The Tribune

By FELICITY DARVILLE

THIS Christmas has been different from any we have ever seen in The Bahamas. We have lost more people this year than any other in recent history. The pandemic has claimed the lives of 713 Bahamians, many of them succumbing to COVID-19 in 2021. Then, there are those still recovering from the loss of loved ones due to Hurricane Dorian.

Bahamians everywhere are doing their best to have a happy holiday season; but for some, it is bittersweet as many homes are a bit emptier without the laughter of loved ones. Yes, there’s lots of things to be grateful for. But we cannot overlook those who are having a hard time adjusting to life without the people who made the holidays special to them. We want them to be able to overcome their sadness and be happy, too. One way to do that is to be able to identify those family members and friends who may be having a harder time than others, then offer them the help they need. They need all the love and support we can give them to help them to look at the bright side of things.

Nadia Cash, clinical psychologist and member of the Bahamas Psychological Association said one of COVID’s most unfortunate impacts is causing the unexpected death of a sufferer.

“Suddenly losing someone you love to COVID-19 can be devastating,” she said, “especially considering the quick rate the disease takes over one’s body. It may take some time to process and deal with all the emotions that come with loss and to adjust to living without that person in your life.

“Acknowledging your feelings can help you to put them in context of the loss,” Dr Cash advises.

“Denying your feelings can extend the period of grief longer than intended. It’s okay to say, ‘I’m not okay’. Thoughts surrounding grief may sound like, ‘I wish they were still here’, ‘I don’t know how to do life without them’, ‘What am I going to do now?’ ‘If only I had (said/did certain things) while they were still around’. These are all valid statements and may need to be addressed by talking to a close friend or through therapy.”

Some physical sensations that can happen with grief are feeling exhausted, having headaches, losing your appetite, not being able to concentrate, or not being able to sleep. The simple act of noticing if there are changes in your physical state can help you through the grieving process.

Behaviours associated with grief may include withdrawal, refusing to speak about the person, avoiding any situations/places/people associated with the person, talking about the loss a long time afterwards, or not taking practical steps to deal with the loss, including cleaning or giving away the person’s belongings. Dr Cash says grief takes time to process and go through. Some may believe there is a time limit to grieve, but this varies from person to person. Some people may take a few days to get past their grief, some may take years. The process is personal. Acknowledging you are grieving, however, allows you and others to be more patient with your specific process.

Studies show that during this season, approximately three percent of the population experience Seasonal Affective Disorder (SAD). Megan Johnson, Assistant Coordinator of Mental Health and Psychosocial Support for the Bahamas Psychological Association, knows her fellow Bahamians are going through a rough time and grief may be compounded by SAD.

She explains that for those who already battle with major depression, about 10 to 20 percent of those individuals face SAD. Up to 25 percent of people with bipolar disorder experience SAD. This very real and common challenge of SAD impacts its victims on an average of 40 percent of the year. Shining a light on this issue will help us better understand what signs to look for, and how to address it.

She said even the change of time, which results in an earlier sunset, can affect your mood: “After the time changed, did we all feel a difference? It felt like we were chasing the daylight, and night seemed to show up before it’s time. We can see and feel the seasons transition from fall to winter, where cold fronts are more frequent, and our days are shorter. Many people at this time of year are celebrating and preparing for holiday festivities. For some, however, this time of year is difficult and unwelcome.”

SAD is a form of depression that is also referred to as seasonal depression, winter depression or winter blues. This is a type of major depression characterised by a seasonal pattern. This just means those who suffer from SAD see changes in their mood at the beginning and ending of the shifts between seasons. Many people report that they begin to “feel down” as the days become shorter during the fall and start to see major improvements in their mood with the emergence of spring. While SAD is commonly known to affect most people in the fall and winter, some individuals may even experience a SAD depressive episode in the spring and summer. This summer-pattern SAD is much less common where, unlike winter-pattern SAD, loss of appetite and lack of sleep are more likely to occur.

The typical onset of this condition begins when people are in their twenties or thirties, but teens can experience SAD as well. It is more common in women than men, and many people never realise that they have it. Research also suggests that SAD usually co-occurs with attention deficit hyperactivity disorder, anxiety disorder and eating disorder.

Having a family member with depression or other mental health issues may also predispose an individual to SAD. This is why this Christmas may seem bluer for some Bahamians than any other they have ever experienced.

Some sufferers may not experience SAD every year, with about 30-50 percent of people reporting symptoms in consecutive winters. It is estimated that 40 percent of individuals with SAD continue to have depressive episodes after winter where they feel no relief in the summer months. This specific course of the disorder leads to a change in diagnosis to either major depressive disorder or bipolar disorder.

Dr Keva Thompson, National PAHO Consultant: Non-Communicable Diseases and Mental Health PAHO/WHO Office for The Bahamas and the Turks and Caicos Islands shares this advice to help beat the winter blues:

• Keep up with activities that you enjoy and find alternatives for things that are no longer possible.

• Stay connected with friends and family.

• Eat at regular intervals and get enough sleep.

• Exercise regularly if you can – even if it’s just a short walk.

• Avoid or restrict alcohol intake and only take medicine as by your health-care provider.

• If you think you may be depressed, talk to someone you trust about your feelings.

• Seek professional help – your local health-care worker or doctor is a good place to start.

Because SAD is not a separate disorder, but a type of depression, the treatments available are close to that of major depression or bipolar disorder. Psychotherapy or ‘talk therapy’ can assist those with SAD to replace their negative thoughts often associated with seasonal changes, with more positive thoughts. Evidence has shown that psychotherapy has long-term effectiveness for treating SAD, which can be further improved when combined with antidepressant medication, or light therapy.

Light therapy is an empirically supported method of treatment for SAD, where the person sits in front of a very bright light box every day for about 45 minutes. These lights are 20 times brighter than indoor lighting and help to make up for the decrease in light exposure throughout the day. Medications used to treat SAD addresses deficits in serotonin, and significantly enhances mood. Increasing vitamin D levels may also improve symptoms of SAD, as sufferers often have vitamin D deficiencies. For Bahamians, it can be as simple as spending more time outdoors, as we are fortunate to have year-round sun.

During this holiday season, the Ministry of Health & Wellness, Public Hospitals Authority, Pan American Health Organization, and the Bahamas Psychological Association advise that getting help for SAD should be important for those that struggle with this difficult condition. Take the time to notice if anyone in your family is having difficulty as they grieve the loss of their loved one. Please seek help from your doctor or a mental health specialist. You can call or WhatsApp these numbers for help: 819-7652; 816-3799; 815-5850; or 812-0576.