Tag Archives: holiday blues

Three steps to rediscover hope during the holidays

By Esther Scott December 8, 2021

As the seasons change from fall to winter, the rollercoaster of emotions we’ve experienced in dealing with the COVID-19 pandemic for the past two years continues to affect us. Some people are planning holiday celebrations that will make up for the ones they missed last year, whereas others are still dealing with a range of emotions triggered by the pandemic and the state of our global community. But this time of the year also presents a great opportunity to fortify our mental health by rediscovering the hope this season brings.

We saw our lives change rapidly during the holidays last year: We canceled plans, put relationships on hold, moved celebrations to later in the year and modified our traditional celebrations to uphold new social-distancing guidelines. In addition, we experienced a great deal of emotional pain caused by the death of friends and relatives from COVID-19. We also witnessed social problems, relationship struggles, and the loss of jobs and important plans. These experiences are not trivial, and they have had a real impact on our mental health.

In fact, studies show that our experience with this pandemic is already shaping behavior, and some project it will have lasting effects on the basic ways in which we interact with each other and the world. If people are socializing less often, for example, it could affect how they view themselves and how they relate to their community.

Just as nature plans for difficult times — with trees letting go of leaves to conserve energy and ants and squirrels gathering resources to sustain them through the winter — we must also prepare emotionally as we enter this holiday season. For us, planning ahead could mean organizing our thoughts and emotions, which not only allows us to grow in our ability to overcome the emotional and psychological effects of post-COVID-19 changes but also helps us prevent situational depression and be ready to face unexpected turns confidently.

The following mental health plan, which consists of three steps, serves as a valuable resource for emotional protection as we face both the physical and emotional change of seasons, and it can help us turn these experiences into opportunities for growth and rediscovering hope.

Anshu A/Unsplash.com

 Step 1: Understand your emotions.

Our emotions, even the uncomfortable ones, are always telling us something. The Pixar movie Inside Out does a great job at highlighting some of the emotions that help keep us safe: Disgust motivates us to stay away from germs. Anger helps us react to something we consider unjust or threatening. Fear and anxiety increase and prompt us to fight or escape something dangerous. Sadness encourages us to withdraw for a while to rest and heal, and tears signals to others that we need care.

Understanding our emotions helps us realize that what we are currently experiencing is a natural and expected reaction to the present situation. We have lost many things during the pandemic: social skills, connection, income, relationships and loved ones. Our emotions are, therefore, natural responses that appear when we lose something of value to us.

The pandemic has caused many people to reevaluate what is really important in their lives and to make changes. In psychology, this is called posttraumatic growth — a phenomenon in which positive change occurs as a result of struggling with challenging and stressful lives events. Studies have shown that a happy life starts with emotional well-being, and emotional well-being is a result of a healthy mind. That is why it is important to learn to be aware of our emotions, listen to them, take care of them and accept them.

Step 2: Focus on your resilience.

According to a recent U.S. Census Bureau’s Household Pulse Survey, about 41% of U.S. adults reported symptoms of anxiety or depressive disorder during the pandemic. A KFF Health Tracking Poll from July 2020 also found that many adults are reporting specific negative impacts on their mental health and well-being, including difficulty sleeping (36%) or eating (32%) and an increase in alcohol consumption or substance use (12%).

Although these statistics can be discouraging, it is also important to remember that you can focus on your resiliency and ability to overcome difficult situations. In fact, resilience is a psychological trait that can help keep you safe. Resilience can boost your immune response by providing you with an optimistic and hopeful view of the future; you believe your future will be better than your present and that you have the capacity to make that happen.

Psychological studies have found that our physiological immune system can help us not only detect and fight infectious disease but also detect and defend against “emotional infections.” In a similar way to how our body produces serotonin to help us heal from infections, our body can release dopamine, the “feel-good” hormone, to help us heal emotionally.

Throughout the pandemic, counselors, psychologists, pastors and community leaders have all offered advice on how to handle stressful situations and reduce cortisol levels. The most important ones to remember during the holiday season are

  • Have self-compassion and avoid demanding so much out of yourself
  • Stop constantly reading and watching news
  • Keep your internal emotions in check

Step 3: Use a rationalization technique.

Studies have shown that people are prone to overestimate or underestimate situations based on their emotions. For instance, people who are anxious about flying tend to overestimate the risks of flying when compared to driving, even though statistically flying is safer.

But just as fear can spread, hope can also be spread. Be a holder of hope. Make sure you remind yourself of your strengths, confidence and abilities. Crises are usually viewed as negative or dangerous, but they can also bring opportunities for improvement. The COVID-19 pandemic, for example, allowed individuals to find innovative ways to work from home and celebrate birthdays and weddings under social-distancing guidelines. And infidelity may cause a couple to reassess how much they value their relationship, which leads them to form a stronger bond and develop better boundaries.

After the difficult holiday season, we experienced last year in quarantine and isolation, you may feel relief this year because you can celebrate with your family and friends again, or maybe you feel you have personally grown and have a renewed perspective and appreciation for what matters most. This renewed perspective, along with realistic expectations, can be helpful as you move forward. Expect that you will miss the things, experiences and people you have lost during the pandemic. Expect to be emotional as you continue to adjust to the “new normal.” But you can also expect that you can overcome and improve your situation.

Remember that the beauty of the diamond comes from the extreme pressure and heat it experienced. The same is true for us. Just like diamonds, we may have gone through extreme conditions of pressure and heat last year. But we can emerge stronger from this crisis if we focus our energy on finding the positive lessons it gave us and hold on to one another this holiday season.

 

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Esther Scott, LPC

Esther Scott is a licensed professional counselor and solution-focused therapist in Arlington, Texas. Her specialties include relationship counseling, grief, depression, anxiety and teaching coping skills. Contact her at positiveactionsinternational.com.

 

 

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Counseling Connoisseur: Holidays 2020

By Cheryl Fisher December 16, 2020

“This is the season when people of all faiths and cultures are pushing back against the planetary darkness. We string bulbs, ignite bonfires, and light candles. And we sing.” —Anita Diamant

The holiday season is upon us, and navigating tradition with safety during the pandemic has proven challenging. The current dramatic surge of COVID-19 infections has resulted in a return to greater restrictions and fewer opportunities to safely meet with family and friends. The U.S. Centers for Disease Control (CDC) has recommended avoiding inside gatherings that include anyone outside our immediate household. An alternative is to gather outdoors, but the weather in colder climes makes this more difficult. This reduced ability to gather with loved ones may make this winter seem particularly dark. Yet, we are resilient, and, as we are reminded, this is a season that is about bringing light into darkness at its core.

