As I write this, it is almost palpable—the grey gloom of a West Coast November. Some love to be out during the dark rainy days of this season, but for most of us it is a challenging time. One primary care tip is to never stop mood disorder medications in the late fall as this commonly leads to clinical deterioration. The number of patients seen with mood disorders, particularly depression, seems to peak during this period of a constant wet twilight.
Personally, I struggle with lower energy and reduced motivation as the leaves fall and the winter season approaches. Leaving for and returning from work in the sprinkling darkness drains my joie de vivre. This is one major reason why I try to book a yearly winter escape to a sunny destination to recharge my batteries for the months ahead.
Due to the pandemic, this will not be happening this year. I realize that not being able to go on a Mexican vacation is a first-world problem, but I can already feel the darkness creeping in, so I am allowing myself to grieve a little. I am trying to remember that just because other people have bigger problems does not mean I cannot mourn my little one.
I do feel a little guilty focusing so much on myself, and in looking for ways to deflect these negative thoughts I choose to look to others. COVID-19 has increased feelings of isolation for so many vulnerable individuals in our society, particularly the elderly and those with disabilities. For these individuals, socializing prepandemic was not always easy either, due to mobility, transportation, and other issues. The knock-on effects of this pandemic—mask wearing, physical distancing, and limiting human interaction—all further increase isolation. At least during the summer (thanks to better weather) some outside contact was possible. I fear that, with the onset of harsher weather conditions, social isolation will deepen, leading to significant deterioration in well-being and mental health.
All of us are aware of at least a few at-risk individuals through our family, friends, and patient contacts. Perhaps reaching out to them will be a benefit to all. I can think of a few distant relatives, social contacts, and patients in my practice who are particularly at risk of a mental health crisis secondary to social isolation. Awareness is the first step, but is not likely to result in any positive change. Therefore, I am going to strive to contact these individuals over the winter months. A spontaneous phone call does not cost much other than time, and it could make a positive difference in someone’s struggle. I am even toying with the idea of creating a network for these people so they can talk with each other through this difficult time.
Thinking about reaching out to others already makes me feel a little better about the upcoming dark months. Maintaining a positive mental attitude can be challenging at times, so let’s keep connected and remember that we are all in this together.
—David R. Richardson, MD
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