It is deep into November, the days are cooler and shorter, and Thanksgiving and Christmas are upon us. For many of us, this time of year is filled with special occasions, each one celebrating friends, family and community.
But with these holidays comes an aggressive assault on our health. We eat too much, exercise too little, and simmering family conflicts often lead to stress, high blood pressure and an increased risk of heart attack and stroke. Unfortunately, this time of the year is accompanied by a dramatic increase of depression.
For some, the dreary, cloudy winter days lead to a high incidence of a condition called seasonal affective disorder, or SAD, which manifests with insomnia and significant declines in mood. It can also be accompanied by a sense of increased hunger, a craving for carbohydrates and weight gain. Most experts believe SAD is caused by lack of sunlight, which interferes with our sleep-wake cycle or circadian rhythm. This causes many adults to lose the ability to distinguish night from day and sleep poorly. A decline in serotonin, a chemical released from the brain, affects mood and leads to depression. The diagnosis of SAD is suspected if a person has symptoms of depression at least twice during winter, particularly if symptoms are present in more than one family member.
Depression during the Thanksgiving and Christmas holidays is more common in older people, particularly those who live alone, have lost significant loved ones or no longer celebrate in their own homes. We often reminisce and long for beloved parents, spouses or friends who are no longer with us. And feelings of loss, whether it is loss of a loved one or loss of a tradition, are more acutely felt during this time of year.
A depressed older person will often feel unwanted and unnecessary, shrinking into the background and avoiding the hustle and bustle of winter festivities. And sadly, many of us can easily get wrapped up in the frenzy of planning and miss the warning signs of a depressed friend or loved one.
So how should we approach the winter blues? First and foremost, it is important to understand the fundamental reasons why many people feel sad and depressed. Remember, depression is not a weakness, an intrinsic mental flaw or a nuisance that can be easily wished away. Baby boomers have a particularly important responsibility to understand the plight of their parents who may not feel engaged in the party preparations or can become particularly upset by family spats.
During this time, make sure that everyone feels involved and useful. Most importantly, draw on the core tenets of this time to show continual love and understanding. Be welcoming and sympathetic. It will do a great deal to improve the situation.
In addition to the lifestyle changes that can improve depression, there are many medical treatments to address the winter blues. SAD can be readily treated. Many physicians prescribe light therapy to improve symptoms. The patient can sit in front of a bright light, usually from a light box, for at least half an hour a day.
A second approach is to use dawn stimulation, where a light comes on as you wake up and gets progressively brighter mimicking the sunlight. Within a week, symptoms often improve and research has shown that this approach can be very effective.
Irrespective of the cause, therapy with antidepressants should also be considered. Here the best choices are the serotonin reuptake inhibitors, many of which are now generic and include Zoloft, Prozac and Celexa. These medications help raise the concentration of serotonin in the brain and within two weeks can significantly improve mood. Counseling, with a qualified therapist to help improve coping skills, should always complement medications. We all need to learn to deal with adversity, cope with loss, put ourselves first, learn to say no and make sure that our needs are met.
Never downplay the sadness that can come at even the happiest of times. Depression is a serious medical condition that can lead to disastrous outcomes if ignored. Be understanding, seek help, and Thanksgiving and Christmas can truly bring the joy, happiness and contentment we all deserve..
Dr. David Lipschitz is the director of the Dr. David Health and Wellness Center in Little Rock. To find out more about Dr. David Lipschitz, visit www.drdavidhealth.com