cognitive and psychological testing, neuropsychological evaluations include a detailed clinical interview, diagnostic psychological evaluation, and review of medical, psychological and/ or neurological documentation. Interpretation of the comprehensive neuropsychological profile and formulation of diagnoses are informed by considering the interplay and impact of many variables.

Questions that can be answered by a neuropsychological evaluation, depending on the nature of the referral, can include the following:

• Diagnosis of neurological or neurodevelopmental disorders and their impact on cognitive function.
• Provision of clinical opinions and information to assist multidisciplinary care teams in reaching diagnoses of complex conditions or determining whether a medical intervention or medication was successful in improving cognition.
• Diagnosis of psychological conditions, including their impact on cognitive function.
• Types of cognitive abilities impaired or preserved.
• The severity of cognitive difficulties.
• Factors likely contributing to or causing cognitive difficulties.
• Improvement or decline in cognitive functioning over time with repeat testing.
• Recommendations pertaining to treatment plans for neurological and/or psychological conditions.
• How to optimize cognitive functioning via intact cognitive abilities (cognitive rehabilitation).
• Recommendations pertaining to accommodations for work and academic settings.
• Whether cognitive changes are normal for age or indicative of a neurodegenerative process.
• Guidance on future planning and decision-making in cases of neurodegenerative or brain injury conditions (dealing with finances, medication administration, meal preparation, and driving).
• Informing prognosis and/ or recovery in neurological and psychological conditions.

Neuropsychologists have advanced training in the administration and interpretation of psychometric tests, psychological and neurological diagnoses, neurocognitive and behavioural interventions, and psychotherapy.

Attention-Deficit/Hyperactivity Disorder or ADHD is a neurodevelopmental condition that was previously separated into ADHD and Attention-Deficit Disorder (ADD). ADHD is now the umbrella term for 3 different conditions: Inattentive, Hyperactive/Impulsive, and Combined. ADHD occurs in about one in every twenty children with a third of children retaining their diagnosis into adulthood. You are more likely to have ADHD if you have a first-degree family member with ADHD, such as a parent or sibling. ADHD is diagnosed twice as often in males than in females. Males are more likely to have readily apparent hyperactivity symptoms whereas females tend to have inattentive symptoms. As a result, ADHD is more often missed in females.

For many individuals ADHD symptoms can be chronic and lifelong. Although more than 50% of individuals with ADHD are diagnosed in childhood and adolescence, many people are not formally diagnosed until adulthood. Symptoms of ADHD can present differently across the lifespan, with teens and adults showing fewer symptoms of hyperactivity than children.

Inattentive symptoms:

• Lack of attention to detail or tendency toward careless mistakes in school or at work.
• Difficulty sustaining attention during task completion.
• Tuning out when spoken to, even without external distraction.
• Failing to follow instructions or complete work or school assignments.
• Often having difficulty organizing tasks or activities (keeping belongings in order, disorganized work, poor time management, failing to meet deadlines).
• Avoiding, delaying or reluctance to engage in tasks requiring sustaining mental effort.
• Often losing or misplacing things.
• Frequently being distracted by inner thoughts or outside stimuli.
• Forgetfulness for day-to-day activities (house maintenance tasks, paying bills, keeping appointments).

Hyperactivity-impulsive symptoms:

• Often fidgeting with hands, feet, or having difficulty sitting still.
• Difficulty staying seated for longer periods of time in situations where this is socially expected.
• Feeling restless.
• Difficulty engaging quietly in activities.
• Often being “on the go” and feeling uncomfortable staying still for extended periods of time such as at restaurants or in meetings.
• Talking excessively.
• Interrupting others in conversation, blurting out the answer before the question is completed, finishing other people’s sentences.
• Difficulty with waiting, such as in line.
• Interrupting or intruding on others’ conversations, games, or activities, or using other people’s things without asking.

If you experience several of the above inattentive, hyperactivity-impulsive symptoms or a combination of both, and these symptoms are interfering with your functioning at school, work, and/ or in your social life, it is possible that you have ADHD. A formal assessment can help clarify whether a diagnosis of ADHD is appropriate.

Individuals can receive a diagnosis of ADHD from a mental health provider (e.g., psychologist or psychiatrist) or a primary care provider (e.g., family physician). However, it is important to note that diagnosis of ADHD can often be complicated in the presence of other medical, psychological, neurological, or circumstantial conditions, such as nutritional deficiencies, thyroid dysfunction, severe anemia, medication side effects, history of mood or anxiety disorder, history of concussion and other neurological conditions, or circumstances such as high stress or sleep deprivation.

