Mental health experts offer Clark County residents advice for surviving another SAD winter

It’s OK not to feel OK.

“Not feeling OK is a fact of life. Sometimes you’re going to be sad, or impacted by all the uncertainty,” said Kim Schneiderman, executive director of the Southwest Washington chapter of the National Alliance on Mental Illness, a peer-support agency. “Human beings are not good with uncertainty.”

What appears to be certain, unfortunately, is that COVID-19 has become a permanent part of our world.

“It’s not going away,” Schneiderman said. “If we’re lucky it will be like a common cold or flu, something that hits us every year, but now we know how to take precautions.”

The same applies to mental health, she said. During a time of extraordinary uncertainty and stress, it’s wise to take precautions that preserve and even strengthen your ability to cope and keep on living.

“Resiliency is where it’s at,” Schneiderman said.

That’s the art of bending without breaking, of stretching without snapping, when your limits are tested.

NAMI Southwest Washington’s local take on resiliency has gone national, Schneiderman said. Sister agencies and individuals as far away as New York and Florida have downloaded its online guide to “Resiliency During COVID-19 and Beyond.”

NAMI’s favorite example of resiliency is Thomas Edison, the great American inventor. His attempts to perfect all sorts of modern miracles — most notably the light bulb — fizzled thousands upon thousands of times before they finally sparked.

Schneiderman said she takes a page from Edison.

“The more projects I focus on, the better I do,” she said. “It’s always great to have something you’re working on or looking forward to.”

Morning light

Edison’s modest incandescent bulbs have nothing on today’s high-intensity, daylight-reproducing lamps and light boxes. That’s a good thing for Pacific Northwesterners with seasonal affective disorder, or SAD, a form of depression tied to short days and weak light that makes enduring the pandemic even more difficult.

Ideally, exposure to bright, natural morning light keeps our internal body clocks in sync with the 24-hour rotation of the Earth. But maintaining normal circadian rhythms can be a real problem for some people. The short, dim days of our long Pacific Northwest winter don’t help, said George Keepers, a clinician and professor of psychiatry at Oregon Health & Science University.

“Even after the sun comes up, we have this persistent cloud cover that lowers our exposure to light very substantially,” Keepers said.

For people who are genetically prone, the result can be classic symptoms of depression: sadness, mood swings, low energy, lack of focus, insomnia or excessive sleepiness, weight gain or loss.

Fortunately, a simple, sensible treatment for SAD is readily available in the form of specialized, super-bright lamps that mimic morning sunshine, found online for as little as $35.

“Light is an excellent treatment for this condition,” Keepers said.

The key is intensity and timing. Standard home and office indoor lighting usually tops out at 500 to 800 lux (a standard measurement of brightness). But SAD-specific lamps and light boxes crank out 10,000 lux — that’s about as bright as outdoor light on a clear day — and emphasize the natural white-blue rays of morning while filtering out harmful ultraviolet rays.

Keepers suggested using the light box for at least half an hour in the morning, perhaps along with your morning coffee and newspaper, “Words with Friends” or however you rev up.

“It should be timed like summer morning light,” he said. “It doesn’t do any good to get a lot of bright light at noon.”

While the bright light must enter your eyes for this to work, Keepers added, don’t hurt yourself by looking directly into your lamp. Set it to one side so light enters your eyes obliquely.

SAD doesn’t exist close to the equator, where daylight is long and bright, Keepers said. The prevalence increases the farther north you go. Keepers said in Anchorage, Alaska, the first thing you hear when you call the community health clinic is a recorded suggestion that, before anything else, you try light therapy for two weeks.

Medication can also help those with Seasonal Affective Disorder, Keepers said, but he prefers starting patients with light. He often advises beginning light therapy as early as the fall equinox in September, when days start getting shorter.

Schneiderman said she fired up her light box earlier than ever this year, well before daylight saving time ended in November, and she can feel the difference.

“There have been years when I’m in bed by 8 p.m. I’m not experiencing that this year, and I think it’s because I started light therapy early,” she said. “It’s not an ‘aha’ moment, but it seems to me the longer you use it the better it works. Like many natural therapies, it can take time. I prefer it to medication.”

While it’s always wise to seek help with mental health issues, there’s no point in waiting for an official diagnosis of SAD, Schneiderman said.

“The average length of time for somebody to get a mental health diagnosis — any mental health diagnosis — is 11 years,” she said. “I spent many years suffering in winter before it became evident to me what it was.”

Not alone

Fatigued by nearly two years of pandemic anxiety and loss, now we’re confronting virus variants with unknown consequences.

“We’re not done yet,” Keepers said.

The pandemic drove a big rise in demand for mental health services, he said. Health care providers and children are two groups that have especially struggled.

“Completely unnecessary death is hard on health care personnel who did everything they could — personnel who have tried to help people understand the pandemic and the necessity of vaccinations and preventative measures like masks,” Keepers said. “There’s a portion of the public that ignores what we say or have even actively attacked us for it. Those are reasons why nurses and physicians say, ‘I’ve had enough.’ ”

Children are back in school, Schneiderman said, but too many remain disoriented and dubious about the future. Just this month, the U.S. surgeon general warned that the pandemic has exacerbated what was already a crisis in children’s mental health.

“It’s unclear whether the suicide rate in adults has increased, but it appears to have increased in children,” said Keepers. “That’s a very unfortunate outcome of this pandemic.”

Healing requires speaking up and seeking help, Schneiderman said.

“We need to let kids know they’re not alone,” she said. “We need to end the silence around mental health for everybody. We all walk around thinking we’re the only one, and nobody knows what we feel.

“But lots of people understand, and want to talk, and want to be there for you. Lots of people want to help.”