For most of us, the chill of fall and the yellows, reds, and oranges of autumn foliage signal the upcoming holidays and the feelings of joy that coincide with family, friends, and traditions. It is a time to reflect, give thanks, and gather with loved ones. But for some, instead of those comforting feelings, there is a sense of despair, hopelessness, sadness, and even depression. These negative feelings can be reversed and don’t necessarily signal a slide into depression and a need for mental health services. It is when sad feelings, paired with persistent negative thinking patterns, and typically accompanied by all-or-nothing qualifiers, lead to hopelessness, and sometimes suicidal thinking, that help from mental health service providers is indicated. Some examples of these negative thinking pattern chains are as follows: “I hate the holidays.” “I have no friends and no family.” “Nobody loves me.” “No one invites me to a holiday dinner or holiday party.” “No one cares for me.” “Nothing ever works out for me.” “I am always alone.” “I might as well be dead.” “I might as well kill myself.” Negative thinking chains such as these are typical of depression and can also be associated with significant changes in sleep, energy, appetite, and enjoyment of life. Although all-or-nothing qualifying words can precipitate and prolong depression, there is one time when all-or-nothing qualifiers can be beneficial, and that is in regard to suicidal thoughts: NEVER act on a suicidal thought and ALWAYS get help if you are experiencing them.
There is no reason to suffer alone with depression. We now have many research supported therapies, including both verbal therapy and medication, that can help. Talking therapies are aimed at changing negative thinking patterns to more rational and acceptable positive thoughts. Sensory modulation techniques compete with the negative thoughts that perpetuate depressive symptoms. Medications such as SSRI’s, tricyclic antidepressants, mood stabilizers, and other adjuvant medications can also help, especially when combined with the verbal, cognitive behavior therapies. At the Brattleboro Retreat we have a variety of programs and clinicians who can provide a continuum of care from outpatient, hospital outpatient, and partial hospital, to inpatient services. In most instances, depressive symptoms can be relieved and positive thinking, hope for the future, and enjoyment of life and the holiday season can be restored. Like most people mastering new skills, (such as learning a new language,) some work, practice, and establishing new routines are required. It is worth the time and effort. So, if your holidays are dimmed by the cloud of depression, don’t sit alone; get help.
Best wishes for an enjoyable holiday season from the Staff at the Brattleboro Retreat,
William A. Knorr, MD, FAAP, Medical Staff President, Brattleboro Retreat

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