In other words, difficulties with attention are not specific to ADHD and can occur for several reasons. Likewise, ADHD is frequently missed in people with psychiatric and neurological conditions as the related symptoms can mask those of ADHD. A comprehensive neuropsychological evaluation can provide a clearer understanding of relevant medical, neurological and psychiatric conditions, and whether they are contributing to or accounting for your attentional difficulties.

Moreover, neuropsychological evaluations include a detailed clinical interview of your personal history and current symptoms, review of medical documentation, diagnostic psychological evaluation, psychometric measures of psychological symptom severity, and objective psychometric testing of your attention and other cognitive abilities.

Neuropsychological assessment involves an examination of brain and behaviour. Your performance on a variety of paper-pencil and computer tests provides a cognitive profile and information about the integrity of your brain function. Cognitive testing can take several hours to complete depending on the reason for referral. For many conditions, objective cognitive tests are more sensitive in detecting brain dysfunction or changes than current neuroimaging methods. Thinking abilities tested can include attention, IQ and academic abilities, processing speed, learning and memory, language skills, visuoperceptual abilities, motor coordination, and executive functions, such as problem solving, planning, reasoning, impulse control, and working memory (the ability to hold and manipulate information in mind).

Psychological psychometric testing is also completed. All psychometric scores are compared to normative datasets. Normative datasets can control for the effects of age, education, gender, neurological or psychological conditions on test scores. In addition to cognitive and psychological testing, neuropsychological evaluations include a detailed clinical interview, diagnostic psychological evaluation, and review of medical, psychological and/ or neurological documentation. Interpretation of the comprehensive neuropsychological profile and formulation of diagnoses are informed by considering the interplay and impact of many variables.

Questions that can be answered by a neuropsychological evaluation, depending on the nature of the referral, can include the following:

• Diagnosis of neurological or neurodevelopmental disorders and their impact on cognitive function.
• Provision of clinical opinions and information to assist multidisciplinary care teams in reaching diagnoses of complex conditions or determining whether a medical intervention or medication was successful in improving cognition.
• Diagnosis of psychological conditions including their impact on cognitive function.
• Types of cognitive abilities impaired or preserved.
• Severity of cognitive difficulties.
• Factors likely contributing to or causing cognitive difficulties.
• Improvement or decline in cognitive functioning over time with repeat testing.
• Recommendations pertaining to treatment plans for neurological and/or psychological conditions.
• How to optimize cognitive functioning via intact cognitive abilities (cognitive rehabilitation).
• Recommendations pertaining to accommodations for work and academic settings.
• Whether cognitive changes are normal for age or indicative of a neurodegenerative process.
• Guidance on future planning and decision making in cases of neurodegenerative or brain injury conditions (dealing with finances, medication administration, meal preparation, and driving).
• Informing prognosis and/ or recovery in neurological and psychological conditions.

Neuropsychologists have advanced training in the administration and interpretation of psychometric tests, psychological and neurological diagnosis, neurocognitive and behavioural interventions, and psychotherapy.

An accurate diagnosis of ADHD is important to effectively treat the underlying cause of attentional symptoms. For instance, if your difficulties with attention are due to underlying anxiety, then taking prescription medication for ADHD will not improve your symptoms. Once a diagnosis is attained, the first line of treatment for ADHD is a medication which can be prescribed by primary care providers and psychiatrists. Education about the nature of ADHD, related conditions diagnosed, and their impact on your symptoms and difficulties can be helpful in creating an effective treatment plan specific to your needs.

The benefit of combined treatment for ADHD, medication and cognitive behavioural treatment is supported by research and widely recommended as it can lead to better functional improvement than one type of therapy alone. For instance, stimulant medication, the primary pharmacological approach to treating ADHD, cannot cover the whole day due to the need for medication breaks to address side effects such as insomnia and appetite suppression. Likewise, learning and implementing cognitive behavioural strategies may be challenging without sufficient ability to focus.

ADHD is also often accompanied by other conditions such as depression, anxiety, sleep problems, low self-esteem and substance and/or alcohol misuse, that if treated, can improve one’s overall well-being, productivity and functioning.

Cognitive behavioural treatment for ADHD can include cognitive, behavioural and psychological strategies including:

• Time and task management
• Prioritization
• Problem management and decision making
• Planning and organization
• Goal management
• Dealing with distractions
• Procrastination and avoidance
• Initiation and motivation
• Environmental modifications
• Coping with task-interfering thoughts and emotions

Psychological interventions or psychotherapy for conditions often associated with ADHD may include the following approaches:

• Acceptance and commitment therapy
• Mindfulness-based approaches
• Cognitive behavioural therapy (CBT)
• Assertiveness and healthy boundaries in personal and professional relationships.
• Other evidence-based approaches, as needed, to treat accompanying psychological conditions, facilitate navigation of academic and workplace issues, or integration of cognitive remediation and behavioural tools (see above).

