Mood, Stress & Mental Health
Depression, anxiety and chronic stress shorten healthy life in ways that are measurable - through sleep, blood pressure, activity and the willingness to look after oneself. They are also under-recognized in older adults, where low mood is too often accepted as part of ageing. It is not, and it responds to treatment at every age.
What this means for healthspan
Mood, stress and mental health shape everyday health. Depression, anxiety and long periods of stress can affect sleep, energy, appetite, motivation, relationships and how well people look after their physical health. In the other direction, pain, poor sleep, illness and loss can affect mood.
Low mood and worry are not a normal or unavoidable part of ageing, and they can be treated at any age. They are also easy to miss, because people may describe tiredness, aches or poor concentration and not sadness. Caring for someone else can add its own strain, and it deserves attention too.
What we assess, and why
We may ask about your mood, anxiety, stress, coping, daily activities, sleep, alcohol and substance use, relationships and work or caregiving pressures. Where it helps, we may use short validated questionnaires to start a conversation and track change over time.
These tools do not diagnose a condition. A diagnosis needs a clinical assessment that looks at your whole situation. If anything in this section raises concern, we talk about it with you and discuss the supports that fit your situation.
What we may assess
Mood, anxiety, stress, resilience, coping strategies, life satisfaction and relevant social or occupational pressures, using validated tools when appropriate.
What is used is chosen for you, according to your individual risk, clinical appropriateness, the evidence and what you decide with your physician.
Why it matters
Recognizing concerns early can help guide practical support, appropriate treatment and strategies for sustainable wellbeing.
Examples of assessments and investigations
These are examples of what may be considered. Which of them are used for you depends on your history, your risk and what you decide with your physician.
Clinical conversation about mood and stress
An unhurried discussion of how you have been feeling, what is stressful, and what has helped. This is the main part of any assessment.
Depression symptom questionnaire
A short, validated questionnaire about mood over the past two weeks. It may be used when you have symptoms or concerns, and to track change during treatment. It does not diagnose depression.
Anxiety symptom questionnaire
A short, validated questionnaire about worry and tension. It may be used when anxiety is a concern and to track progress. It does not diagnose an anxiety disorder.
Stress and coping review
Questions about stress at work or home, caregiving load, coping strategies and support. It may be considered when stress is affecting sleep, health or daily life.
Alcohol and substance use review
A brief, non-judgmental review of alcohol, cannabis, tobacco and other substances, which can affect mood, sleep and anxiety.
Safety questions when needed
If you tell us you are struggling, or the answers suggest a risk to your safety, we ask directly and plan next steps together. Anyone in crisis should call or text 9-8-8 or call 9-1-1.
Review of physical contributors
Where symptoms suggest it, we consider medical causes and medicines that can affect mood, such as thyroid problems, low iron or B12, pain, sleep disorders and some prescriptions.
Referral and coordination
Where needed, we help connect you with your family doctor, counselling, psychotherapy, psychiatry or community mental health services.
What the evidence supports, and where it is uncertain
What the evidence supports
- The Canadian CANMAT 2023 guideline for depression describes both psychological treatment and medication as first-line options, with the choice based on severity, preference and past response. Treatment can help at every age.
- Short questionnaires such as those used for depression and anxiety can help track symptoms during care, once a person has symptoms or is being assessed.
- Regular physical activity, good sleep, limiting alcohol and staying socially connected are commonly recommended to support mood and wellbeing, alongside treatment where needed.
- Talking about mood and safety directly, in a caring way, is appropriate in clinical care.
Limits and uncertainties
- The Canadian Task Force on Preventive Health Care recommends against routine screening of adults without symptoms for depression using a questionnaire with a cut-off score, because the evidence of benefit is very uncertain. For this reason we use questionnaires when you have symptoms or concerns, not as a routine test for everyone.
- Questionnaires can over-identify or miss people. A high score does not mean someone has depression or anxiety, and a low score does not rule it out.
- Mood changes have many causes, including grief, illness, medicines, poor sleep and life events. Sorting them out takes time and sometimes more than one visit.
- Wellbeing and resilience scores are less well studied than symptom measures, and they should not be used to label a person.
- Treatments may take weeks to work, and people respond differently. Finding the right fit sometimes takes more than one try.
From findings to a plan, and what follows
How findings can inform a plan
Findings can help shape a plan that fits you. Depending on what we learn, that might include practical steps on sleep, activity and stress, a referral for counselling or psychotherapy, a discussion of medication with you and your family doctor, support for caregiving or social isolation, or a safety plan. Plans are made together, and you decide what feels right. We do not provide emergency or crisis care.
Follow-up, monitoring and coordination
Follow-up may include checking in on how you are feeling, repeating the same questionnaire if it was helpful, reviewing how treatment is going, and sharing information with your family doctor or mental health provider with your consent. If you feel worse or have thoughts of harming yourself, do not wait for a scheduled visit. Call or text 9-8-8 (Suicide Crisis Helpline) at any hour, or call 9-1-1 or go to the nearest emergency department if you are in immediate danger.
What happens here
The approach is the same in every area: establish where you are, change something on a cadence, then measure again to find out whether it worked. Mood, Stress & Mental Health does not have a program of its own. It is assessed as part of every membership and worked on with your physician, and with the dietitian, kinesiologist or counsellor where that is what it needs.
Mood & Energy Check
A 9 question screen for low mood, motivation, and energy over the last two weeks. It runs in your browser and takes about 5 minutes. Your answers are not sent to us; if you're signed in, your result is saved to your account.
Reliable places to read more
These are independent organizations. Monarch Health does not control their content and has no arrangement with them.
Government of Canada and Crisis Services Canada partners
9-8-8: Suicide Crisis Helpline (call or text, 24 hours a day)(opens in a new tab)
BC Partners for Mental Health and Substance Use Information
Here to Help: mental health and substance use information and self-help(opens in a new tab)
CMHA BC
Canadian Mental Health Association, BC Division(opens in a new tab)
Centre for Addiction and Mental Health (CAMH)
Depression: signs, causes, treatment and support(opens in a new tab)
HealthLink BC
Mental Health and Substance Use(opens in a new tab)
Where to go next
The other areas we work on