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Fleeting daylight. Colder weather. Gloomy skies. The churn of conflicting emotions and financial distress that can accompany the holidays.
These elements constitute the recipe for the annual anxiety stew that Jon Weingarden’s patients have to swallow. Add to that the recent fallout of a vitriolic presidential election and the COVID-19 pandemic, and it can be an overwhelming scenario—especially for those with seasonal affective disorder.
“We definitely do see that,” said Mr. Weingarden, a clinical psychologist and the senior program director of the Integrative Health and Aging Program and Center for Eating Disorders at UPMC Western Psychiatric Hospital.
“I work in an acute hospital setting,” said the 34-year-old who has a doctor of psychology degree. “We do see more people now that are saying, ‘Yes, this is a direct effect of COVID-19,’ whether it’s via job loss or loneliness or losses of resources, financial issues. So we are seeing more … people getting exhausted from it.”
The SARS-CoV-2 coronavirus primarily affects the respiratory and circulatory systems and has contributed to the deaths of nearly a quarter of a million Americans since February. But Mr. Weingarden has a different view of it.
“I look at it as a stressor,” he said. “Stress is a psychological term. There are acute stressors like traumas and there are chronic stresses. At first when we experience stressors, even traumatic ones, it’s more common for people to have growth from a stressor, but then we tend to wear out from it.”
A recent Washington Post story said that a survey published in September in the JAMA Network Open, a monthly open access medical journal published by the American Medical Association, “found that U.S. adults were reporting levels of depressive symptoms more than three times higher during the pandemic than before it” and that a June survey conducted by the Centers for Disease Control and Prevention yielded similar results.
Just as COVID-19 typically has a long arc between exposure and its symptoms, so too did the mental health ramifications of the disease take time to manifest.
“Even though people were extremely anxious about the pandemic, there were people who were sort of motivated, who were engaged. There is something that all of humanity was tied together in response to it, for the most part,” he said. But as it’s worn on, “I think people are really starting to get exhausted from this.”
And that gives him pause as a clinician.
“I think that’s where it really starts to couple with this seasonal depression because there’s not as many (safe) ways that you can cope with it compared to what you may have been able to do over the summer.
He said three things contribute to depression at this time of year.
“The holidays tend to become more sort of nostalgic and bittersweet. You not only have good memories, but memories of loss of things you’re no longer able to do or people you’re no longer able to see.
“Many people struggle with winter weather, something we call the winter blues. The things that tend to trigger that are the shortened days, less sunlight and colder weather where we might be less active. We look at it very much as a sort of circadian rhythm biological process.
“We also just had a time change, which is hard for people. Sometimes when they’re depressed they want to oversleep, which worsens it. If you oversleep, you miss your one sliver of sunlight. So if you’re not getting any sunlight in the morning, there’s nothing telling your body, ‘Hey, it’s daytime. Get active.’ If you’re getting up and going straight to work and getting home at 4 or 5 and not seeing any daylight, that’s a problem.”
Here’s the Catch-22 of COVID-19:
“If someone has a seasonal pattern (of depression), they might be less likely to do the things they enjoyed, and now we’ve cut the number of things they can do significantly. So that’s gonna be a major challenge. How do you stay engaged throughout the winter because those opportunities are much decreased?”
Mr. Weingarden emphasized that no one should suffer in silence or tough it out.
“The first thing I would say is that if you really are—or anticipate—struggling, get supportive resources from a professional. Connect with a counselor or a psychiatrist. If you are really, really struggling, emergency resources are the way to go.”
To help with the daily struggle, get outside, plan ahead, stick to commitments and be prepared to try something new.
“Get outside now while the weather is still nice. If you avoid going outside now and you wait until the thick of the winter, it’s going to make it much harder. Take a walk in the morning. Get up at a reasonable time. Get outside during your lunch break while the weather is still nice, and even once it gets bad, commit to bundling up,” he said.
He noted that Europeans seemed to handle winter weather better than some Americans.
“They love the cold and they don’t bat an eye at it. We’re gonna have to bundle up and change our culture a little bit, and that’s gonna be easier for some people than others.
“Commitment is a big challenge. If you commit (only) to yourself, it’s easy to let yourself out of it. But if you have a buddy at work or a neighbor or family member and you decide to walk together every day, committing with somebody really strengthens that because nobody wants to be the one to drop out. If one of the two of you says, ‘Hey let’s do it,’ then both of you are more likely to go.
He said the pandemic monotony of telecommuting and home schooling can lead to the feeling that every day is the same.
“If you’re eating dinner with the same person every night, that doesn’t mean that you can’t say every Friday we’re going to do something special, whatever your means allow for. (That) will make the weeks go by more quickly.
“It has been hard and it’s going to continue to be hard,” he said, suggesting people keep an eye on the big picture.
“While we’re gonna have to get through a really difficult winter, we are anticipating starting to see some vaccines in the coming year.”
For those who are concerned about family members or friends, he suggests making plans and holding the person to them.
“Make plans with each other, whether it’s a Zoom phone call every Thursday, taking a walk every morning, or checking in with each other and offering resources, making plans with each other that are safe.
“Don’t be afraid to ask somebody, ‘Hey, are you OK? Can I help?’ It’s important to make this more normalized and less stigmatized.”
Dan Gigler