CLARKSBURG, W.Va. (WV News) — The winter months can be a difficult time for many as the days get shorter and the pressures of the holidays mount, and symptoms can worsen for those already dealing with mental health issues.
There are multiple reasons for the change, and modern worries like pandemic burnout and economic and political issues may exacerbate those feelings this year, according to behavioral health specialists.
Behavioral health specialists stress that individuals are not alone, and there are multiple courses of action people can take to improve their mental health, depending on the cause and severity.
“I want folks to know that it’s normal, but that it’s also important to talk to your health care provider. It could be a primary care provider. It could be a mental health provider. If you don’t know where to start to get help, then that’s where our call lines become really important,” said Christina Mullins, commissioner for the West Virginia Department of Health and Human Resources’ Bureau for Behavioral Health.
Seasonal affective disorder, or SAD, tends to be more prevalent in the winter months.
According to Harvard Health Publishing, SAD is a type of depression that typically occurs in the late fall and winter months and often lasts until spring or summer, likely caused by a lack of light.
Light stimulates the hypothalamus, which helps control circadian rhythm. Issues with circadian rhythm can cause the brain to produce too much of the sleep hormone melatonin and release less of the feel-good chemical serotonin.
SAD can cause major depressive episodes with feelings of hopelessness or worthlessness; loss of interest in activities; sleep disruptions; changes in appetite and weight; and feeling sluggish or agitated.
For those experiencing seasonal affective disorder, light therapy can help, according to behavioral health providers.
A 10,000-lux light therapy light is recommended. Individuals should follow instructions and sit about 18 inches from the light for a period of 20 to 30 minutes in the mornings, according to Dr. Dilip Chandran, outpatient medical director at WVU Medicine Chestnut Ridge Center.
This can also be beneficial upon waking for people working night shifts, he said.
The lights can be found online, with some models as low as $30-$50.
In addition to seasonal affective disorder, the winter months also bring other stressors that can affect mental health.
For many, the holidays are associated with increased pressures, financial stressors and perhaps high expectations, Chandran said.
“It’s a busy time of year with the holidays — Halloween, Thanksgiving, Christmas, New Year’s — so there’s a lot of traditions that we all value and have to get done or want to get done, or traveling that may happen,” he said.
Chandran said self-care is particularly important this time of year. Eating well, exercising, getting enough sleep and practicing mindfulness seem to become more difficult this time of year but are still imperative.
Chandran recommended managing time and modifying expectations, as well as perhaps prioritizing, determining realistic expectations and cutting back on other unnecessary activities to ensure there is time for these self-care measures.
There’s also a lot of sadness associated with the loss of loved ones during the holiday season.
“There’s a lot of emphasis towards being with family and being with loved ones and celebrating and, you know, all those kinds of things. And so for people who either have lost loved ones, maybe don’t have someone that they’re close to, they’re on the outs with their family, just feel more isolated and more down, and I have people say — and we all kind of anecdotally hear people say — things like, ‘Oh, I hate the holidays,’” said Dr. Toni Goodykoontz, chief medical officer at Highland-Clarksburg Hospital.
People sometimes also associate bad memories with the holidays.
“We tend to remember things with respect to dates and times and events, and holidays are oftentimes a marker for that. So people begin to feel isolated and down,” she said.
Individuals already seeing a mental health provider can increase their appointment frequency this time of year as needed. For those who do not have a provider, there are multiple avenues to begin care.
Some might choose to reach out to counselors or psychiatrists directly. Those with a primary care provider can reach out to their provider for a referral to care, Goodykoontz said.
For some, more prompt care is necessary.
“If you start having symptoms that really impede on your overall quality of life and functioning, if you start having those hallmark symptoms of depression or severe anxiety that’s making you have problems functioning at home or work or your noticing a qualitative change, that we’re not really able to find enjoyment or its a too overwhelming kind of feeling, it’s always nice to try to get into a counselor,” Chandran said.
Individuals seeking help can call 988, the new, easy-to-remember number for the suicide and crisis lifeline. The DHHR also offers Help4WV for individuals seeking help for mental illness or addiction. The resource can be reached by calling or texting 844-HELP4WV, or at help4wv.com.
Help4WV is a “one-stop resource,” Mullins said. “I am continually impressed by how they catalog resources so they know about everything that’s going on statewide. They can connect you to providers all over the state.”
In some communities, mobile crisis services are available for children and even some for adults, she said.
Calls to the 988 suicide and crisis hotline have increased since the transition to the simpler number, Mullins said.
Goodykoontz stressed that a local hospital emergency department is also an acceptable place to go for individuals who need help and do not know where else to turn.
“If nothing else, if you are alone and you really don’t know where to look and you’re just at a loss, then the emergency room is an appropriate place to go. It’s not like we’re trying to overload our emergency rooms, but there are some people who are either so overwhelmed or they’re so unaware of what options are, that for them, the emergency room may be that last-resort place to go to to try to get some help,” Goodykoontz said. “I know as a physician who’s seen many a person in the emergency room, it’s not uncommon for someone to say, ‘I just didn’t know where else to go. I just didn’t know what else to do.’ And so, thankfully, they come to the emergency room, because they don’t know what else to do.”
Efforts are underway to enhance mental health services in the state, according to Mullins.
The mental health workforce in West Virginia and in most places in the country does not meet the national recommendations for the number of counselors and psychiatrists required for the population.
There are mental health facilities in each county, and active recruiting efforts to bring more providers to fill positions in those facilities are underway to improve wait times for services across the state, according to Mullins.
Goodykoontz said feelings of stress are normal, and care comes in many forms, including telehealth from home, to ensure that it works for the individual.
“There’s constantly something that is stressful. We live in a very stressful world. What I would say is, the majority of people do feel stressed by this and it is perfectly typical for people to feel stressed, and that there is help out there,” Goodykoontz said. “And it doesn’t necessarily have to be medicine, and it doesn’t necessarily have to be having uncomfortable, awkward or embarrassing conversations either. There’s a way to seek help in a situation that is very comfortable and reassuring. I would encourage people to recognize that lots and lots and lots of people are having this and that there’s clearly help out there for them in a variety of settings.”