As the winter solstice approaches, so increases the chances residents might feel the onset of the winter blues.
For many Alaska and Peninsula residents, feelings of hopelessness and despair give way to depression as the days get shorter, the air gets colder and winter drags on. Often, those feelings could be part of Seasonal Affective Disorder, said Dr. Kristie Sellers, director of Behavioral Health Services for Central Peninsula Hospital.
It's a branch of depression that affects a good deal of Alaska residents, somewhere close to nine times more than places closer to the equator, and isn't something to take lightly despite the general stigma surrounding mental health diseases, Sellers said.
Sellers said slipping into a SAD depression isn't hard considering the Alaska winter, but there is help for those who are affected.
"We know our behavior, our thoughts and our feelings are all going to be kind of in equilibrium and so if I feel depressed, my behavior is going to be lethargic and my thoughts are going to be depressed, hopeless about the future," she said. "If I change any one of those areas, I have to ability to change the other two."
There are varying levels of the condition that can cause everything from mild life impairment up to hospitalization. Symptoms presented include lethargy, loss of energy and loss of interest and cheerfulness. Cravings for sugary carbohydrates are common, Sellers said.
Depressed residents' mental reward systems have a harder time functioning.
"There really is a change in the way our brains work when are suffering with depression," Sellers said.
Although most are affected by the condition as winter starts, most people have a real difficulty with depression after the winter solstice as the days begin to get longer. Suicide rates in Alaska are highest in the spring, Sellers said.
"When we think about someone with seasonal affective depression they have a lot of lethargy, they have a hopelessness," she said. "They don't have much energy. But if the days start to get longer, unfortunately what happens with people that have seasonal affective disorder is they tend to get agitated and uncomfortable and get a lot of restless energy."
However, the more common risk of SAD is the damage done long before a resident gets to the point of considering suicide. Often it affects more than just the person, Sellers said.
"It's causing missed days at work, dysfunctions in families, it does a lot of damage before you get to the point where it takes someone's life," she said. "Depression is really a very debilitating condition."
Joe Cannava, deputy director of Behavioral Health at Peninsula Community Health Services, agreed.
"Other people might recognize your lack of motivation," he said. "That's when you know it is really getting to a level is where it is starting to affect your daily living when other people get to recognize it and normal things that you do are a struggle."
Sellers said she is amazed at how many Peninsula residents aren't able to soak up the sunlight, get some fresh air and get out of the office before the end of the day.
"So many of us go to work in the dark and come home in the dark and we miss the light we have," she said.
However, a going for a short walk on a lunch break, rearranging a work space to sit closer to a window, and getting a bit of fresh air can make a big difference. Also people who think they might be affected should make sure there are a number of "resiliency factors" built into their lives and have things they are passionate about, she suggested.
Medication may also be an option, but consult with a doctor, Sellers said.
"Do they have meaningful support ... do they have ways to remain active through the winter months?" Sellers said. "Do they have meaningful relationships, do they have valuable roles in life and connections to other people that are important? Sometimes spirituality or faith can be really helpful for folks."
Cannava said his staff also helps residents through special lights, talk therapy, oxygen treatment and medications as a last resort.
He said help is only a call away -- 262-3119.
"Anybody in the community can call here for an appointment and they can be seen within the next day and that's at Cottonwood Health Clinic," he said.
Sellers said there has always, and will likely continue to be a stigma around mental health problems, SAD included.
"We (naturally) want to blame the sufferer for what is happening to them and that is unfortunate, but it comes from not really understanding what is happening for people," she said.
Sellers said residents also feel there might be a lack of services, or a lack of awareness of the available services to help with mental health in the area.
A total of 602 interviewed residents identified resources and services for mental health as either the second or third highest needed service in the area, according to a January 2010 CPH-commissioned report.
"Really that's what the people of the Peninsula told us is that there is not resources out there for mental health or substance abuse treatment," Sellers said. "That's in part true. There are some resources, but they are probably insufficient for the needs of our community."
"There is room for more," he said. "We are doing a lot, we could do more."
Brian Smith can be reached at firstname.lastname@example.org.