The Winter Blues

Seattle, and the Northwest as a whole, is an amazing place to live but comes with a yearly price tag in the form of a dark and rainy winter (can I say dark again?). Some individuals may find that they feel a little less motivated, less energized, or just a little "down". Others may feel these and more, with much more intensity, otherwise known as SAD (seasonal affective disorder) now considered a subtype of major depressive disorder in the DSM 5. In order to get away from the pop psychology understanding about this condition, it is helpful to discuss exactly what SAD is and what we can do about it. 

What Is Seasonal Affective Disorder? 

When folks talk about SAD, they are really talking about major depressive disorder which continues to occur during seasonal changes (winter being the most common), but is alleviated with the change in seasons. Symptoms may include increased sleep (20% more than usual), overeating, weight gain, prominent energy, and craving carbohydrates. These symptoms are also not explained by a seasonal job loss, school schedule, or any other extraneous circumstance tied to seasonal change. 

What Can Help?

Like many other forms of depression, medication has been a proven form of treatment and can be discussed with your primary physician or psychiatrist. Light therapy, or phototherapy,  has also been shown to alleviate symptoms of seasonal affective disorder as well, but care must be taken to discuss with your primary care provider as to which light box is appropriate and how it should be used. 

What About Counseling? 

Psychotherapy has also been shown to be an effective treatment method for SAD, and is often recommended in unison with medication and/or light therapy treatments. Working with a counselor who utilizes cognitive behavioral therapy to identify negative thought patterns and resulting feelings and behaviors can alleviate symptoms and give individuals the tools to combat symptoms of SAD in the future. 

What Now?

If you are concerned about SAD, or feel it may explain feelings of sadness and depression you experience seasonally, please feel free to contact me to discuss counseling options. Also, below are a list of resources to find out more about SAD. 

http://www.apa.org/helpcenter/seasonal-affective-disorder.aspx

http://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml

http://www.apa.org/monitor/feb06/sad.aspx

Two-Choice Dilemmas

The venerable David Schnarch, Ph.D. (author of Intimacy and Desire) applied the phrase "two-choice dilemma" in the context of intimate relationships as a way of conceptualizing a primary area of concern for couples who are experiencing "issues" in their relationship, particularly around sex. As an example, many of us can imagine the two-choice dilemma inherent in the spouse who is cheating, but also wishes to stay in their relationship. The spouse wants two things at once: to have an affair and to maintain a marriage (or avoid the pain inherent in ending it). As Schnarch highlights in The Passionate Marriage, the spouse is saying "I want this other person AND I want you". The problem is the spouse cannot have both, or cannot have both for very long and will ultimately need to account for engaging in the affair (possibly leading to another two-choice dilemma: I want to fix my marriage but I don't want to change!). 

the two choice dilemma gives us a good way to view many of life's "Problems"

While the two-choice dilemma has obvious footing in the context of couples and marriages, I feel the two-choice dilemma gives us a good way to view many of life's "problems" and how they contribute to our daily trials. For those struggling with substance use, the dilemma may be: "I don't want to use, but I also don't want to feel so terrible". For someone in the depths of depression: "I want to push myself socially, but I also want to feel safe". In these examples we see what is ultimately a choice between the lesser of two evils. The problem, particularly with these common dilemmas, is the greater evil (the higher anxiety choice) is often the one which will ultimately benefit us the most and the lesser evil is the more familiar, unthreatening choice. 

Two-choice dilemmas highlight the area in which we can make the most growth

Why bring this up? I have found in my life and in my work with others that the two-choice dilemma, and the inherent confrontation with anxiety it entails, often highlights the area in which we can make the most growth. If you find yourself in the midst of a decision which feels challenging, take it as an opportunity to ask an important question: "Which choice will ULTIMATELY benefit me the most?" 

The most difficult decisions often Bring great benefit

Of course, the more difficult decisions in life are the ones which take more time, and are not quickly rewarded. It would be convenient if every time we challenged ourselves we were quickly given the positive benefits, and motivation along with, in order to be propelled forward in a burst of productivity and progress. With this in mind, it may be best to remind ourselves to take comfort in the struggle of the storm because, when it passes, we will be rewarded with clear skies, smooth seas, and bolstered capability and confidence. 

For further reading about David Schnarch and the two-choice dilemma, check out my resources page.