December: Seasonal Affective Disorder Awareness Month

Seasonal Affective Disorder
Feeling SAD?

Seasonal Affective Disorder, or SAD, is often referred to as “winter depression” because the symptoms are more apparent and tend to be more severe during the winter months. Thought to be related to the shortening of daylight hours and colder temperatures, Seasonal Affective Disorder affects an estimated 10 million American adults.

SAD is diagnosed more often in women than in men, although men typically report experiencing more severe symptoms. Younger people are at a higher risk of developing Seasonal Affective Disorder, as are those who have blood relatives with Seasonal Affective Disorder or another form of depression. And not surprisingly, states with colder climates such as New York have a much higher incidence (almost 10 times more) than warmer, southern states like Florida or Arizona.

Symptoms of SAD can include:

  • lethargy and fatigue (low energy level)
  • withdrawal from friends and family
  • persistent depressed mood
  • inability to focus or concentrate
  • changes in sleep and/or appetite
  • loss of interest in activities you once enjoyed
  • agitation, irritability or anxiety
  • lowered sex drive
  • feelings of hopelessness

What can you do about it?

  • Maintain structure. Developing and sticking with a routine can help your body feel consistent. Get enough rest by going to bed at a regular time and place an emphasis on establishing consistent exercise routines and eating healthy, balanced meals throughout the day that include lean proteins, whole grains, fruits, and vegetables.
  • Soak up the morning sunshine. Symptoms of Seasonal Affective Disorder tend to be worse in the mornings, just as people are getting out of bed. Take a walk outside or open the curtains wide to invite the sunlight in as soon as you rise.
  • Repaint your walls. Paint with brighter, vivid colors, like Citrus Blast, Pumpkin Orange or Sunburst Yellow. Yellows and oranges tend to remind us of glowing sunshine, beautiful spring flowers and refreshing citrus fruits, and have the power to cheer up even the darkest of moods and bring warmth into your life when it seems you’re surrounded by an endless winter of gloom.
  • Get a massage. The healing power of touch has been shown to alleviate some of the symptoms of SAD while giving much needed relief to tired, achy muscles. According to a study from the University of Miami School of Medicine, massage appears to increase levels of serotonin, one of the “feel good” chemicals in the brain. Tight on cash? Learn how to give yourself a massage here.
  • Invest in a light box. Light boxes have been shown to reduce symptoms of Seasonal Affective Disorder, according to the Mayo Clinic. Light boxes provide a measured amount of balanced spectrum light equivalent to standing outdoors on a clear spring day. This has been shown to help regulate the body’s internal clock.
  • Get outside. Whenever possible, get outside during daylight hours. Take a long walk, go make a snowman, eat lunch at a nearby park…do whatever it takes to get outside at least once a day. The more light you can expose yourself to, the more vitamin D your body will make, and the better you’re going to feel.
  • Book a trip. Have unused vacation time at work? You deserve a break! Plan a trip to a sunnier destination to help boost your light exposure. Not only is enjoying the destination helpful, but experts say just the sheer anticipation of a vacation can lift your mood.
  • Avoid alcohol. Alcohol is a depressant, which makes you feel tired. Over time, alcohol can even create a deeper form of depression. Controlling the amount of alcohol you consume or completely eliminating it from your diet will help in the fight against SAD.

Like depression, Seasonal Affective Disorder is treatable, so it need not be a death sentence. If symptoms persist, or if you are experiencing thoughts of self-harm or suicide, seek help immediately from your doctor or a licensed professional (i.e., mental health counselor, social worker, psychologist).

Most of all, remember that you are not alone in this.

Click here for more information on Depression Treatment.

How to Help When Someone You Care About is Suicidal


Love One Thinking of Suicide
Your good friend has been in a state of deep depression for months. And now, she’s talking about suicide–swallowing a bottle of pills and never waking up–what should you do?

One of the most terrifying experiences someone can endure is hearing a loved one talk about ending their life. You may feel afraid to approach the topic or experience uncertainty around which direction to take to help your friend. But speaking directly and openly about suicidal thoughts and feelings can save a life. Here are some tips when talking with a suicidal friend or loved one:

Take all mentions of suicide seriously. Almost everyone who attempts or completes suicide has given some clue or warning beforehand to indicate to others that they were in deep despair. When a person tells you that they are thinking about suicide, you are being given a precious opportunity to help before it’s too late. All suicidal talk or behavior should be taken seriously.

Listen. Really listen to your friend. This is a big one. People who are suicidal don’t want advice, answers or solutions. They want a safe place to vent and unload their despair. No matter how shocking or upsetting what they say may sound to you, allow your loved one to talk and talk as much as they need to—without judgment, without interrupting, and without trying to problem-solve. Simply be present with your friend in their pain. Offer a hug or your shoulder to cry on. Let them know you care and that they are important to you.