Traditional winter holidays

Hanukkah, also known as the Festival of Lights, is an eight-day Jewish celebration marking the rededication of the Temple in Jerusalem by the Maccabees after their victory over the Syrians. Upon entering the Temple for battle, the Maccabees immediately relit the ner tamid (eternal light) with a small amount of oil that should only have lasted a day. Miraculously, it lasted eight days. Celebrants mark this by lighting one candle on each of the eight nights of the holiday.

Kwanzaa is an African American celebration of family and community that lasts from December 26 to January 1. The holiday honors seven principles: unity, self-determination, collective work and responsibility, cooperative economics, purpose, creativity, and faith. The Candlelighting Ceremony is central to Kwanzaa and takes place at time when all family members are gathered. Seven candles — representing the seven principles — are placed in the Kinara (candleholder). Beginning on the 26th, one candle is lit each day.

Diwali is a five-day Hindu festival beginning on the 15th day of the month of Kartika (sometime during October or November on the Gregorian calendar). Also known as the “row of lights” it symbolizes good triumphing over evil and light over darkness and is celebrated with music, dance and lights.

Advent is the season in which many Christian denominations prepare for the birth of Jesus Christ with prayers of anticipation and for peace and hope. Advent begins four Sundays before Christmas. Part of the observance centers on the Advent wreath, which has five candles; one lit on each of the four Sundays and one in the center to be lit on Christmas Day.

The Winter Solstice is the first day of winter and the longest night of the year. Many of the elements of modern winter holidays are drawn from traditions in past celebrations of the solstice. Numerous cultures continue to celebrate this day with various rituals, including the lighting of candles, bonfires, or the burning of a Yule log to celebrate the eventual return of the sun following the coming time of darkness.

 

Celebrations that center on light span the globe. They mark the eventual return of the sun, new beginnings and the embrace of family. Amidst the pandemic that has dominated this year, it is more important than ever to find ways to keep those celebrations alive. Here are four things to consider when planning your holidays.

Manage expectations

While we have become more accustomed to limiting our social activities, it is important to recognize that this year’s holiday experience may be quite different than years gone by. Gatherings (if any) are much smaller and more subdued. Lean into the difference. Plan for the change.

Order in — One of my brothers usually hosts our grand Thanksgiving feast. This year, because we are honoring the recommendation to limit gatherings, each family will host its own meal. As I am a vegetarian and no one in the family trusts my ability to cook a turkey, I have ordered our turkey dinner from a local market so that my husband can get his fill of turkey and gravy while I prepare (and enjoy) my signature side dishes and desserts.

Drive-by desserts — Although we will not share a meal together, I am preparing my father-in-law’s delicious pumpkin custard pie and bringing it to the assisted living facility where he resides. We can gather outside his bedroom window for a few moments, enjoy a piece of pie and savor the precious time we have together.

Zoom gathering — While we all have Zoom fatigue, we are still so fortunate to have the opportunity to see loved ones in “real-time.” Zoom during your mealtime. FaceTime while taking an after-meal walk. Enjoy a phone call during coffee and dessert. Connect with your loved ones.

Traditions matter

Now, more than ever it is important to connect to that which solidifies our identity and heritage. Traditions matter!

Decorate — Holiday decorations are part of the experience and this year we are motivated to deck the halls sooner in the season. Trees are trimmed. Outdoor lights are hung. Neighborhoods are having decorating contests to ignite neighborhood engagement. Host your own virtual tree trimming party. Create an environment that welcomes celebration and holiday cheer.

Create socially distanced adventures — What activities are traditions in your family? Do you sing holiday songs? Do you have a jigsaw puzzle around which family gathers informally, placing puzzle pieces while sharing stories together? Borrowed from a creative neighbor of mine, I have initiated a Family Jigsaw Puzzle Frenzy. I sent each family the same puzzle. When everyone has received it, we will join on Zoom and officially begin the frenzy of puzzle making. Over the holidays, family members chronicle their progress with pictures and videos. Awards for the first puzzle completed, the last savored, the funniest photo or most memorable puzzle moment will be presented. The most important part of this endeavor is that families recognize that while we cannot be physically together, we can still engage in merriment together while apart. Be creative!

Cook holiday foods — Every year I make my mother-in-law’s famous gingerbread recipe for my husband and his family. She has long been deceased, but this recipe is reminiscent of a time when my mother-in-law was present, the family was all together, and the holiday magic was infused with the aromatic spices. This year, care packages of these yummy cookies will be gifted as a reminder of a simpler time and in hope of our gatherings soon to come.

Make music — Music soothes and inspires. Turn on those holiday tunes and let them ring. Sing out loud. Zoom in family and friends for a holiday sing-along. Do drive by caroling in your neighborhood. Allow the magic of music to be part of your holidays.

Connect — This is the year for holiday cards and letters. Bring out beautiful stationary. Write the annual family letters. Slip a teabag into a card and invite the receiver to share teatime with you. If you would prefer not to send paper cards, consider ecards or video greetings. Call people you think about but have not talked to in eons. Text “just thinking of you” random messages.

Journey within

The holidays are a perfect time for reflection and contemplation. Follow nature’s lead and allow yourself time to journey within.

Meditate — Take time to quiet your mind and experience stillness. Breath in the calm and exhale anything that is not serving you. Create an internal space for the holiday light to shine brightly.

Be in gratitude — Cultivating an attitude of gratitude is powerful. This year has offered many challenges. Despite these obstacles, are there things for which you are thankful? For example, in these trying times, I am incredibly grateful for the comfort of my home, food on my table and a warm bed at night.  Additionally, as a counselor, I have been able to resort to telehealth and continue to see my clients without fail. I am incredibly grateful for the work that I am privileged to do.

Journal — This is a great season to take pen to paper and write down thoughts from the year. Review the challenges, perhaps the losses and honor your emotions about these concerns. Note how resilient you are to have survived, possibly thrived the difficulties that 2020 has presented. Describe how you have navigated this unprecedented year and savor your resiliency.

Keep the faith

The holidays are also a time to lean into one’s beliefs and understandings around hope, peace, and community.

Read inspirational words — Minimize listening to and watching information that promotes fear and division. Focus on literature and media that are encouraging and unifying. Sacred texts, inspirational podcasts, positive and hopeful movies can plant seeds of hope and renewal.

Pay it forward — Alfred Adler knew the value of social interest in overall well-being. Consider sending a care package to first responders. Order a meal to be delivered to local emergency room staff. Pay for a stranger’s coffee in the drive-through line. For example, I have taken home-baked cookies and treats to the local fire and police departments and leave Starbucks gift cards for the postal and delivery workers over the holiday. It does not need to be costly. Volunteer at an animal shelter. Randomly rake your neighbor’s front lawn. Shovel the snow (yes, we are already seeing snow in some areas) from the sidewalk in front of another’s home. Create a neighborhood swap by setting up a table in front of your yard and inviting neighbors to take or borrow your used books, puzzles or games.

