Holidays Got You Down?

Many people can experience feelings of anxiety or depression during the holiday season. People who already live with a mental health condition should take extra care to tend to their overall health and wellness during this time.  Extra stress, unrealistic expectations or even sentimental memories that accompany the season can be a catalyst for the holiday blues. Some can be at risk for feelings of loneliness, sadness, fatigue, tension and a sense of loss.  A lot of seasonal factors can trigger the holiday blues such as, less sunlight, changes in your diet or routine, alcohol at parties, over-commercialization or the inability to be with friends or family. These are all factors that can seriously affect your mood.

Via nami.org

 

Post-Holiday Depression

Presents have been unwrapped; cookies cooked and consumed, memories of joy on faces remain in your phone. But now that the festivities are over and it’s time to start taking down the lights, are you feeling down? It’s no surprise that the decrease in celebration and excitement can certainly affect moods, causing disappointment or even sadness. “It’s not an uncommon phenomenon, so if you are feeling that way, you are not alone,” says Martha Nelson, CHAS Health Behavioral Health Provider.

 

Causes:

  • Busyness – It’s a crazy hectic time of year. You just finished having so many people to get the perfect present for, the perfect meals, and attended too many functions. It’s such a wonderful time, but also, exhausting. Coming down from the busyness and hype is tough.
  • Family – Family is the best! Family is the worst! All kinds of feelings come up during the holiday season and it can certainly take an emotional toll. Do you have family members that are stressful to be around? “Hope for the best, prepare for the worst,” most definitely applies here. Even the most incredible families can cause some levels of exhaustion.
  • Memories – Holidays bring past memories, and often a sense of nostalgia for good times that have passed and loved ones that may be gone.
  • Fatigue – Fatigue is a common contributing factor for holiday depression. It can be a packed time of year, with normal routines and exercise out the window. Additionally, it’s cold outside (and so warm under the blankets). No wonder you can feel fatigued. It’s the time of year I personally put off a lot of things in exchange for sleeping in or going to sleep early.
  • Sugar and food – So many good treats! So many good foods! During this time of year, there is so much to eat, drink, and be merry with. It’s easy to go overboard, throw your routine out the window, and over eat (or under eat if you swap eating something good in order to splurge on a dessert). The amounts of blood sugar spikes can lead you feeling crabby, hungry and a little bit sad.

 

Ideas to help cope with post-holiday depression:

  • Take what you enjoyed during the holidays and continue it throughout the year. If you enjoyed spending time with friends and family, invite them over soon for a meal, play some games, or watch a movie.
  • Have fun! Go to a movie, see a play, go to the Museum of Arts and Culture, ski or do some tubing at Mt. Spokane.
  • Start or continue your exercise routine. Sometimes exercise goes out the window during the holidays (sometimes it goes out the window well before the holidays too). But, now is a perfect time to re-start or get in to a new routine. Include a buddy so you have company and someone you look forward to hanging out with and to hold each other accountable.
  • If you’ve gained weight, don’t worry about it. There were a lot of good treats around. No regrets. It doesn’t mean you are weak, worthless, or irresponsible, it means there were some awesome cookies around…gotta live a little. Right? However, it’s never too late to get back on track with a healthy eating plan.
  • Plan something each week to look forward to.
  • Take care of yourself, including eating well (don’t confuse this with not eating), exercising and getting enough sleep. Have a good attitude as well; it’s easily to slip in to negative notions.
  • If the post-holiday blues hang on for too long, consider reaching out to a behavioral health specialist. Seasonal affective disorder is a legit issue that many people deal with. As we roll in to 2017, remember to make the resolution to highlight health and happiness.

By Matt Grebe and Martha Nelson

Holiday Blues

Many people can experience feelings of anxiety or depression during the holiday season. People who already live with a mental health condition should take extra care to tend to their overall health and wellness during this time.  Extra stress, unrealistic expectations or even sentimental memories that accompany the season can be a catalyst for the holiday blues. Some can be at risk for feelings of loneliness, sadness, fatigue, tension and a sense of loss.  A lot of seasonal factors can trigger the holiday blues such as, less sunlight, changes in your diet or routine, alcohol at parties, over-commercialization or the inability to be with friends or family. These are all factors that can seriously affect your mood.

