“I went through a depressive swing. It was unbearable, ”she says. Eventually, Hornickel told her roommate that she wanted to die.
Since then, Hornickel has been on a partial hospitalization program to treat suicidal ideation, depression and bipolar disorder, and she admits her initial reaction to quarantine was a manic episode. Even though she is doing much better, there is one nagging worry: winter.
“For me, personally, the night is really tough,” says Hornickel. “And when there’s no sun or sun or things to do – this time of winter – it definitely makes those feelings worse.
Hornickel describes seasonal depression, known as seasonal affective disorder, or SAD. It’s a type of depression that happens when it’s colder, there’s less light, and it’s harder to get out. Mental health experts fear that because the pandemic has already triggered depressive symptoms in many Americans, more people will experience seasonal depressive symptoms this winter.
A study published in the Journal of the American Medical Association in September found that American adults reported more than three times higher levels of depressive symptoms during the pandemic than before. A survey conducted by the Centers for Disease Control and Prevention in June found similar results, with more American adults reporting adverse mental health symptoms, especially among young adults, racial and ethnic minorities, and essential workers. (On the other hand, a survey of American teens from May to July found that teens do well when it comes to depression and loneliness.)
The American Psychological Association has seen a surge in suicidal ideation, especially among young adults, during the pandemic, according to Vaile Wright, senior director of innovation in healthcare. “I think that’s, in large part, due to the level of uncertainty around covid,” she said. While most disasters have a beginning, a middle and an end, she adds, the pandemic has continued – with no end in sight.
Summer offered a bit of a break. As evidence mounted that socializing outdoors was safer, “I think people were really relying on their ability to enjoy the good weather,” Wright says. But the coming winter months are likely to make it more difficult for people to experience depression, whether they also have SAD or not, experts say.
Although only a small percentage of people typically report seasonal depression (most estimates place it at 6% of the U.S. population for severe symptoms and 14% for mild symptoms), Wright says she wouldn’t be surprised ‘there was a further increase in depressive symptoms among the general population as the cold weather exacerbates social isolation.
Lisa Carlson, president of the American Public Health Association, agrees. Seasonal depression, according to Carlson, is more common in people who have a history of depression. “It may be that the people at risk for seasonal affective disorder are the same people for whom covid has already triggered depression,” she says. “So we can have a lot of overlap in these people.” Carlson also says that seasonal depression and clinical depression exhibit similar symptoms, including social withdrawal and weight gain, which can make it difficult for people with the disease to distinguish between the two.
Either way, providers agree: Now is the time for people who fear symptoms of depression or their depression getting worse during the winter months to make a plan. And this is a particularly crucial time, as research has found that the change from daylight saving time to standard time, or the clock shifting backwards, which occurs on November 1, has been associated with to an increase in depressive episodes.
Here is some advice from providers and people who have suffered from depression and seasonal depression.
Line up the things that help: Joshua Gordon, director of the National Institute of Mental Health, says, “If you know that today is fine, but winter can be harsher, prepare the ground.” Gordon says this can include making sure you have a steady supply of medication in case it becomes more difficult to go out, have a therapist lined up, and schedule weekly calls with loved ones. If exercise helps, plan to train safely indoors during the winter; Mark Riechers, a 34-year-old radio producer with an affinity for cycling, says it can provide structure and normality.
Know your triggers: Be aware of what could trigger a depressive episode. Hornickel says recognizing her triggers helps her know when it’s time to ask for more help; for her, this is when she takes less care of her personal hygiene, especially not brushing her teeth.
She recommends writing down warning signs in advance when depression may get worse – for example, when you stop taking care of yourself or your home.
Get a Softbox or SAD Lamp: These are lamps specially created to imitate exterior light. Ken Duckworth, chief medical officer for the National Alliance on Mental Illness, says people with SAD should use one for a few hours in the morning during the winter. Wright agrees, but says if you can’t get your hands on a lamp, plan your day by maximizing sunlight: running errands during the day or spending 10 minutes drinking coffee by the window. Emily Pfenning, a 26-year-old from Portland, Ore., Who has suffered from clinical and seasonal depression, frequently uses one, both because she lives in a less sunny area and because she is afraid to go out. because of a lack. to wear a mask in his area.
Find ways to stay connected: Wright says that the instinct of some people with depressive symptoms may be to isolate themselves, but she says to fight the urge, especially now when it’s even easier to do so. “Even during the darker months, we know that human connection is really essential in dealing with our anxiety and depression,” she says. So maybe it’s time to start using Zoom again or other remote ways to connect with people – popular at the start of the pandemic, but abandoned by some when fatigue set in.
And try to expand your support network beyond your loved ones. “Reach out to the people around you, find your online communities, just to know you’re not alone,” says Pfenning.
Gordon says talking to someone else about your feelings can also help you determine if you’re just feeling bad or if something more serious is going on. “For people who are considering harming themselves, talking to someone really helps,” he says.
Take advantage of online therapy: Barb Foy, a 58-year-old retired social worker and mental health activist from Northern California, sees a therapist twice a month to treat her clinical depression, but to do so safely, they talk on FaceTime. It’s one of the tools she uses to prepare for the winter months and to stay out of what she describes as a black hole.
Telehealth, or virtual health care, is revolutionizing mental health care and making it more accessible, says Carlson. It can also make therapy a little less intimidating for new patients, as it is accessible directly from home.
Preparing coping mechanisms like this will do more than help alleviate depression; it will make people more prepared to deal with new crises, says Gordon. “While the pandemic is a challenge for all of us,” he says, “it is also an opportunity to build resilience.”
Chelsea Cirruzzo is a district health policy and local news reporter.