Be the change — If you want peace, promote unity and connectedness. Invite conversations with those who differ in your beliefs or understandings. Listen with an open mind and heart and hold the space for differences to be tolerated. If you want hope, cultivate a positive presence with inspirational words and actions. Sponsor a family or child in need. Use your personal power to advocate for those whose voices may be marginalized.

 

This year has been difficult. It has posed many obstacles to endure. However, it has also allowed us to tap into our skillset around patience and innovation. It has allowed opportunities for us to demonstrate kindness and generosity. It has promoted the development of resiliency. This holiday season, use those skills to ignite the flame of hope and love. To quote author Hamilton Wright Mabie, “Blessed is the season which engages the whole world in a conspiracy of love.”

From my family to yours, Happy Holidays!

 

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Related reading from Cheryl Fisher:

The Counseling Connoisseur: Enjoying the holidays by letting go of expectations”

“The Counseling Connoisseur: Cultivating silence in a noisy world”

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Cheryl Fisher

Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland. She is director and assistant professor for Alliant International University California School of Professional Psychology’s online MA in Clinical Counseling.  Her research interests include examining sexuality and spirituality in young women with advanced breast cancer; nature-informed therapy; and geek therapy. She may be contacted at cyfisherphd@gmail.com.

 

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Facing a winter of discontent

By Laurie Meyers November 19, 2020

In 2005, a Welsh psychologist announced that he had created a formula combining factors such as weather, holiday debt, the amount of time elapsed since Christmas and the likelihood of already-abandoned New Year’s resolutions to determine the most depressing day of the year: the third Monday in January, aka “Blue Monday.”

To many people — particularly those in the upper latitudes of the Northern Hemisphere — this sounded logical. After all, January can seem a little grim, with its feeble sunlight and frequently unpleasant weather, the end of holiday festivities, and endless commercials for diets and exercise equipment. As we rise in the dark to trudge to work and are again greeted by darkness on the commute home, spring does seem particularly far away.

But the vaunted “discovery” was, in truth, a public relations stunt masquerading as science. Blue Monday and its phony formula were commissioned by a savvy travel agency in the United Kingdom as a faux-scientific excuse for people to stop sitting in their cubicles complaining about dreary weather and book a vacation to someplace warm and sunny.

In 2020, winter arrives toward the end of a calamitous year and with additional challenges beyond the usual seasonal funk. Americans are already reeling from a spring and summer spent isolating and physically distancing to avoid the novel coronavirus that causes COVID-19. It was difficult or unsafe to participate in many of the sun-soaked rituals that normally help buoy people against the coming of winter.

As fall arrived, more than 200,000 Americans were dead, and the country began experiencing another nationwide surge of COVID-19 cases. Many people have lost loved ones. Isolation, lack of contact with friends and family members, and the difficulties of home schooling and working from home have taken a significant toll.

Winter promises more of the same, and what spring might hold is entirely uncertain at this time. The holiday season — which can be difficult for many people under the best of circumstances — is especially fraught this year. Public health experts have discouraged indoor gatherings that include people who do not live in the same household. This directive has left many wondering how — or if — they can celebrate with loved ones.

Unhappy holidays?

In a year when virtually nothing has been normal — “new” or otherwise — the longing for traditional celebrations may be especially intense. But it’s essential for clients to realize that the holidays, like the preceding seasons, will most likely be atypical, says licensed professional counselor (LPC) Stacy Blassingame.

“Most of us are feeling an increasing loss of connectedness to relationships and traditions we’ve come to rely on to give life meaning and purpose,” she says. But clients need not give up on the idea of sharing the holidays with loved ones; their celebrations simply need reimagining, says Blassingame, a member of the American Counseling Association whose specialties include anxiety and family issues.

She helps clients explore what aspects of the holidays have traditionally felt the most meaningful to them — such as baking and cooking, gift-giving, taking pictures or sharing stories — and then identify different ways of incorporating those things into celebrations. Blassingame and her clients have looked into ways of using the entire holiday season, rather than just a day or two, to connect with friends and family via Zoom or even through small, physically distanced gatherings.

One advantage of the increasing incorporation of technology into celebrations is that clients are more likely to include family members who aren’t usually able to travel to in-person gatherings, she points out. “In fact, this summer, I had the opportunity to participate in a Zoom bridal shower that connected me with family members I haven’t seen in years,” says Blassingame, a counselor and managing director at the St. Louis counseling practice Change Inc.

Lauren Ostrowski, an LPC in a Pottstown, Pennsylvania, group practice whose counseling specialties include depression, anxiety and relationship issues, suggests that clients get creative with technology. Instead of gathering in person as they normally would, family members could mail or drop off their gifts and then open them at the same time on Zoom, or use the platform for cooking and eating a holiday meal together, suggests Ostrowski, a member of ACA.

Not everyone views the holidays as a time when all is merry and bright, however. “The holidays are complicated for many people in the best of times,” notes John Ballew, an LPC practicing in the Atlanta area. “For many people, not being able to spend time with those we love has been painful. For others with complicated family relationships, the idea of not being able to visit during the holidays may be more distressing than the actual loss of time with family.” Some clients might tell themselves how awful it is that the pandemic is keeping them from spending the holidays with extended family, when the reality is that the prior year at Thanksgiving, they ate and drank too much and got into a big fight with their relatives, he says.

“Counselors never want to minimize their clients’ experiences,” cautions Ballew, an ACA member. “But helping clients explore what’s really important to them, what’s meaningful, may help alternatives emerge.”

Perhaps a holiday away from family conflict will provide a much-needed break, he says. And if clients end up spending the holidays mostly alone — by choice or not — can they find a way to make the season meaningful in a new way?

“Holiday time is often an overwhelming whirl of shopping, consuming and busyness,” observes Ballew, whose counseling specialties include depression, anxiety, relationship problems and couples counseling. “Yet this time of year also lends itself to reflection and thinking about what is important. Counselors have an opportunity to help clients understand the potential for something good beneath the layers of loss.”

Laura Brackett, an LPC and the director of community engagement at Change Inc. in St. Louis, notes that her clients have been bringing up the holiday season and how different it will be for months in advance. She says that before discussing how to mark the holidays, it was essential for her to understand whether the holidays had historically been a time of celebration or pain for each of her clients and if something — besides the pandemic — was contributing to making this year different from past holiday seasons.

For example, marking the holidays during a year in which a parent died and the pandemic prevented a client’s family members from gathering to mourn is drastically different from welcoming this year’s social distancing as a break from having to travel to four separate places in a 24-hour period, Brackett emphasizes.

