Atypical day during the year is hectic enough for Serena*. Transporting her children to and from school and social events takes a huge chunk of her time. But she also has to help the kids with their homework, shop for the family, clean the house, make dinner and support her husband’s business, all while working a full-time job. She rarely has time for herself.
Like so many, her days get even more hectic around the holidays, and every year, Serena gets depressed. She dreads family holiday gatherings so much that she makes up excuses to avoid attending them. She resents the impositions on her time and finances and becomes angry and bitter. She cries at the drop of a hat and is short with her family.
“Although the holidays can be a wonderful experience for many people, they lead to a tremendous amount of stress and anxiety for others,” observes Edward Zawadzki, DO, a board-certified forensic and adult psychiatrist at Lighthouse Health Group in Jupiter. “These feelings of anxiety and depression are often referred to as the ‘holiday blues.’
“The onset of the holiday blues typically begins in the fall and progresses through the holiday season. Symptoms often begin with feelings of stress and irritability. Sadness and fatigue may follow, and some people may become reclusive.
“The condition may degenerate into a more formal depression or anxiety disorder. When that occurs, those symptoms may be present, but more serious symptoms, such as episodes of tearfulness and suicidal thoughts, may also develop.”
While the holidays can be delightful, they are accompanied by certain stressors that can lead to the development of the holiday blues, Dr. Zawadzki asserts. Two of the most common stressors are finances and family.
“People understandably feel more anxiety and sometimes experience depression or a more serious psychiatric issue, or have a worsening of an existing condition, due to those stressors,” the doctor relates. “Some people with the holiday blues unconsciously or subconsciously move away from their families at this time of year if their families are a source of stress for them.
“Old feelings such as guilt may get dredged up when families gather, and that can lead to anxiety and anger, which can cause a person to become depressed. There are also many obligations, and events people are expected to attend that they may feel uncomfortable attending. That can stir up anxiety and even panic in those with the holiday blues.
“Financial pressures are also heightened during the holidays with the added costs of entertaining, decorating and buying gifts. Those with the holiday blues may resent being expected to spend the extra money. Resentment leads to anxiety and anger, causing the person to further isolate themselves from friends and family.
“We encourage anyone experiencing symptoms of the holiday blues to seek professional help, and we can definitely provide that help. People can make an appointment for an initial consultation, and we can quickly determine the treatment they need, whether it’s psychotherapy or medication or both.”
Lighthouse Health Group is a full-service psychiatric practice offering both traditional and leading-edge treatments for patients with mental health disorders, including the holiday blues. In addition to a board-certified psychiatrist, the staff includes a certified psychiatric nurse practitioner, doctoral-level psychologists and master’s-level therapists.
Dr. Zawadzki and his staff at Lighthouse Health Group use a mixture of science-based psychiatry and traditional psychotherapeutic methods to treat their patients. Traditional methods include individual and family therapy.
“We use different types of therapies designed for specific types of disorders,” Dr. Zawadzki describes. “We have an eclectic assortment of treatments that includes traditional psychodynamic psychotherapy and supportive psychotherapy. But we also have treatments such as TMS [transcranial magnetic stimulation], EMDR [eye movement desensitization and reprocessing], esketamine therapy and a nutrition-based wellness therapy. We use this wide range of modalities to better help our patients.”
TMS, esketamine therapy and EMDR are three of the newer treatments available at Lighthouse Health Group. Each of these treatments has a place in treating patients with certain mental health disorders. TMS is used for medication-resistant depression.
“During TMS, a high-strength magnet is placed on the head over an area of the brain called the dorsolateral prefrontal cortex,” Dr. Zawadzki describes. “This area of the brain is considered important in the development of depression. It has been shown on MRI studies to be under-functioning in people who have depression.
“Pulsing the magnet over that section of the brain induces a small electrical charge that forces the neurons in that area to fire. This essentially wakes up the dorsolateral prefrontal cortex so it functions normally again, which relieves depression symptoms.”
Esketamine is a new medication that helps people suffering from depressive disorders rapidly achieve symptom relief. TMS and esketamine are typically considered after patients fail to achieve significant symptom relief using medications.
“Esketamine is an analog of ketamine, an anesthetic that’s been around for many years,” Dr. Zawadzki explains. “But esketamine has been reformulated as a treatment for depression. We use esketamine as a nasal spray, and we administer it in our office. It’s not something patients take home with them.
“Esketamine is an NMDA-receptor antagonist, which is a complicated way of saying it works on neurotransmitters in the brain that are involved with depression and other emotional states. By modulating those neurotransmitters with esketamine, we can help people feel dramatically better very quickly.”
EMDR is a newer, nontraditional form of psychotherapy that’s used primarily for patients suffering from post-traumatic stress disorder, or PTSD. PTSD is a condition that develops after a person experiences or witnesses a traumatic event such as a physical assault, a serious accident or military combat.
During EMDR, the patient is instructed to follow the back and forth motions of the therapist’s fingers with their eyes. The patient then recounts their traumatic event while the therapist gently shifts their negative thoughts to more pleasing ones. The goal of EMDR is to weaken the effects of the negative emotions associated with the traumatic event.
Patients with mental health disorders sometimes suffer physical pain as well. To address their patients’ painful conditions, Lighthouse Health Group offers the services of a board-certified physiatrist on site at the clinic.
“We’re not a pain clinic, but our physiatrist, Dr. Ellen Babinsky, treats patients for many types of musculoskeletal complaints, including back pain and joint injuries,” Dr. Zawadzki states. “As a physiatrist, she can address any type of muscle or bone issue patients may experience.”
People don’t have to be mental health patients to see a physiatrist at Lighthouse Health Group or to receive help from its staff. Someone such as Serena, who suffers severely during the holiday season, could profit immensely from the services available at Lighthouse Health Group, where a board-certified psychiatrist will determine if she would benefit from medication, and a trained therapist can teach her skills for coping with the stresses and demands of the holiday season.
“Good things can happen when people see a psychiatrist or therapist around the holidays,” Dr. Zawadzki says. “We can help them keep their bearings throughout the holiday season and beyond.”
*Patient’s name withheld at her request.
Source: Florida Health Care News, Inc.