Some of the common symptoms of anxiety include:

Physical Symptoms:

• Heart racing
• Tightness/pressure in the chest
• Trembling, feeling shaky
• Tingling in the hands, feet, or face
• Nausea, diarrhea or stomach upset
• Hot flashes/chills
• Light-headedness/dizziness
• Feeling nervous
• Trouble falling asleep
• Difficulty concentrating/paying attention
• Tiring easily

Cognitive Symptoms:

• Excessive worry
• Difficulty concentrating
• Mind going blank
• Feeling as though one is going crazy
• Obsessive thoughts/rumination

A panic attack is the sudden onset of intense fear that triggers many symptoms including (e.g., racing heart, tightness/pressure in the chest, tingling in hands/feet, dizziness etc.). The symptoms can be so severe, that people often fear that they are having a heart attack, are suffocating, or that they are in danger of dying.

A panic attack typically reaches it’s peak after a few minutes. Panic attacks generally subside within a few minutes to about 20 minutes; however, it is possible in more severe cases, to have several panic attacks in a row, or throughout the day.

Cognitive behavioral therapy (CBT) is a form of therapy that has a solid grounding in science, with proven effectiveness in treating anxiety-related disorders such as Panic Disorder, Generalized Anxiety, Health Anxiety, Social Anxiety, Agoraphobia, and Specific Phobias.

A psychologist trained in CBT can work with you to identify the negative thoughts and behaviours that are maintaining or making anxiety worse.

For more information, read: How a Psychologist Can Help You Better Manage Anxiety

Individuals with depression may experience some (or many) of the following symptoms:

• Sad or depressed mood
• Feelings of hopelessness or emptiness
• Mood swings
• Feeling irritable or frustrated
• Less interest or pleasure in things usually enjoyed
• Having trouble thinking or concentrating
• Difficulty making decisions
• Feeling guilty
• Changes in sleep patterns (sleeping more or less than usual)
• Being more fidgety or restless
• Feeling slowed down
• Being more fatigued/ having low energy
• Feeling worthless
• Withdrawing from or avoiding people
• Decreased sexual desire
• Difficulty starting tasks
• Decrease in appetite and/or significant weight loss (not intended)
• Increase in self-critical thoughts
• Thoughts of self-harm/suicide

Cognitive behavioural therapy (CBT) is a form of therapy that has a solid grounding in science, with proven effectiveness in treating major depression, dysthymia as well as other mood disorders. A psychologist trained in CBT can work with you to identify the negative thoughts and behaviours that are maintaining or making negative moods worse.

Emotion-focused therapy (EFT) is another empirically supported therapy for the treatment of depression. A psychologist trained in EFT can help individuals with the development of strategies that promote the awareness, acceptance, regulation and transformation of negative emotion.

The symptoms of post-traumatic stress disorder (PTSD) typically begin within 3 months of the traumatic event, but some symptoms can develop later. Symptoms last at least one month and cause a significant disruption in day-to-day functioning.

Re-experiencing Symptoms:

• Reoccurring distressing memories and/or dreams of the traumatic event
• Distressing thoughts related to the traumatic event
• Flashbacks of the traumatic event (where it feels as though it were reoccurring)
• Intense, prolonged psychological distress/stress when exposed to trauma-related cues.

Avoidance Symptoms:

• Staying away from memories, thoughts, feelings, related to the traumatic event
• Staying away from people, places and/or things related to the traumatic event.

Negative Changes in Cognition and Mood

• Having difficulty remembering an important aspect of the trauma
• Negative thoughts about oneself, others, or the world
• Negative beliefs about the cause or consequences of the traumatic event
• Ongoing negative emotions (e.g., fear, horror, anger, guilt, shame)
• Significantly less interest or participation in important activities
• Feeling detached or estranged from others
• Persistent inability to experience positive emotions

Significant Changes in Arousal and Reactivity

• Irritable behaviour, angry outbursts, being “on-edge”
• Engaging in reckless or self-destructive behaviour
• Hypervigilance
• Being easily startled
• Having difficulty concentrating
• Having difficulty falling or staying asleep

Symptoms may also present with feelings of depersonalization (feelings of detachment / as if one were an observer of one’s mental processes/body) and derealization (altered sense of reality).

Cognitive behavioral therapy (CBT) is a form of therapy that has a solid grounding in science, with proven effectiveness in treating post-traumatic stress disorder (PTSD) as well as other trauma-related disorders. A psychologist trained in CBT can work with you to identify the negative thoughts and behaviours that are maintaining or making trauma-related symptoms (e.g., emotional and physical reactivity) worse.