“In general, I ask my clients what they need to grieve, to celebrate, to remember and to let go of,” she says. “We also discuss what power they have in deciding what this holiday season will be to them, including if they want to acknowledge it at all.”

Some clients this holiday season may have mixed emotions, including guilt and grief, Ostrowski says. “There are a lot more people who have an empty chair at the table this holiday,” she observes.

Ostrowski helps clients find ways of honoring their absent loved ones, such as decorating a certain way or even just sharing memories with a friend or family member. She also reminds clients that it is OK to experience a moment or time of joy amidst the grief as a kind of gift to themselves. Ostrowski asks clients to notice those feelings — how one part of them may be sad, while another part is enjoying the moment. “You can have two different emotions at once,” she confirms to clients.

A new kind of family conflict

Even among the most even-tempered families, it wouldn’t be the holidays without at least a little conflict. This year, some of the dissent is likely to be about public health experts’ advice against gathering — at least indoors — for the holidays. Family members may have divergent views of what a “safe” gathering looks like.

“Anxiety about these situations is very real,” Ballew says. “It has been called insinuation anxiety: a worry that not agreeing with someone’s choices implies criticism of how they are managing pandemic life. It is important to affirm clients who are rigorous in social distancing if that’s what they’ve decided is the best course of action.”

Ballew also probes for signs that the conflict is an indication of problematic family dynamics. “It isn’t unusual for clients to report that they feel disrespected in long-standing patterns with parents and other family members,” he explains. “Social distancing decisions may be merely the most recent manifestation of this. Coaching them through this involves several steps: identifying the problem and the desired outcome, clarifying their boundaries and choices, then using behavioral rehearsal or role-play to gain some skill in navigating these challenging interactions.

“Many people want family members to validate their choices as a way to ease their own anxiety in the face of uncertainty. I find it helpful to point out how this gives the client’s power away, leaving them at the mercy of people who may have values significantly different from their own.”

Blassingame says many of her clients feel as if the pandemic has ruined large parts of their lives. She says that allowing clients to give voice to all their disappointments often helps them realize that in some ways, they agree with those who are against a socially distanced celebration because they believe it won’t feel like the holidays without gathering in person. Recognizing this allows clients to empathize with family members and approach the conflict feeling more empathetic and centered.

Blassingame adds that some clients also find it helpful to rehearse how to respond to family members who are hurt or disappointed. They can use statements such as, “I’m really sad that it’s not safe for us to get together too. I can’t wait until we’re all together again.”

However, some clients face weightier decisions, she says. “I have also had clients who had to seriously weigh the pros and cons of spending a holiday without aging loved ones, recognizing that this may be their last holiday together,” Blassingame explains. “One client of mine had an open and difficult conversation with her aging parents weighing the pros and cons of not seeing them this year.”

In the end, the client and her parents decided that they would always regret it if they ended up missing a potential last chance to celebrate together. They have decided to spend the holiday together while taking all possible safety precautions, Blassingame says.

Julie Cavese, an LPC with a private practice in Portland, Oregon, proposes some middle ground. She suggests investing in a space heater, decorating the garage or carport and having a few family members over for a physically distanced gathering. Or, clients could suggest that family members take a holiday walk/hike or gather outside with some hot chocolate.

For clients who don’t feel comfortable getting together with extended family, even outside, “I think just being honest goes a long way,” Cavese says. Clients could tell family members that of course they’d love to see them, but they just don’t feel safe doing so. Then they can add that they’re really looking forward to seeing them next year.

Family members may not be happy with that decision, but Cavese asks clients what their priority is. Is it their personal safety and public health? “Or is it keeping the peace at all costs, even if that means Grandma gets sick?” Cavese says.

Welcoming winter

Blue Monday may be a myth, but there’s a reason that it still pops up in news articles every January. Even people who do not experience seasonal affective disorder (SAD) sometimes feel more sluggish and unmotivated during the winter. Winter weather can make it difficult or undesirable to go out. Many areas of the country routinely deal with heavy snow, biting winds, sleet and freezing rain or, at minimum, uncomfortably cold rain. Even on sunny days, the light frequently feels a bit anemic.

“I’m finding that as the days get shorter, those whose moods are affected by the changing seasons have started struggling with low mood much earlier than in years past,” Blassingame says. “I can’t help but attribute this to the fact that most of us have spent a lot of time alone and in our homes already this year.”

As Ballew notes, this winter we are facing all the usual challenges without the social stimulation of parties and little pleasures such as concerts and plays. 

Blassingame has been urging all of her clients — with or without SAD — to prepare for the increased isolation of the upcoming winter. Take advantage of the time that can be spent outdoors right now, she advises.

“In many areas of the country, individuals can bundle up and go for walks or even consider fall camping or hiking to take advantage of the outdoors during even the coldest months of the year,” Blassingame says. “I [also] encourage clients to think about the things they love to do during the slower, ‘hibernating’ months of the year and begin preparing for them now by planning winter projects and activities such as home projects, crafts [and] cooking new recipes. Some are stocking up on books to read and movies to watch in anticipation of having more free time. Having something to look forward to can be a beneficial tool to cope with longer periods of isolation.”

“This year, self-care is going to be particularly important,” Ballew adds. “Don’t overindulge in self-soothing by overeating and over-drinking, though don’t completely avoid those pleasures either. Exercise is key. Look for something new to add to routines, or change things up if you get bored.”

Blassingame agrees. “During these long months, I’m urging clients to be mindful of their intake of alcohol … as many are more prone to drinking to cope with loneliness and feelings of sadness. Clients also often need help identifying friends they can ask for support to set them up for greater success as the winter drags on.”

One of Blassingame’s clients is assembling a group of friends to do regular check-ins with each other and to drop off or mail random small gifts, such as a candy bar or a package of tea or coffee, so that no one feels forgotten.

Ballew is encouraging clients to renew contacts with old friends and to stay in closer touch with existing friends. He also urges clients to explore online offerings such as meetups, 12-step groups (if appropriate) and other options.

“With single clients, I often talk about how to use online dating apps effectively during a time when dating looks very different from the way it looked last year,” Ballew says.

“It is also helpful for people to cultivate an appreciation for their relationship with themselves,” he continues. “Encouraging new hobbies or reinvesting in old ones may help them reexperience time alone as something to be valued, not just endured.”

Although clients need to find ways to make winter more enjoyable, they shouldn’t feel an obligation to be “productive,” say Blassingame and Ballew.

“For example, I have one client who, at the beginning of the pandemic, was feeling a sense of guilt over not baking bread, learning a new hobby or expanding her mind through reading a new book,” Blassingame says. “We spent time talking about the messages she received growing up about productivity and laziness.”