Via nami.org

Adolescent Suicide on the Rise in Spokane

alone-depressed-depression-3351

A recent article in the Spokesman Review states, “Five teen suicides this school year – including three in the past month – have jolted the community. It’s the highest number in the history of Spokane Public Schools, prompting parents, students and community members to ask what they can do to help.”

As a Pediatrician here at CHAS I have noticed since mid –March an increased number of teenagers coming into my office for significant suicidal concerns with several reporting that they don’t feel safe going home from the clinic. This is very alarming and hard to manage if our Mental Health Staff has a full schedule. Periodically, the only option we may have available is to ask the family to go to the Sacred Heart Children’s Hospital Emergency Room for safety and to get prompt access to a mental health professional or other services.

Another article from the Inlander just three years ago, covers this local topic as well. They report, “experts say the region needs to start talking about the problem. Spokane has a rate of suicide higher than the state average. It’s the city’s second-leading cause of death for people ages 10-24.” Suicide isn’t just an issue for Spokane, but the entire Inland Northwest. Coeur d’Alene has the highest suicide rate in Idaho, and Idaho consistently has one of the highest rates in the nation, according to a report by Suicide Prevention Action Network of Idaho.

Both articles go on to discuss the need to work on being open and frank with all adolescents. As a medical care team we need to remember to do annual mental health screenings for all teenagers and the PHQ (Patient Health Questionnaire) is a validated test and a reasonable way to open the conversation with any teenagers in your office. The biggest obstacle is getting over the awkwardness of discussing this topic which is hard for many individuals to do. Teenagers tend to be more open and honest when they feel you are open with them and showing them that you actually care about their personal story.

Scientifically we know the adolescent brain works differently than the adult brain as teenagers seem to be pre-programmed to take greater risks and have less inhibition of impulse behaviors. This makes them appear to live more in their current emotions and less in their analytical/reasoning brain where adults tend to spend more of their time. This can lead to behavior that seems uncharacteristic and reckless to others but does not seem strange or out of the ordinary to teens in my office when they bring up the topic.

To try and keep this commentary to a minimum, I have provided links to both of the recent articles which I feel are informative for our community. They do go on to provide resources which I have attached below.

What Causes Suicide?

According to the National Alliance on Mental Illness (NAMI), “90 percent of youth suicide victims have at least one major psychiatric disorder, although younger adolescent suicide victims have lower rates of psychopathology.” Overall, NAMI asserts that 90 percent of people who complete suicide could have been treated for a mental or substance-abuse disorder.

Suicide Prevention Meetings

Prevent Suicide Spokane is hosting a meeting about what can be done in the community to help. The event is 1 to 3 p.m. Friday at Spokane Regional Health District, 1101 W College Ave. For more information contact Sabrina Votava at (509)475-7334 or sabrina@yspp.org.

Prevention Resources

First Call for Help Crisis Hotline: 509-838-4428

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

suicidepreventionlifeline.org

LGBTQ Crisis Hotline: 1-866-4-U-TREVOR

American Foundation for Suicide Prevention: afsp.org

QPR Institute: qprinstitute.com

Youth Suicide Prevention Program: yspp.org

Some Warning Signs

  • Talking or writing about death, dying or suicide when these actions are out of the ordinary for the person
  • Acting reckless or engaging in risky activities — seemingly without thinking
  • Increasing alcohol or drug use
  • Withdrawing from friends, family and society
  • Feeling anxious or agitated, being unable to sleep, or sleeping all the time
  • Experiencing dramatic mood changes
  • Changes in eating and sleeping habits
  • Unusual neglect of personal appearance
  • Marked personality changes
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • SOURCES: National Suicide Prevention Lifeline (suicidepreventionlifeline.org); National Alliance on Mental Illness (nami.org)

By Dan Moorman, Physician