Help and hope through the First Episode Mood and Anxiety Program

Summer 2019

Kirstie Leedham remembers her initial group session at LHSC’s First Episode Mood and Anxiety Program (FEMAP). She was sitting with 10 other young women just listening to them talk, and felt that everything they spoke about was something she was struggling with too.

“It was the first time in my life I understood that I wasn’t the only one who felt that way, and that was very, very hopeful,” says Kirstie.

At the age of 11 Kirstie was diagnosed with depression by a paediatrician in her hometown of Chatham.

“I had pressed my parents to take me to see someone because I’d see my friends really happy and I’d be angry at them because I wasn’t feeling the same way. It was almost like they were rubbing it in by feeling happy.”

By the time she was 18, Kirstie began having anxiety and panic attacks so severe that she went to the emergency department because, as she says, “it felt like my heart was about to explode.”

It took a long time to understand where her panic attacks originated, but she now sees that often it comes from stress-related situations like starting a new job.

Over the years Kirstie saw several counselors but felt they were not really helping her, and couldn’t relate to what she was experiencing.

She was also prescribed a number of medications, including anti-depressants, some which left her unable to sleep or eat.

“After a couple of years I decided to try and deal with it on my own through marijuana and alcohol,” says Kirstie. But it wasn’t helping.

One of her friends was a patient at FEMAP, a program designed for older teens and young adults who have concerns with anxiety or their moods. She encouraged Kirstie to check it out.

Kirstie was skeptical. “I had seen a lot of counselors and I thought, ‘well, I’ll go and prove her wrong.’ And then when it was so helpful it was, ‘ok, you win.’”

What she found was others who felt as she did, and a program that helped her reduce her anxiety and depression.

Dr. Elizabeth Osuch, FEMAP Founder and Physician Lead/Psychiatrist, runs the program and the research behind the work at FEMAP.

“Early intervention is so important. A full 75 per cent of these illnesses start before the age of 24, so we’re seeing an early onset of depression and anxiety, and if something is interfering with your ability to function, it has a huge developmental impact on your education, your social life, your family. We also know if left untreated the situation can get worse.”

Of the patients at FEMAP, 80 per cent are self-referred and 20 per cent are physician-referred. Only five per cent have never looked for help anywhere else, while 78 per cent had seen a school guidance counselor, 75 per cent had seen a family physician and one-third had been to the emergency department with their symptoms.

“Our goal is for our patients to get better and back to a normal developmental trajectory for their lives. The focus is on the individual and the nature of their illness, and the likelihood of success is really quite high when the motivation to participate in treatment is also high,” says Dr. Osuch.

FEMAP staff includes psychiatrists, a psychologist, addiction and family counselors, and clinical social workers.

“As a psychiatrist at FEMAP, I do a full clinical assessment to make a diagnosis, determine how best to proceed and what the treatment options are for the patient.”

Individual counseling, medication as well as group therapy are some of the treatment options for patients. Group therapy includes a stabilization group for young women who have experienced traumatic events, and one or more groups focused on anxiety symptoms.

“A huge part of healing from any episodic or chronic illness is to recognize when symptoms are occurring and finding strategies to prevent or reduce them as early as possible, before they cause irreparable damage to the person’s life,” says Dr. Osuch.

Participating in research

FEMAP is involved in research and is working with professionals in various academic disciplines. The program also trains undergraduate, graduate and postdoctoral students in clinical research and treatment involving mood and anxiety disorders.

Patients can participate in research that evaluates their characteristics before they start treatment, during treatment and a year after they started treatment.

“The purpose is to evaluate and ensure that we are doing what we set out to do.  FEMAP is one of the very few mental health care programs in Canada that does this,” says Dr. Osuch.

The data show that:

  • For most who come to FEMAP it is not actually their “first episode”,
  • Most individuals have not been functioning normally for over four days per week by the time they arrive at FEMAP,
  • On average, individuals seeking help at FEMAP endured multiple traumatic events and often have Post-Traumatic Stress Disorder,
  • When they contact FEMAP many youth are unsuccessfully trying to manage their symptoms with alcohol and/or drugs (especially  marijuana)

 

“We’re seeing that at the six-month follow-up point our patients are both clinically and statistically better and their functioning has improved significantly as well. They rate their satisfaction with the program as very high,” says Dr. Osuch.

“The biggest improvement is in their day-to-day functioning as they become more likely to get on track with life’s challenges. They are able to have more stable relationships with friends and family, and continue their education and find jobs.”

Kirstie is now 29. She is newly married and has an exciting career in digital media.

She attended FEMAP weekly for a year. Over that period she learned to identify symptoms and her reaction to stressful situations, how to be more introspective and coping mechanisms to help her better regulate her mood. She turned down medications because of her previous experience with them.

Is she cured?

“I feel I can manage well for long stretches, which leaves me feeling cured. The bad times have gotten fewer and shorter and not as intense,” says Kirstie.

“You don’t have to live that way and there is always something out there. Help is different for everybody, it looks different for everybody. There is hope.”

 

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