(surviving the New England Winter)

     Call me Scrooge. While billboards, radio announcers and mall loud-speakers proclaimed the joy of the holiday season, I brought the psychiatrist's annual bad tidings of midwinter blues, holiday depression and Seasonal Affective Disorder (SAD).
     Now, there are those who just love the New England winter. For them, it's chestnuts roasting by the open fire, a stand of pine trees draped in a mantle of still, white snow and the joyful cries of children defending their forts in a snowball fight.

      At last count, there were at least fifteen RIGHA members who felt this way.

      The rest of us envy the hibernating bears and squirrels, and wish that, like them, we could awake to find the snow melted and the trees budding.

      During the holiday season itself, our Mental Health Services aren't very busy. True, many people, hearing "Joy to the World" and seeing pictures of families laughing and loving together as they gather around the Christmas tree, don't feel particularly happy. They may remember how their childhoods were marked by parental strife and disharmony, by alcoholism, by poverty, or even by abuse. Or they may recall loved ones who are gone after a divorce or a death, or children who have grown and left the nest. The holidays are a time of nostalgia and remembering, and sometimes the memories are painful.

      But most people are determined not to let that inner sense of emptiness get to them. They hope that perhaps this year things will be different at holiday time. They convince themselves to hang on. (An interesting phenomenon has been noted in a study of elderly
Chinese women, In the weeks just before the Chinese New Year, an important family holiday in that culture, the death rate among these women drops to a significant degree. And then, after the holiday passes, the death rate suddenly climbs, as though the women were hanging on, clinging to life in order to make it through the holiday.)

      A similar phenomenon may take place at the Thanksgiving-Christmas-New Year's holiday season. After the holidays are over, people who have been holding on may be overcome with sadness and emptiness. The suicide rate, which is actually rather low at holiday time, rises. The rates of psychiatric hospitalization climb. The winter ahead begins to look very gray indeed,

Seasonal Affective Disorder (SAD)
      Some people suffer significantly from the diminished sunlight that marks the winter months. They feel ndepressed, tired, and irritable, lacking in energy and interest; their eating and sleeping patterns become disturbed, When summer comes and the days grow longer, their symptoms go away. Seasonal Affective Disorder, whose appropriate acronym is SAD, can be effectively treated with very bright light in the early hours of the morning, and/or with antidepressant medication. If you want to learn more about SAD and phototherapy (light therapy), come to the Health Education workshop, "Light Up Your Life," that will take place next November, just as winter begins. Check with the Health Education office at RIGHA/Warwick.

The New England Winter
      The Puritans never smiled. Look at the paintings of them in your kid's history book, or at the RISD Museum. Was it their dour dispositions that brought them to New England? Or was it the New England winter that brought the scowls to their faces?

      Today's winters, it seems to me, are even more unpleasant then they were thirty or forty years ago. Perhaps my memory has been clouded by the veil of nostalgia, but I recall cars moving slowly through the clear and silent night, the chains on their tires cutting through the pure white snow with a merry jingle, like sleigh bells. Today. there is very little snow, mainly gray slush. The air is polluted, not only with hydrocarbons, fluorocarbons and acid rain, but also with the curses of drivers caught in a traffic jam in the dark at mfive in the afternoon. And once President's Day (formerly Washington's Birthday) is past, we have no more holidays to look forward to until the end of May.

What To Do Until The Flowers Bloom
      1.Trust and accept your feelings. If you didn't love the holiday season, if your feelings were not what the TV says they should be, take heart. There are no "shoulds" when it comes to feelings. You are entitled to feelings, whatever they are. Find friends, loved ones, clergy, writers, therapists, who will affirm and validate the way you feel. Know that this, too, shall pass, and that summer will come again, as it does each year.

      2. Turn the clock back. Write your Congressman, urging him to pass legislation lengthening the period of daylight saving time, when we enjoy more light in the late afternoon and evening. (Senator Pell has been trying for years to lengthen the period of DST.)

      3. Call Mental Health Services. RIGHA's experienced therapists understand mid-winter depression. Some of us also hate the winter.

      4. Move to the sun belt. Think about it. (I do, all through the winter. So why don't I move? Guess there's too much of the
Puritan in me.)

      5. Lift Up Your Soul With The Arts. (Please forgive the use of the word "soul;" it's just the English translation of the Greek "psyche." Attend a symphony or choral concert. Stroll through the RISDMuseum. Next year, go see Trinity Rep's A Christmas Carol. It has a happy ending, and even Scrooge is redeemed.

Michael A. Ingall, MD

by Michael A. Ingall, MD, Psychiatrist, Mental Health Services, Warwick Center, Rhode Island Group Health Association.