Doing Better Therapy

A Blog For Mental Health Professional's

The Mid-winter Blues: A Check List for Clinicians 


By Jennifer Powell-Lunder, Psy.D

Once the hurrahs of the holidays have faded it is back to business as usual.  For many folks the cold dark months ahead can be difficult to manage.  As clinicians we learn to be on the look-out for signs of stress and seasonal depression.  In the extreme seasonal symptoms of the blues may actually meet criteria for Major Depressive Disorder with a seasonal pattern.  The criteria is met if an individual experiences the depressive symptoms only during specific times of the year.  For the many individuals this begins in fall and increases throughout the winter months and early spring.  Regardless of whether depressive symptoms are a one time experience or a seasonal one, symptoms can be difficult to deal with.  Of note however, is that studies indicate that while depressive symptoms may seem more prevalent during the winter, the suicide rate is actually lower in comparison to the spring and summer months.  Although there are many hypotheses about this phenomenon, no definitive explanation has yet to be identified.
In any event, the winter can be harsh on many levels.  What follows is a quick check list to help clinicians catch the signs of seasonally related depressive symptoms:

  • Client reports feeling increasingly bored and tired, less motivated to engage in activities in which they were previously interested.
  • Difficulty falling asleep and staying asleep.
  • Changes in appetite; eating more or less than is generally typical for them; sudden weight loss or gain.
  • Increased irritability or agitation. This is especially common in children and adolescents.
  • Feeling sad at points during the day, or throughout the entire day, everyday.

It is important to note that in many instances depression during the winter months is less about the seasonal change and more about increases in situational stress.  Students for example, often take midterms during January or February which can increase levels of anxiety.  In the workplace it is common in many industries for there to be a slow climb in business which starts after the holiday and increases monthly.  Difficulties, related to harsh weather conditions such as more difficult commutes, can also result in increased levels of stress, anxiety and even depression. 
The key as a clinician is to hone in on the subtle shift you may sense in your clients.  It is not uncommon for depressive symptoms to slowly increase.  A keen clinician can catch the signs early and focus on helping clients to develop appropriate coping skills to both manage and head off an increasing pattern of symptoms.


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