Offer empathy, not sympathy. Imagine sitting in the middle of a deep, dark, cold tunnel. You peer through the darkness into the distance and can faintly see your family and friends standing at the opposite end of the tunnel, shouting words of hope and encouragement to you. This is sympathy. Now imagine your family and friends actually venturing into the tunnel, crawling through the cold and the darkness to find you and sit beside you. Instead of looking in at you from afar, they’re now right there with you—experiencing the world alongside you and through your perspective. This is empathy.

Ask direct questions. Mentioning the word suicide or talking openly about the topic of suicide will not put ideas into someone’s head or make it any more likely to happen. In fact, the opposite is true. Be sensitive, but ask direct questions suicide, such as:

“Are you thinking about suicide?”
“Have you thought about when you would do it (this evening, tomorrow, a week from now)?”
“Have you thought about how you would do it?”
“Do you have the means or materials available to act out your plan?” If so, “What and where are they?”
“Have you ever attempted suicide before?”

Be supportive, but know your limits. You don’t need any specialized training or education to be a caring and supportive friend, but know when it would be wise to connect with someone trained to work more comprehensively with those experiencing suicidal thoughts and ideation. If you are talking with someone who has specific plans for ending their life, hook them up with a crisis center or trained mental health provider. You might provide further support by offering to make the first phone call together, help them search for clinicians, or accompany them to their first treatment session.

Don’t promise confidentiality. Though you may be asked to guarantee confidentiality, try to avoid making this promise if you believe someone is close to suicide. Privacy is important, but the best response you can offer your friend is that because you care about them, you’re unwilling to make that promise. You are taking his/her words and behavior seriously, and this is the kind of situation you cannot handle alone.

Check in on them. Even if you think the crisis has passed, check in on your friend regularly to see how they are coping and feeling. Give them a call, send a text message, stop by their house, make plans to grab coffee or dinner…anything to let them know you care and are thinking about them. Again, just being there and offering your presence can be extremely helpful.

If you or someone you know is in suicidal crisis or emotional distress, help is available through the 24-hour, confidential, toll-free National Suicide Prevention Line by dialing 1-800-273-TALK (8255).

Click here for more information on Depression Treatment.

Talking About the “S” Word: Deconstructing the Taboo of Suicide

The Taboo of Suicide

It’s a topic that can evoke feelings of discomfort and fear. One that’s often treated as a “hush-hush” subject that many of us would prefer just to sweep into the shadows, as if discussing it would be toxic or contagious. Yet, despite the fact that it’s a taboo word plagued with stigma and shame, suicide remains a serious national epidemic. According to the Center for Disease Control and Prevention, suicide is the second leading cause of death among young people in the Unites States, ages 10-24.

So, why is it that many of us are frightened to talk about suicide and come face-to-face with such a condemned topic? Because it can be difficult for us to comprehend what might drive another individual to suicide, and even more painful to imagine that someone we care for so immensely may choose to end their own life. It stirs up very deep, raw, and gut-wrenching emotions within us. We may turn inward and imagine the circumstances under which we ourselves might also make that choice. We view suicide as contrary to natural self-love, a violation of our primal sense of preservation, and an act of disobedience to the laws of God. In many religious circles, suicide is considered to be an unpardonable sin and those who commit the act will be damned for eternity.

Furthermore, there exists a common belief in our culture that talking about suicide will make someone suicidal. Many fear that by asking a person about suicidal thoughts or feelings, it may trigger thoughts of suicide or suicidal behaviors or heighten existing suicidal feelings. The assumption that asking about or discussing suicide could put ideas into someone’s head or “push them over the edge” is simply not true; evidence does not support that. In fact, it’s quite the contrary. Engaging in open, honest discussion about this very real and very final topic is probably one of the most helpful things you can do.

And it’s not only the general public who tiptoe around the subject. Police officers and law enforcement agents often use “special codes” in their language, like “no suspicious circumstances were apparent”, which the public has come to interpret as meaning suicide. Treatment professionals—those whom you would expect to be the LEAST uncomfortable with the topic of suicide—often feel apprehensive about discussing it as well. Throughout my career, I have experienced a plethora of doctors, nurses, therapists, etc. who are just plain uncomfortable asking about suicidal thoughts or behaviors directly when sitting with clients or while conducting risk assessments. Fellow professionals, you’re going to need to get comfortable using terms like suicide, death, cut, asphyxiate, vein, decapitate, burn, self-mutilate, and vomit. Practice saying them out loud in front of a mirror, over and over, if that helps.