The client’s father had taught her that it wasn’t OK to spend time relaxing and recharging, Blassingame notes. “When we explored how she wanted to spend her time of isolation, she shared that she has a list of her top 50 favorite movies that she has always wanted to get around to rewatching,” Blassingame says.

The client realized that she didn’t even want to learn how to bake bread. “During her time at home, she watched quite a few of her favorite movies and is saving the rest for this winter when she anticipates spending more time indoors,” Blassingame says. “Sometimes, we just have to help clients give themselves permission to spend their time the way they truly want to spend it.”

It’s great that some people are spending this time learning or doing new things, Ballew says. “But for most of the people I work with, the pandemic and the changes in work and relationships it has wrought have used up much of their bandwidth,” he adds. “Telling a parent balancing working from home with sketchy child care that they should also be learning to speak another language or learn to play the flute is cruel. Yet that’s what some of my clients have been expecting of themselves.

“Counselors are in a great position to help clients recognize the demands that life is placing on them. In my experience, clients’ No. 1 need is to learn greater self-compassion.”

Everyone has their own optimal level of stimulation, Ballew explains. Some people are stretched thin by the demands of the pandemic, while others are understimulated and bored.

“Counselors need to help clients understand their own situation and how to care for themselves,” he says. “Does a client need more structure to calm some of the chaos around them? Or do they need to add a challenge that they will find meaningful?”

“One recommendation I make for most clients is to take time every day to walk with a partner or by themselves,” Ballew continues. “If they are walking by themselves, listening to audiobooks or podcasts can satisfy the urge to learn or do something meaningful. At the same time, the exercise helps them better regulate their mood.”

It’s OK to take winter as a time for self-nurturance, Cavese tells clients. She urges them to embrace its coziness and let themselves enjoy the wrapping up, hot drinks and movie nights.

Holding on to hope

During the long nights of winter to come, it might be easy to feel as if the coronavirus era is endless.

“I don’t think it’s evident to most [people] that what they’re experiencing during the pandemic is a form of grief,” Blassingame says, adding that just naming and normalizing the grief can be therapeutic. Counselors and clients should also explore what has been lost, both personally and as a society, she emphasizes.

“When some clients are struggling, I’ve found it helpful to just say, ‘This really sucks, doesn’t it?’” Ballew says. “Just acknowledging what is right in front of us can be freeing. Give clients space to talk about frustrations, fears and losses, even if they said pretty much the same thing last week. Many clients are struggling to support others, and the counseling session may be their only opportunity to acknowledge the depth of their loss. The goal is to help clients move to a place of acceptance if they can.”

“It’s crucial for helpers to acknowledge how these times have been tough for them as well,” Blassingame urges. “As paradoxical as it may seem, we can often be more helpful when we resist the urge to fix or remove the grief and pain that clients are experiencing. Be a fellow struggling human being who is walking beside them in the same struggles.”

Brackett also believes that counselors may want to consider self-disclosure. “As counselors, we often appear to our clients like we have it all figured out, even if we don’t intend to present that way,” she says. “Would normalizing an experience with your own life help? For example, a client recently discussed worry about the dropping temperature and how it will limit their ability to see people. While we considered ways to keep connection when outdoor activities aren’t as easy, the part of the conversation that steadied them the most was my own disclosure about that concern: ‘I don’t know how to maintain connection during a global pandemic during holiday season in the Midwest in the winter either, and it’s intimidating! Maybe we can figure it out together.’

“It’s that last word — together — that reminds them that even if they don’t know what to do, someone is with them.”

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Contact the counselors interviewed for this article:

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Laurie Meyers is a senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Positive actions to prevent the holiday blues

By Esther De La Rosa Scott December 11, 2019

‘Tis the season to be jolly! The season for candlelight, friends, gatherings and warmly lit fireplaces. Although the holiday season is a time full of parties and family gatherings, for many people it is also a time of self-evaluation, loneliness, reflection on past “failures,” and anxiety about an uncertain future. It is the season for the holiday blues. The National Alliance on Mental Illness defines the holiday blues as temporary feelings of anxiety or depression during the holidays that can be associated with extra stress.

There is much connected to our holiday festivities that can cause us stress. What to wear? What food to bring? What gifts to get? For some people though, the more pressing question is, “How will I get through the holiday stress and the memories that accompany the season?”

This is also the season, with the days getting shorter and shorter, when we spend a significant amount of time inside and in the dark. Waking up in the dark, going to work in the dark, and leaving work in the dark can be tough for many of us, putting us at risk for seasonal affective disorder (SAD) in the wintertime.

 

What causes the holiday blues?

Researchers have yet to uncover the specific cause for SAD, which is also referred to as the holiday blues. However, they do acknowledge that several factors are at play.

The reduction in sunlight in winter can throw our biological clocks out of whack and reduce our levels of serotonin (a brain chemical that regulates our mood) and melatonin (a chemical that regulates sleep and mood).

The holiday or winter blues can be triggered by other factors that include unrealistic expectations, overcommercialization, or the inability to be with our families and loved ones. The increased demands of shopping, parties, family reunions, and houseguests also can contribute to these feelings of tension. Even people who do not become depressed can develop other stress reactions such as headaches, excessive drinking, overeating, and difficulty sleeping during the holidays.

 

When to seek help

Recent studies have shown that environmental factors — namely fewer hours of sunlight — can contribute to feelings of depression around the holidays. SAD is considered a category of depression that emerges in particular seasons of the year. Most people notice SAD symptoms starting in the fall and increasing throughout the winter months. If you are experiencing SAD symptoms (e.g., changes in sleep and appetite, a loss of pleasure in activities you once loved, depressed mood, feelings of hopelessness, a lack of energy, difficulty concentrating, reduced sexual interest, unhappiness, thoughts of death or suicide) make an appointment with a mental health provider.

We all have days when we feel unmotivated, but if your symptoms are causing disruptions in your life, it is time to reach out for assistance. A mental health professional can help you figure out the things in your life that are stressing you out and help you make a plan to manage or minimize their impact on your emotional health. In addition to seeking help from a mental health professional and avoiding specific unhealthy habits, implementing the positive actions described in this article can help improve your symptoms.

During the holidays, there are many obligations — from attending parties to wrapping gifts to baking treats — that can cause us stress. We can easily get caught up in fulfilling these obligations rather than spending time doing the things that would actually bring us joy. Rather than letting the season take a toll on us, we can take positive actions to emotionally prepare ourselves for winter and the holiday blues. After all, the holidays are supposed to be a time for us to recharge and restore our energy for the year ahead.

 

Positive actions

Here is a partial list of positive actions that can help prevent the holiday blues.

