With the holidays and winter fast approaching, many people may feel blue. A number of things could be the cause: the stress of the holiday season, a lack of sunlight, or even clinical depression. Michael Henry, MD, medical director of the MGH Bipolar Clinic and Research Program, discusses signs and symptoms to be aware of as well as coping mechanisms.
Q. The holidays can be a tough time for some people. Why?
A. The holidays are a special time but they can be a time when people struggle and find they feel sad rather than joyous. This can occur for several reasons. First, there is the reality that the demands of the season put a dent in their wallet, especially during these difficult financial times. Second, they can remind us of loved ones that have passed on and cause us to grieve. Also, since they occur when the days are getting shorter and there is less light, these feelings can be mixed with Seasonal Affective Disorder (SAD), a form of depression that is associated with the fall and winter.
Q. What about when those unhappy feelings last past the holidays?
A. When the symptoms are severe enough to disrupt a person’s daily functioning, it could indicate a diagnosis of SAD, which is unipolar or bipolar depression that occurs with a seasonal change. These seasonal episodes are frequently accompanied by very low energy, increased sleep, carbohydrate craving, overeating and weight gain. There are several treatments available, starting with even a brief vacation in sunnier latitudes for those with mild symptoms. Other effective treatment options may include light therapy, psychotherapy and antidepressant medication.
Q. Where does major clinical depression fit in?
A. Episodes that meet the criteria for major depression are characterized by at least two weeks of depressed mood most of the day, nearly every day, or a loss of interest or pleasure in usual activities. In addition, there must be disturbances in sleep, energy level, concentration, appetite, increased focus on past mistakes, as well as, in severe cases, thoughts of death and/or suicide. If you know of anyone who has these symptoms, encourage him or her to call their doctor immediately.
Q. If you find yourself feeling blue and sluggish, but don’t feel it is severe enough to warrant seeing a doctor, what can you do to feel better?
A. There are several things you can do right now. First, make sure you are working out at least three to four times a week for a minimum of 30 minutes. Remember, if you haven’t exercised in a while, please consult with your physician before starting a rigorous exercise program. That short amount of time has been shown to effectively relieve the symptoms of mild to moderate depression. You should focus on a healthy diet to avoid holiday weight gain. I suggest limiting caffeine, even though it may sound counterintuitive. Coffee and tea can be dehydrating and there is a sense of a crash when the caffeine wears off. Caffeinated sodas spike insulin levels and drop blood sugar levels, thereby contributing to a sense of fatigue after the initial boost. If you need a lift, reach for water instead. That plus a small snack may give you a more consistent and healthier energy boost. And finally, get outside. Since daylight hours are fewer in the winter, try to sneak in a 15-minute walk when you can. Some vitamin D from the sunshine coupled with fresh air will do your mind some good.
Read more articles from the 12/14/12 Hotline issue.