April 1st, 2015

Winter 2015: mental health impacted

PHOTO BY TOM CROKE
Mary Anderson, Ph.D., clinical psychologist at Commonwealth Psychological Associates in Boston, Mass., said that the harsh winter especially can take a toll on individuals suffering from anxiety and depression.

The first two months in 2015 registered as momentous for New Englanders in several ways. In addition to near record snowfalls, bone-chilling temperatures, treacherous road conditions and significant transportation glitches, some residents experienced an increase in stress, anxiety and depression. For those already carrying a mental health diagnosis, these additional factors added to overall emotional tension.

Winter disregulates a certain portion of New Englanders, but those who have anxiety or depression can be especially hit hard, according to Mary Anderson, Ph.D., clinical psychologist at Commonwealth Psychology Associates in Boston, Mass., who specializes in behavioral medicine and health psychology. She explained that this unusually harsh winter may lead to compromised self-care behavior and negative self-talk, impacting a person’s ability to function.

“We are doing fewer social activities and social support is important for mood. It’s harder to get out so we spend more time at home alone. And there is an increase in unpleasant activities, such as shoveling snow and walking outside in the cold,” Anderson said. “We also have less exposure to nature. We feel a lack of control.”

Anderson added that worry about practical issues, such as snow on the roof, ice dams and logistical problems with enormous piles of snow increase irritability and provoke an overwhelmed feeling, said Anderson. “We encourage clients to keep a regular routine in ways they can control. This is a good stress management strategy,” she said. “I recommend my clients give double the amount of time to get to work. Rushing increases anxiety. When possible, plan a vacation to a sunny place, even if only for a short time. Self care is vitally essential for managing mood.”

This harsh winter may have an added impact on those with seasonal affective disorder (SAD). Approximately 40 percent of the population has a reaction to the loss of light, according to Shelley H. Carson, Ph.D., associate of the Department of Psychology and lecturer at Harvard University whose research focuses on creativity, psychopathology and resilience. She indicated that personality changes, including increased irritability, withdrawal, a decreased sense of humor, loss of interest in sex and other previously enjoyable activities are clear signs of depression.

Carson explained that circadian rhythms are disrupted in the winter months. People go through phases of regression, which are compounded by having to be inside. Confinement can produce tension, stress and anxiety, she said. Additionally, panic issues may be exacerbated. She also cited changes in appetite and sleep patterns, confusion, inability to make decisions, hopelessness and helplessness and suicidal thoughts as common symptoms for those suffering from SAD.

Coping strategies fall into two categories: emotionally focused and problem-focused, according to Carson. The former helps reduce negative emotions; the latter strategy prompts the individual to “go out and meet the problem head on.”

“There are a lot of individual differences in response. Some people have more of a problem with confinement; others have a better coping mechanism,” Carson said. “Most psychologically healthy people will do better than someone with psychological issues.”

Carson compared New Englander’s situation to the findings of Lawrence A. Palinkas, Ph.D., who has studied the effects of long-duration seclusion and confinement. He noted that individuals who endure such situations go through three phases. “When confined, there is excitement around it. We are ready to help others. In the second phase, we’ve had enough and get angry and anxious,” Carson noted. “Third is resignation. We come to grips with the situation and learn to cope. In New England we are [currently] in phase two and will be out of this before phase three. In the long term, we won’t need to learn how to cope.”

Carson recommended several coping strategies in the interim. “Partial sleep deprivation works forty to sixty percent of the time,” she said. “Go to bed at the normal time but set the alarm to get up at 2:00 or 3:00 am. A body of literature looks at this intervention, which is fairly well known for mild to moderate depression.”

Using a light box and engaging in creative, expressive activities, such as writing, painting, drawing or playing a musical instrument, may slow the downward slide, according to Carson. “Writing for three consecutive days for 20 minutes or longer will have a lasting effect. When you paint or draw, depict your emotions,” she said.

But her number one recommendation is exercise. When you are stuck inside, Carson advised using in-home equipment. “You could even run or march in place. The point is to get some aerobic exercise, which improves sleep and depressive symptoms,” she said.

Lisa A. Uebelacker, Ph.D., research psychologist in the Psychosocial Research Department at Butler Hospital and associate professor of psychiatry and human behavior for the Alpert Medical School of Brown University, said that parents face added stress when weather prompts school cancellations. “Parents have to make last minute arrangements when they have to work,” she said, noting that parents with existing anxiety and depression are starting at a more vulnerable place. “It’s more difficult for them to absorb stress.”

While treatment results in the likelihood of having a better outcome, some individuals with anxiety and/or depression may feel ambivalent about seeking professional help. However, Uebelacker highly recommended looking for outside help to manage symptoms. “A psychologist or mental health counselor can help patients engage in life. They can help them learn to problem solve about the limits that weather puts on them,” she said.

Furthermore, Uebelacker encouraged patients to be honest about their reluctance to engage the services of a professional. She suggested patients see a psychologist for one or two visits and then decide if the therapy is helping. “A psychologist can give new perspective. When you’re caught up in depression, it’s hard to have perspective,” she said.

Anderson gives New Englanders credit for the resilience they demonstrate in the face of the extreme weather conditions this year. “We really are on the other side of winter. You have to stay in the day and practice mindfulness. Focus on small daily pleasant activities. They make a difference and really help promote balance.”

By Phyllis Hanlon

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