1) Get organized. The brain functions better when structure is provided. Take time to go through your closet and put away any clothes you won’t be using during the winter months. Move the key pieces you will be reaching for during the cold months to the front of your closet. This will give you a feeling that you are in control.

2) Get festive. Decorate for the holidays to make your space feel a little less monotonous. Put on some appropriate tunes while you are decorating. This will help you feel included and as so many others are celebrating in their own unique ways. Remember that holiday cheer does not automatically banish reasons for feeling sad or lonely. There is room for these feelings to be present, but a little holiday spirit can help you better manage your emotions.

3) Let go of the past. Don’t be disappointed if your holidays are not like they used to be. Life brings changes. Each holiday season is different and can be enjoyed in its own way. You set yourself up for sadness if everything has to be just like the “good old days.” Instead, prepare yourself by stocking up on delicious smelling candles, or light a fire and sit down with pen and paper to write a gratitude journal, or send handwritten notes to friends and family. Don’t be afraid to try something new. Celebrate the holidays in a way you have not tried before. Try volunteering some time to help others. Dopamine (“happy juice”) is released in the brain when we perform acts of kindness.

4) Go window shopping. Go shopping without buying anything. Take advantage of holiday activities that are free of charge, such as driving around to look at Christmas decorations in your neighborhood or participating in your community tree lighting or church service tradition.

5) Spend time with people who are supportive and care about you. Do you ever find yourself staying late at work because you don’t have a reason not to? Make reasons to leave. Make plans with friends ahead of time so you can’t back out and just stick around the office.

 

Things to avoid

1) Do not stay inside and be alone for too long. Try going outside as often as possible; getting plenty of sunlight will lift your mood. Visit a church or gather with others. The holidays are intended to be a time to get together with people we love to express gratitude for the things in our lives that we treasure. It is a time to spread messages and acts of love to one another. Keeping sight of the true reason for the season and spirit of the holidays will help to improve your mood.

2) Do not stop your exercise routine. Exercise works like an antidepressant. It increases levels of serotonin and dopamine in the brain, boosting your mood. But for many people, the holiday season brings drastic changes in routine. They lose their sense of normalcy and stop the routines they have established that help them to feel healthy and secure. It is of great importance to maintain your usual routines — particularly your exercise routine — even throughout the holidays. Sometimes, something as simple as sticking to a routine can help you maintain a sense of control. Don’t forget to keep a reasonable sleep schedule as well.

3) Do not drink excessively or use drugs. For those who have lost someone close to them or experienced a romantic breakup, the holidays can trigger intense feelings of loss and pain. Some people fall into the trap of self-medicating with alcohol or drugs to alleviate emotional pain and other symptoms of depression. In reality, treating these problems with alcohol or other substances only makes the problem worse.

Alcohol and depression have a dangerous relationship. Although alcohol can create a sense of pleasurable feelings in the short term, it is ultimately a depressant on the central nervous system and will leave you feeling worse. In addition, alcohol lowers serotonin levels in the brain, causing a person who feels depressed to slip into an even deeper depression. Alcohol also interferes with metabolic processes and sleeping patterns, which can further worsen the person’s condition.

Instead, it is helpful to prepare for these triggers with a therapist or close friend. Then you will know what to expect and how to handle the strong emotions that you may experience. Another way to mourn the loss of a loved one around the holidays is to honor their memory through a holiday tradition that they enjoyed. Perhaps this involves baking their favorite dessert, putting up their favorite decorations, or sharing stories and special memories of the person.

Make an agreement with yourself about how many drinks you plan to have in advance, and stick to it. Seek immediate help if you are using alcohol or drugs to manage your pain and are experiencing suicidal thoughts. Call the National Suicide Prevention Lifeline at 800-273-TALK (8255).

 

Next step

There is nothing new under the sun, and the same is true for the ideas discussed in this article. I have not suggested any strategies that are not already known or that have not been given by somebody else. But what I have done is provide an organized list of positive actions that you can take to prevent the holiday blues.

If you anticipate that the holidays may be a challenging time for you and you could use a little extra support implementing any of the positive actions from this article, make an appointment with a mental health provider. Counseling in one of the most powerful weapons we have to protect against emotional pain, depression, the holiday blues, and even the everyday ups and downs of life. Having someone who is trained and there specifically to talk about your feelings is invaluable. Remember, asking for help is a sign of strength and movement toward a better version of yourself.

You can’t force yourself to have fun, but you can push yourself to take the positive actions necessary to protect yourself against the emotional impact of the holiday blues. Make time for leisure activities that bring you joy, whether it is painting, singing, playing the piano, working on crafts, or simply hanging out with friends. And consider how you can start implementing these positive actions today for a more meaningful, well-balanced, healthier life this season and every season.

 

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Esther De La Rosa Scott is a licensed professional counselor. She is a solution-focused specialist and couples therapist. Her specialties include relationship counseling, grief, depression, and teaching coping skills. Contact her through her website at positiveactionsinternational.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

A light in the darkness

By Bethany Bray October 30, 2017

Erin Wiley, a licensed professional clinical counselor in northwestern Ohio, once had a client tell her that seasonal depression was like diving into a deep, dark pond each fall. Wiley understands the comparison. With seasonal depression, “you have to prepare to hold your breath for a long time until you get across the pond, reach the other side and can breathe again,” she says.

Wiley routinely sees the effects of seasonal depression in her clients — and in herself — as summer wanes, with the days getting shorter and the weather getting colder. Ohio can be a hard place to live when daylight saving time takes effect and the sun starts setting just after 4 p.m., she says.

Seasonal depression “feels like a darkness that’s chasing you. You know it’s coming, but you don’t know when it’s going to pin you down,” says Wiley, a member of the American Counseling Association. “[It’s like] getting pinned down by a wet blanket that you just can’t shake, emotionally and physically. … For those who get it every year, you can have anxiety because you know it’s coming. There is a fear, an apprehension that it’s coming. [You need] coping skills to have the belief that you have the power to control it.”

For Wiley, the owner of a group practice with several practitioners in Maumee, Ohio, this means being vigilant about getting enough sleep and being intentional about planning get-togethers with friends throughout the winter months. Keeping her body in motion also helps, she says, so she does pushups and lunges or walks a flight of stairs in between clients and leaves the building for lunch. If a client happens to cancel, “I will sit at a sunny window for an hour, feel the sun on my face, meditate and be mindful,” she adds.

Seasonal depression, or its official diagnosis, seasonal affective disorder (SAD), can affect people for a large portion of the calendar year, Wiley notes. Although there is growing awareness that some people routinely struggle through the coldest, darkest months of the year, it’s less well-known that it can take time for these individuals to start feeling better, even once warmer weather returns in the spring. According to Wiley, seasonal depression can linger through June for her hardest-hit clients.