It’s important to note that a lot of people have experienced some degree of suicidal ideation (thoughts about killing oneself, ranging from fleeting consideration to having a detailed plan) at one point or another throughout their life. But the majority of individuals who experience thoughts of suicide will never actually act on them. Usually, those who do attempt or commit suicide don’t really want to die. They just want their pain to end. By starting a dialogue and asking directly about suicide, you’re giving the other person permission to share openly about their suffering. People who have felt suicidal will often experience an incredible sense of relief when given the opportunity to verbalize their pain to someone with whom they trust and feel safe. Notably, once individuals start talking, they’ve got a better chance of discovering other options to resolve their pain, options that may remove suicide from their coping list.

The CDC suggests that the key to reducing the number of suicides is to reduce risk and increase resilience. But how are we supposed to accomplish this if we can’t even talk openly about suicide? Even though it may be hard, even if it feels terrifying, discussing what we’ve been so afraid to talk about will be a huge step towards abolishing the stigma of suicide that continues to plague our culture, and a tremendous step towards saving lives.

Let the conversation begin.

Click here for more information on Depression Treatment.

 

10 Helpful Things to Say to a Depressed Person

Supporting a Depressed Person
Supporting a loved one who is depressed can oftentimes be a difficult, emotional process, and searching for the “right” words to offer someone in the midst of their pain is not an uncommon struggle. In my previous post, I wrote about some of the well-intentioned things that people often say to their depressed loved ones, not realizing that their words may be causing more harm than good.

Understandably, whenever someone we care about is struggling, we yearn to fix their heartache—and may be quick to spout out eyeroll-worthy clichés, offer advice or suggestions, or default into problem-solving mode in order to rescue our loved one from the depths of despair and make their pain disappear. But it’s not our job to “fix” them. Instead, learn how to listen to your loved one without trying to problem-solve. Care for them. Be with them. Exactly as they are.

Here is a list of helpful things to say to someone battling depression (many of which have been said to ME at one point or another by those closest to me, during my own dark moments):

“Tell me about your pain…”

Open-ended questions like this will provide space for the other person to explore their feelings and reflect on their situation. Instead of saying, “I know how you feel”, you’re allowing your loved one the opportunity to share a part of their story with you and to speak about their own individualized experience from their deepest core.

“I’ve noticed ___________.”

that you’ve called in sick to work five times this past month…that you’ve been wearing the same outfit for several days now…that when I text or call your phone, you don’t respond. Focus on specific, observable behaviors, without trying to interpret, label, or judge the other person’s actions or experiences.

“I don’t know the right words to comfort you…just know that I care.”

Sometimes, we really just don’t know what to say, and it’s absolutely okay to verbalize that. It’s not always easy or comfortable to sit with someone in their darkness, and this is an honest and genuine response to share with the other person if you’re struggling for words. The second part of this statement is what truly speaks volumes, however, and will go a long, long way in supporting the other person. The best thing you can do for someone experiencing depression is just to love them. Unconditionally.

“What do you need?”

Instead of telling someone what you think they need to do (get out of bed, go for a walk, take their meds, find a new hobby, etc.), ask them to tell you what they need. They may have the answer(s) within themselves to share with you…or they may not have a clue in that moment what they need. But either way, this question will give the person a chance to “check in” with themselves and perhaps encourage them to dig into a deeper part of their being to search for their own answer. Ask the question. And then listen.

“You are important to me.”

People suffering from depression may feel inadequate, isolated, unlovable, and unworthy. They feel weak or lazy for not being able to change their current mood state. Convey to them that you value them. They matter. Their life is important to you.

“This must be really difficult for you.”

Although this is a skill that may take some practice, when you’re able to validate the feelings and experiences of another, you’re providing a space for the receiver to feel heard, acknowledged, understood, and accepted. Validating doesn’t mean that you have to agree with or accept the other person’s perspective. Rather, you’re putting yourself in their shoes and conveying to them that you understand their thoughts, feelings, and behaviors. The result? They feel genuinely heard.

“I’m not going anywhere.”

Many people suffering with depression feel broken, empty, not good enough, and unworthy of being loved. Give your loved one reassurance that you are not going to leave them or abandon them. Let them know that you are there for them and will remain by their side—no matter what. Remember that your support and compassion are what they need most.

“How are you doing?”

I see this one as being somewhat double-edged, depending on who is saying it and how it’s delivered. Many times, it can be expressed simply as a societal nicety, with the questioner expecting nothing more than a trite response of “good” or “fine” in return. When you have someone in your life who will ask this question genuinely, then wait and truly listen for a real and honest answer, it can promote sharing and actually facilitate the healing process.

“What can I do to help you right now?”

Offer support and direct assistance to your loved one in their struggle. But be prepared to be met with, “Nothing. Go away.” If this is the case, honor your loved one’s request for space, and do just that. They may very well come back to you at some point down the road. Some folks may ask you for help with their groceries, cleaning, or for you to accompany them to a therapist or doctor’s appointment. Just make sure you follow through with whatever it is you’re offering to help your loved one with.