Cognitive Processing Therapy (CPT) is another form of therapy that has been shown to effectively reduce the symptoms of PTSD. A psychologist trained in CPT will work with you to identify, challenge and modify unhelpful beliefs related to the traumatic event. Together, this would help you to form a new understanding or conceptualization of the trauma in a way that will minimize (or eliminate) it’s negative impact on your current functioning and day-to-day life.

A psychologist trained in cognitive behaviour therapy (CBT) can formulate a treatment plan with you to help you manage and ultimately improve anxiety symptoms and everyday functioning.  They do this by working with you to interrupt and challenge the negative thoughts that trigger anxiety. They also help you target and reduce the behaviours that make anxiety worse (e.g., avoidance)..

There are many things we can do to reduce our risk of developing dementia, even starting in mid-life or later. In fact, there is a large and growing body of research on this topic. Through research, we have learned that staying physically active is important to slowing down decline and even improving cognition. The mechanisms by which exercise can be beneficial to brain health are many but can include improving cardiovascular disease and stimulating brain protein production important for growth of nerve/ brain cells and in sustaining them. Advanced education, being a lifelong learner and having an intellectually stimulating career are protective agents against developing dementia as is social engagement. The Mediterranean diet, rich in fruit, vegetables, legumes, whole grains and fish, has been associated with lower incidence of cognitive decline and dementia. Numerous well-designed studies have shown positive effects of diets low in saturated fats on cognition, even showing improvement in as little as 4 weeks.

READ: Dr. Carson’s article for a list of tips on maintaining brain health.

It is well established that memory changes as we age. While memory is commonly understood as a single ability; you either have a good memory or you don’t; we now know that there are several memory systems or processes in the brain. These memory systems are supported by partially independent brain networks which, here is the good news, are not equally affected by age.

Age-related memory changes:

It is well established that episodic memory and working memory decline with age. Age-related changes are most pronounced in episodic memory.

Episodic memory

• Memory for events or details specific to a time and place.
• Episodic memory supports efficient learning of new information (such as one-trial learning), recalling who told you something (source memory), and remembering details of a specific event (episodic autobiographical memory).
• Episodic memory also supports prospective memory or remembering future intentions. Prospective memory involves recalling what you intended to do (episodic memory component) and retrieving the intention at the right moment (the prospective component).

Normal age-related changes in episodic memory can include recalling fewer details about a recent event, reduced learning efficiency for new material (taking more repetitions to learn) or forgetting intentions.

Working memory

• Working memory involves retaining and manipulating or working through information in mind for the purpose of completing a task or while working toward completing a goal.
• Examples of working memory include holding directions in mind until you reach your destination or keeping the name of someone you just met in mind during your conversation with them.

Normal age-related changes in working memory can include reduced efficiency in holding information in mind while thinking through a problem or while planning a task. Or forgetting the name of someone you were just introduced to while speaking with them.

Memory abilities preserved with age include:

There are also several memory systems or processes that are relatively well preserved with age or at least until very advanced years.

Procedural memory

• Memory for well-learned physical or cognitive sequences, routines or tasks.
• Examples include swimming, playing golf, cooking routine dishes or making an espresso, assuming you are well-practiced in these skills.

Semantic memory

• Memory for knowledge about the world or oneself, often used facts and vocabulary.
• The proverb, “with age comes wisdom”, turns out to be true.

Primary memory

• Basic attention span, such as holding a phone number in mind or a list of items.

If you have any concerns about whether your memory changes are normal or not, contact us to set up a consultation.

We offer unbiased and comprehensive evaluation of a range of psychological and neurological conditions. We adhere to the latest guidelines and population-based research on the use and interpretation of symptom and performance-based validity measures. Medicolegal evaluations are provided by doctoral-level psychologists with certification in medicolegal expertise, CMLE (ON) and/ or in the assessment for Catastrophic Impairment – Mental Behavioural, C-CAT (MB), through the Canadian Society of Medical Evaluators / Canadian Academy of Psychologists in Disability Assessment (CSME-CAPDA). Regardless of the reason for referral, your client will be treated with respect and care.

READ MORE

Toronto Brain Health offers a range of clinical services to individuals coping with psychological and/or neurological difficulties. Our referral network is broad and includes physicians, allied health professionals, community and executive health clinics, hospital and rehabilitation centre programs, third party insurers, lawyers and self-referrals from the community. Individuals referred to us by third party sources benefit from our breadth of services and knowledge.

READ MORE

Yes.

Toronto Brain Health seeks to maintain the strictest standards of confidentiality and privacy with respect to your personal health information. We are committed to collecting, using, and disclosing personal information responsibly and only to the extent necessary for the services we provide. We aim to be open and transparent as to how we handle personal health information. This document describes our privacy policies.

READ MORE

Yes.

You may read our terms and conditions of use by following the link below.

READ MORE