“It takes that long to bounce back,” she says. “They’re either sinking into the darkness or coming out of it for half the year.”

Symptoms and identifiers

SAD is classified as a type of depression, major depressive disorder with seasonal pattern, in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. According to the American Psychiatric Association, roughly 5 percent of adults in the U.S. experience SAD, and it is more common in women than in men. The disorder is linked to chemical imbalances in the brain caused by the shorter hours of daylight through the winter, which disrupt a person’s circadian rhythm.

People can also experience SAD in the reverse and struggle through the summer, although this condition is much rarer. Wiley says she has had clients who find summers tough — especially individuals who spend long hours inside climate-controlled, air-conditioned office environments with artificial lighting.

Regardless, a diagnostic label of SAD isn’t necessary for clients to be affected by seasonal depression, say Wiley and Marcy Adams Sznewajs, a licensed professional counselor (LPC) in Michigan. Sznewajs says that SAD isn’t a primary diagnosis that she sees often in her clients, but seasonal depression is quite common where she lives, which is less than 100 miles from the 45th parallel.

“I live in a climate where it is prevalent. I encounter it quite a bit and, surprisingly, people are like ‘Really? This makes a difference [with mental health]?’” says Sznewajs, an ACA member who owns a private practice in Beverly Hills, Michigan, and specializes in working with teenagers and emerging adults. “We change the clocks in November, and it’s drastic. It gets dark here at 4:30 in the evening, so kids and adults literally go to school and go to work in the dark and come home in the dark.”

Likewise, Wiley says that she frequently sees seasonal depression in clients who don’t have a diagnosis of SAD. “I notice it with my depressive clients,” she says. “I have been seeing them once a month [at other times of the year], and they ask to come in more often during February, March and April, or they need to do more intensive work in those months. It’s rare for someone to be healthy the rest of the year and struggle only in the winter. It’s [prevalent in] people who struggle already, and winter is the final straw. They need extra help in the winter and reach out [to a mental health professional] in the winter.”

In other instances, new clients begin to seek therapy because life events such as the loss of a job or the death of a loved one push them to a breaking point during a time of the year — typically winter — when they already feel at their lowest, Wiley notes.

Cindy Gullo, a licensed clinical professional counselor in O’Fallon, Illinois, says that she doesn’t encounter clients who have the SAD diagnosis very often. However, she says that roughly 2 out of every 10 of her clients who have preexisting depression experience worsening mood and exacerbated depression throughout the fall and winter months.

The symptoms of SAD mimic those of depression, including loss of interest in activities previously enjoyed, oversleeping and difficulty getting out of bed, physical aches and pains, and feeling tired all of the time. What sets seasonal depression apart is the cyclical pattern of symptoms in clients, which can sometimes be difficult to see, Sznewajs says. If a client presents with worsening depressive symptoms in the fall, counselors shouldn’t automatically assume that seasonal depression is the culprit, she cautions. Instead, she suggests supporting the client through the winter, spring and summer and then monitoring to see if the person’s symptoms worsen again in the fall.

“If they show improvement [in the spring/summer], and then I see them in October and they start to slide again, that’s when I have to say it could be the season. And certainly if they point it out themselves — [if] they say, ‘I’m OK in the summer, but I really struggle in the winter.’ It’s really when you start to notice a pattern of worsening mood changes in November and December [that alleviate] in the summer.”

Sznewajs recalls a female client she first worked with when the client was 13. She saw the client from October through the end of the school year, and the young woman showed significant improvement. The client checked in with Sznewajs a few times during the summer, but Sznewajs didn’t hear from her much after that. Then, when the client was 16, she suddenly returned to Sznewajs for counseling — in the wintertime. In recounting the prior few years, the young woman noted that her struggles usually seemed to dissipate around April each year, even though the pressures of the school year were still present at that point.

“‘I don’t know what’s going on with me,’” Sznewajs remembers the client remarking. “‘I’m a mess right now.’ It was very evident that there was a pattern [of seasonal depression] with her.”

Wiley notes that clients with seasonal depression often describe a “heaviness” or feelings of being weighed down. Or they’ll make statements such as, “It’s just so dark,” referring both to the lack of sunlight during the season and the emotional darkness they are enduring, Wiley says.

Gullo, an ACA member and private practitioner who specializes in working with teenagers, keeps an eye out for clients who become “very flat” and engage less in therapy sessions in the fall and winter. Other typical warning signs of seasonal depression include slipping grades (especially among clients who normally complete assignments and are high achievers at school), changes in appetite, sluggishness, weepy or irritable mood, and withdrawal from friends and family. For teens, the irritability that comes with seasonal depression can manifest in anger or frustration, Gullo says. For example, young clients may have an outburst or become agitated over small things that wouldn’t bother them as much during other times of the year, such as a parent telling them to clean their room, Gullo says.

John Ballew, an LPC with a solo private practice in Atlanta, estimates that up to one-third of his clients express feeling “more grim,” irritable or unhappy as winter approaches. He contends that the winter holidays “are a setup to make things worse” for clients who are affected by the seasons.

Overeating and overconsumption of alcohol are often the norm during the holidays, and this is typically coupled with the magnification of family issues through get-togethers, gift giving and other pressures, notes Ballew, a member of ACA. In addition, many coping mechanisms that clients typically use, such as getting outside for exercise, may be more difficult to follow in the winter. And although many people travel around the holidays, that travel is often high stress — the exact opposite of the getaways that individuals and families try to book for themselves at other times of the year.

“It’s a perfect storm for taking the ordinary things that get in the way of being happy and exacerbating them,” Ballew says. “People feel heavily obligated during the holidays, more so than in other seasons. It means that we’re not treating ourselves as well, and that can be a problem.”

[For more on helping clients through the pressures and stresses of the holiday season, see Counseling Today‘s online exclusive, “The most wonderful time of the year?]

In the bleak midwinter

The first step in combating seasonal depression might be normalizing it for clients by educating them on how common it is and explaining that they can take measures to prepare for the condition and manage their feelings.

“Educating [the client] can give them control,” Sznewajs says. “People often feel shame about depression. Explain that you can take steps to treat yourself, just like you would for strep throat. You can’t will yourself to get better, but you can do things to help yourself get better. When you know what’s causing your depression, it gives you power to take those steps.”

Ballew notes that many of his clients express feeling like a weight has been lifted after he talks to them about SAD. “Many of them won’t think they have [SAD], but they will say, ‘Winter is a hard time for me’ or ‘I get blue around the holidays.’ They’re caught off guard by this unhappiness that seems to come from nowhere. People seem to feel a certain amount of relief to find that it’s something they will deal with regularly but that they can plan for and be cognizant of. It doesn’t mean that they’re defective or broken. It’s just that this is a stressful time. That helps us take a more strategic and problem-solving approach.”