Nothing.

Although this may be the most uncomfortable choice on the list, because of the desire people have to quickly fill voids of silence, it can actually be the most powerful and the most appropriate of options. To quote Emily Dickinson, “Sometimes saying nothing says the most.” Instead of trying to fill space with words, just sit with your loved one. Look them in the eye. Hold their hand. Ask them how they are feeling and then let them talk. If they are not ready to talk, just be with them in silence. Remember that your caring presence is more powerful than any spoken words could ever be.

I’d love to hear from you! In the comment box below, tell me some things that others have said to you that you’ve found to be particularly helpful (or unhelpful).

Click here for more information on Depression Treatment.

 

 

10 Things Not to Say to a Depressed Person

10-things-not-to-say
Lots of people experience depression, while others just have bad days or feel sad, moody or low from time to time. Offering emotional support to a depressed person, whether their a friend or a loved one, can be an essential part of the healing process. But it’s often difficult to find the right words to say when comforting someone in their struggle. Sometimes the most well-intentioned remarks and gestures may end up causing more harm than good. And even neutral words can be misconstrued, as sufferers are in a vulnerable, sensitive place. Here are 10 unhelpful things to avoid saying to someone with depression:

“I know how you feel.”

No, you don’t. There is no way for us to really know what another is feeling. Even if you have experienced depression yourself and may have an understanding, the truth is that no two people or two situations are ever exactly the same. Everyone has a different lens from which they view and interpret the world.

“Cheer up.”

People feel uncomfortable with emotions like sadness and depression. So, in order to alleviate their own discomfort and feelings of helplessness, they make statements like this in attempt to “move” the other person into a place of happiness and positivity. This can feel invalidating to the receiver, because you’re essentially saying, “What you are feeling is wrong or bad. Change.” If your loved one could ‘cheer up’, they would have done so already.

“Things could be worse.”

Of course they could. For every single one of us, things could always be worse. You lost your job? Well, so-and-so lost her job AND her entire family in a plane crash AND was diagnosed with cancer. So, you shouldn’t feel so bad! Well, just because it could be worse, doesn’t mean that someone’s pain and hurt doesn’t feel raw and real to them in the moment. Sure, things could be worse…but they could also be better.

“You just need to get out more/meet the right person/find a new hobby…”

This is a big one. Folks with mental illness are constantly being bombarded with advice from their loved ones. While it is almost always well-intentioned, the fact is that giving people opinions on how to deal with what they’re feeling and what they “need” to do isn’t helpful. Advice is not usually what people want.

“God never gives you more than you can handle.”

If you’re a religious person, these words may be comforting to hear. For everyone else, however, it’s an all too often heard cliché that can feel insulting and dismissive. It essentially implies that the reason God has dumped the pain and heartache of depression onto your lap is because he believes you are strong and can handle it. And yet, every year nearly 40,000 people in the United States say, “No, this is WAY more than I can handle”, and then take their own lives.

“Think positive thoughts.”

This suggests that people can simply “think themselves happy”. But it can be challenging to find those happy thoughts when your brain is telling you that life is miserable and not worth living. Each time negative thoughts flood your mind, you try to replace them with positive ones, but the negative thoughts are too overpowering—and it can feel like you’re fighting a losing battle.

“You’ll be fine.”

Maybe they will. Maybe they won’t. But people with depression won’t feel any better just because you’re assuring them that everything will all be okay in the end. Can you guarantee they will be fine? Statements like this can feel dismissive and sends a message that you aren’t interested in listening to your loved one. As cliché as it may sound, it really is okay to not be okay sometimes.

“You have so much to be thankful for/live for.”

People suffering from depression are not ungrateful. They are well aware of the good things they have in their life. And if we’ve learned anything from the shocking and untimely deaths of celebrities like Kurt Cobain and Robin Williams, it’s that fortune, fame, success, and the adoration of millions of fans is not enough to cure depression. Mental illness knows no boundaries.

“Let’s go out, grab a drink, and forget about it.”

Suggesting that someone with depression have a drink is not a good idea. Alcohol is a depressant, so it can and often does worsen the symptoms of depression. And a night out on the town will not cure someone’s depression. Depression isn’t just a bad day. It’s a hundred bad days, all at once, with no clear way out.

“Just take medication.”

Not everyone with mental illness improves by taking pills, and even when they do, the decision to take medication isn’t always an easy one. There are several things to consider, like risks, effectiveness, undesirable side effects, and cost. Some folks prefer natural remedies. While others prefer talk therapy only. People have the right to choose whether or not to take medication, and forcing someone into a prescription cure will likely result in the other person feeling resentful.

Now that you’ve read my list of what NOT to say, stay tuned for a follow up post with suggestions of helpful things to say in supporting someone with depression.

Click here for more information on Depression Treatment.