Mood & Anxiety

Over the past 35 years most of my research has been in mood and anxiety disorders. I have examined how common depression is in medical patients both in hospitals and family practice. I was among the first to show that depression leads to poorer outcomes in many medical conditions, and I designed a scale to measure this. I have studied how to treat depression and anxiety when they occur together, and have used leading-edge brain imaging techniques to examine mood disorders. I also looked for the possible underlying changes for bipolar mood disorder in laboratory and clinical  studies.

New Therapy programs

In designing Almond Therapy I was able to build on experience from other intensive multi-modal therapy programs I had developed over the past decade. I am most proud of four: one was school-based and helped over 6,000 youth - successfully reducing rates of depression, anxiety, and suicidal thinking both short-term and long-term; the second helped police officers improve their interactions 

with individuals who have mental health issues; a third has helped youth who have survived sexual abuse; and the fourth has trained adults about how to reduce risks of childhood sexual abuse occurring

 in the first place. I also was able to help audit a sophisticated program that I had not developed, which gave further insights. All of these programs requires excellent teamwork and in the book I both describe the programs and the team.

Long-term impacts of Trauma

In 2016 there was a major wildfire in Norther Alberta. It led to the emergency evacuation of nearly 90,000 people from the city of Fort McMurray. I was involved in several teams that investigated the long-term impact of this trauma on the community. We found that in over 4,000 youth the impacts were severe and long-lasting, and unsurprisingly major impacts were also found in many adults. We also examined what increased resiliency in both youth and the wider community. All of relevant research findings were integrated into Almond Therapy to help ensure it provides the greatest benefits to try and mitigate the long-term effects of trauma.  

Low Self-Esteem

Low self-esteem commonly occurs following trauma or abuse, particularly when these occur during childhood. I published my first research in this area in 1990 and have continue to have a strong interest in the impact of chronic low self-esteem. I have shown how commonly low-self-esteem occurs across a wide range of psychiatric conditions, and also that it is frequent in medical patients. I have also proposed that low self-esteem may be the key factor leading to the development of eating disorders. In the book I discuss how, just possibly, psychedelics plus therapy may help with self-esteem - to make a difference when nothing else has.

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E-mental health solutions:

The need for mental health treatment is so huge that we can only help solve it by including e-mental health solutions. Almond Therapy has many digital and online components and I have been developing electronic, digital, and online approaches since 1995. Additionally, I was able to use e-mental health approaches during the pandemic including: determining the best online tools to support those experiencing intimate personal violence; supporting a new text-based messaging approach; and provided free on-line mental health support throughout 2020 (3). My goal remains to develop effective e-mental health therapies which can help large numbers of individuals – it’s why I developed Almond Therapy.

Other areas

I have been involved as a clinical investigator in over 40 large international studies examining different medications for a wide range of clinical conditions including: depression, anxiety, bipolar disorder, schizophrenia, and post-traumatic stress disorder (PTSD). In other areas, two of my most surprising findings include research to be one of the first suggesting that males and females may use different areas of the brain to solve the same problem. In another set of brain imaging studies we found that individuals would keep following advice even when it was wrong 100% of the time and doing so caused them to lose money! Perhaps the single most consistent finding I would take away from a life-time of research is that you should never confidently predict the outcome.

Amygdala changes after trauma.

A key part of the brain linked to mood and anxiety disorders is the amygdala, so-called as it looks like an almond and (the Latin word for almond is amygdala). We have shown that the amygdala and related areas change in depression. But most importantly we have recently shown that after childhood trauma and stress we can detect changes in small regions of the amygdala even decades later. These findings may provide the physical link about how childhood stress increases the risk of depression and anxiety later in life. It is possible that we can reverse these changes through a combination of psychedelics and specific therapy designed to target the amygdala. This is described in the book, and it is why I have called it Almond Therapy - it focuses on the amygdala.

Amphetamine and related studies

One of the psychedelics of interest is MDMA, whose street name is ‘ecstasy’, which is part of the amphetamine family. For more than 30 years I have been researching amphetamines in both laboratory and human studies. This also utilized advanced brain imaging approaches which included being one of the first to examine how amphetamines impacted brain activation and how drugs interfere with this. Again, all of this research is very relevant to what I concluded in the book.