Many counselors find cognitive behavior therapy (CBT) helpful in addressing seasonal depression because it combats the constant negative self-talk, catastrophizing and rumination that can plague these clients. CBT can assist clients in turning around self-defeating statements, finding ways to get through tough days and taking things one step at a time, Sznewajs says.

Gullo gives her teenage clients journaling homework (she recommends several journaling smartphone apps that teenagers typically respond well to). She also encourages them to maintain self-care routines and social connections. For instance, she might request that they make one phone call to a friend between counseling sessions.

Wiley guides her clients with seasonal depression in writing a plan of management and coping mechanisms (or reviewing and updating their prior year’s plan) before the weather turns cold and dark. She types out the plan in session while she and the client talk it over. Then she emails it so that the client will have it on his or her smartphone for easy access. The plans often include straightforward interventions — such as being intentional about going outside and getting exposure to natural light every day — that clients may not think about when dealing with the worst of their symptoms midwinter.

“It sounds simple, but those [individuals] who are down may not realize that the sun is shining and they better get outside to feel it on their face,” Wiley says. “We list exercises that are feasible. You might not join the gym, but what can you do? Can you walk the staircase at your house five times a day? Or, what’s one [healthy] thing you can add to your diet and one thing you can take away, such as cutting down to having dessert once per week, cutting out your afternoon caffeine or drinking more water. And what’s one thing you can do for your sleep routine? [Perhaps] take a hot shower before bed [to relax] and go to bed at the same time every night.”

Wiley also reminds clients to simply “be around people who make you feel happy.” She suggests that clients identify those friends and family members whom they enjoy being with and include those names on their therapeutic action plans for the winter.

All of the practitioners interviewed for this article emphasized the importance of healthy sleep habits, nutrition and physical activity for clients with seasonal depression. “All of these things are really hard to do when you feel lousy, so that’s why the education [and planning] piece is so important,” Sznewajs says. “Let them know that this [the change in seasons] is why you feel lousy, and it’s not your fault. But there are ways to feel better.”

Sznewajs typically begins talking with clients about their seasonal action plans in early fall and always before the change to daylight saving time. One aspect of the discussions is brainstorming how clients can modify the physical activities they have enjoyed throughout spring and summer for the winter months.

One of the cues Wiley uses to tell if clients might be struggling with seasonal depression is if they mention cravings for simple carbohydrates (crackers, pasta, etc.), sugars or alcohol when the days are dark and cold. They don’t necessarily realize that they are self-medicating in
an attempt to boost their dopamine, Wiley says.

Of course, exercise is a much healthier way of boosting dopamine levels. “Exercise is important, but it’s really hard to get depressed people to exercise,” Wiley acknowledges. “Telling them to join the gym won’t work when they just want to cry and lay in bed. So, turn the conversation: What is something you can do? If you already walk your dogs out to the corner, can you walk one more block? Take the stairs at work instead of the elevator, or park farther away from the grocery store.”

Effectively combating seasonal depression might also include counselor-client discussions about proper management of antidepressants and other psychiatric medications. Gullo recommends that her clients who are on medications and are affected by seasonal depression set up appointments with their prescribers as winter approaches. Sznewajs and Wiley also work with their clients’ prescribers, when appropriate, to make sure that these clients are getting the dosages they need through the winter.

Wiley will also diagnose clients with SAD if the diagnosis fits. “For someone who is really struggling and could benefit from [psychiatric] medication, the prescriber is often thankful for a second opinion. It adds weight and clarity to what the client is saying and what the doctor is hearing,” Wiley says. “It also helps the client to have a diagnosis so they don’t just wonder, ‘What’s wrong with me?’ It removes the blame and shame for people who are really struggling.”

Seeking the light

Many factors contribute to seasonal depression, but a main trigger is the reduced amount of daylight in the winter. It is vitally important for clients with seasonal depression to be disciplined about getting outdoors to feel natural light on their faces and in their eyes, Wiley says. She coaches clients to be disciplined about making themselves bundle up and get outside on sunny days or, at the very least, sit in their car or near a window for extra light exposure.

Wiley cautions clients against using tanning beds as a source of warmth and bright light to fend off seasonal depression. However, she acknowledges that she has seen positive results with tanning beds in severe cases of seasonal depression in which individuals were verging on becoming suicidal. In those extreme cases, counselors must weigh the long-term risks of using a tanning bed versus the more immediate risks to the client’s safety, Wiley says.

In addition to encouraging those with seasonal depression to get outdoors, Gullo and Sznewajs have introduced their clients to phototherapy, or the use of light boxes. Roughly the size of an iPad, these boxes have a very bright light (more than 10,000 lumens is recommended for people with seasonal depression) that clients can use at home.

Sznewajs recommends that clients use a light box first thing in the morning for at least 30 minutes to “reset their body,” increase serotonin and boost mood. If a client responds positively to phototherapy, it also serves as an indicator that he or she has SAD (instead of, or in addition to, nonseasonal depression), she notes.

Neither Gullo nor Sznewajs require clients to purchase light boxes. Instead, they simply introduce the idea in session and suggest it as something that clients might want to try. Insurance doesn’t typically cover light boxes, but they can be purchased online or at medical supply stores.

Gullo does keep a light box in her office so she can show clients how it works. She also recommends “sunrise” alarm clocks, which feature a light that illuminates 30 minutes before the alarm sounds. The light gradually becomes brighter and brighter, mimicking the sunrise. Gullo uses this type of alarm clock at home and finds it helpful.

The light box and sunrise alarm clock “are game changers,” Gullo says, “and a lot of people don’t know they exist.”

Powering through

In The Lion, the Witch and the Wardrobe, the second book in C.S. Lewis’ The Chronicles of Narnia series, characters struggle through never-ending cold that is “always winter but never Christmas.” Grappling with seasonal depression can feel much the same way: an uphill battle in a prolonged darkness in which occasions of joy have been snuffed out.

The key to making it through is crafting and sticking to a plan. Sznewajs says she talks with clients in the early fall to help them prepare: Yes, winter is coming, and you’re probably going to feel lousy, but it won’t last forever, and there are ways of getting through it.

“People need to understand that this is a totally predictable kind of concern,” Ballew concurs. “It’s not weak or self-indulgent [to feel depressed]. This is a hard time of year for many people, and you need to plan for it. … We [counselors] are in a great place to validate clients’ concerns, but also help them to strategize beyond them.”

 

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To contact the counselors interviewed for this article, email:

 

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Bethany Bray is a staff writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

Letters to the editor: ct@counseling.org

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.