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May 26, 2022

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

By , Columbian staff writer
Published:
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Kim Schneiderman, executive director of NAMI Southwest Washington, said sister agencies and individuals as far away as New York and Florida have downloaded her organization's online guide to "Resiliency During COVID-19 and Beyond." (Columbian files)
Kim Schneiderman, executive director of NAMI Southwest Washington, said sister agencies and individuals as far away as New York and Florida have downloaded her organization's online guide to "Resiliency During COVID-19 and Beyond." (Columbian files) Photo Gallery

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.

Mental Health & Other Help

  • Clark County Mental Health Crisis Services, available 24/7, call 800-626-8137.
  • Clark County Teen Talk, “non-judgmental support for teens, by teens.” Call 360-397-2428, text 360-984-0936, visit ccteentalk.clark.wa.gov.
  • Clark County Regional Support Network, clark.wa.gov/community-services/mental-health-contacts.
  • NAMI Southwest Washington, peer support, guidance, resources: namiswwa.org or 360-695-2823.
  • Washington Listens, anonymous nonclinical line for anyone who is sad, anxious, stressed. Compassionate listening, referrals for help. Call 1-833-681-0211 or visit walistens.org.
  • Washington State Coronavirus Response, coronavirus.wa.gov. Click on “mental and emotional well-being.”
  • Forefront, public suicide prevention effort by the University of Washington School of Social Work: intheforefront.org.
  • How Right Now, Centers for Disease Control’s interactive guide to identifying, coping, getting help with complicated and difficult feelings: howrightnow.org.

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.

Warning Signs of Suicide

Talking about:

  • Wanting to die
  • Great guilt or shame
  • Being a burden to others

Changing behavior, such as:

  • Making a plan or researching ways to die
  • Withdrawing from friends, saying goodbye, giving away important items, or making a will
  • Taking dangerous risks such as driving extremely fast
  • Displaying extreme mood swings
  • Eating or sleeping more or less
  • Using drugs or alcohol more often

Feeling:

    • Empty, hopeless, trapped or having no reason to live
    • Extremely sad, more anxious, agitated or full of rage
    • Unbearable emotional or physical pain

What to do:

  • Do not leave the person alone
  • Remove any firearms, alcohol, drugs, or sharp objects that could be used in a suicide attempt
  • Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)

Source: National Institute of Mental Health

“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.”

Tips for coping with winter, pandemic blues

Hate the thought of another winter under the shadow of Seasonal Affective Disorder and pandemic uncertainty? Here are recommendations for building resilience and bolstering your mental health, drawn from NAMI Southwest Washington and executive director Kim Schneiderman; Dr. George Keepers at Oregon Health & Science University; the National Institute of Mental Health; the Centers for Disease Control and Prevention; and the Washington Department of Health.

Healthy food, drink and sleep. “Taking care of your body helps so much,” Schneiderman said. “Give yourself what you really need. Don’t drink a whole bottle of wine at night.” That’s key to keeping your body’s immune system tuned up and ready to protect you, she said.

Regular exercise. It’s not just a platitude: Exercise really does release hormones called endorphins that blunt pain and increase feelings of pleasure and well-being.

“It’s the first prescription most doctors give depressed people,” Keepers said. “Exercise is critical to mental health.”

Health clubs and fitness centers are open again (with mask requirements, of course), while the great outdoors never did shut down. And then there’s always the internet, where you’ll find diverse and inexhaustible exercise, fitness, dance and yoga opportunities at every level, along with cheerful, judgment-free encouragement.

If you can find a walking or jogging buddy, the gentle peer pressure will keep you steady, and the exercise plus chitchat will feel great.

Stay social. We’re back in a gray area for indoor socializing, but what else is new? Vaccines and boosters, that’s what. According to the CDC, you can resume most normal social activities if you and your companions are fully vaccinated and boosted. Wearing a mask indoors remains wise (and mandatory in many places).

Many have survived and even thrived during the pandemic thanks to regular video chats with family and friends, interest groups, church groups, class reunions and educational courses.

Make meaning in your life. Take on projects and set goals. “Don’t hibernate. Don’t just watch TV,” Schneiderman said. “Take back a hobby or start a new one. People can stay about as busy as they want with support groups and classes, there’s so much out there now.” 

“Keep moving forward,” Keepers said. “A sense of accomplishment is important for mental health. Keep your mind engaged.”

Meditate. By contrast, try shrugging off all the stress by simply sitting, breathing, relaxing. Five minutes of this and you might just be surprised to find how refreshing it is. If you want guidance, try an app like Headspace or Calm.

Take a break from news. Limit electronic and social media that shocks, provokes, overwhelms. Try checking into all that just once or twice day. There’s more to life.

Volunteer. Many nonprofits and helping agencies are masked up and back in business. But it’s possible to volunteer from home too. For example, senior-care agency Meals on Wheels People enlists volunteers to call isolated elders at home, just to check in and chat. Many churches do the same.

Feeling lonely, want to talk? Many people out there have the same need.

—Scott Hewitt 

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