Holidays, Depression, and Suicide: Here are Some Surprising Facts

There is hope. Did you know that historically, the months of November, December and January are actually the months when the fewest people take their own lives?

You probably didn’t, because it’s a persistent and age-old myth that gets recycled by journalists year after year without much fact-checking—sort of like myths surrounding the “dangers” of cannabis. (The most daily suicides, in case you were wondering, actually happen between April and August.)

That’s not to say a lot of folks don’t feel blue around the December holidays, or even experience bouts of depression. The causes are as numerous as they are diverse. Social isolation and loneliness, extra stresses and obligations, long dark nights, family dysfunction, death and grief, missing loved ones who are no longer with us, extra work and holiday prep, and even the January return to “normal life” after the holidays can be triggers for bouts of  sadness, lethargy, fatigue, and inability to cope.

Symptoms of Depression

While a few weeks of feeling gloomy may be manageable, it’s important to recognize the symptoms of major depression, which is an entirely different beast.

While depression can occur any time of year, winter-onset Seasonal Affective Disorder (SAD) can manifest around the holiday period and is one form of major depression. Symptoms include daily or near-daily feelings of depression and other signs, including:

• Worthlessness and hopelessness
• Low energy and fatigue
• Irritability and problems getting along with others
• Sleeping difficulties, including insomnia or the opposite—oversleeping
• Lack of interest in things and activities you usually enjoy
• Changes in weight and appetite (a significant gain or loss); winter-onset SAD tends to be accompanied by cravings for high-carbohydrate foods
• Sluggishness or agitation
• Difficulty concentrating
• Thoughts of self-harm, death or suicide

Known Risks of Antidepressant Medication

From 1999 to 2012, JAMA reported the number of Americans taking SSRI medications like Zoloft, Paxil, and Prozac had doubled, from 6.8 percent to 13 percent. And yet, these medications are known to cause rare but serious and significant side effects—including, ironically, a rise in the risk of suicide.

This risk is so pronounced in young people, the Food and Drug Administration has taken a series of escalating steps since 2004, requiring black-box warnings that SSRI antidepressants are known to increase suicidality in children and adolescents. By 2006, the warnings were expanded to include patients under the age of 24.

But these risk of suicide while taking antidepressants may not be limited to young people; Kim Witzczak lost her 35-year-old husband, who had no prior history of depression, after he was prescribed Zoloft off-label for insomnia, and she believes the drug was responsible. Other studies have tracked side effects of these drugs, including agitation, paranoia, anxiety, psychosis, and mania in both adults and children.

Managing Depression: The Basics

Before turning to medications with high risk profiles to treat depression, there are less risky lifestyle interventions to try to manage the condition. If you or a loved one want to avoid SSRIs, start with one or more of the following:

• If you can, reduce the number of sources of stress and responsibilities in your life while you are feeling depressed. If you can opt out of running the carpool, organizing an optional church social, or even baking a cake for the family holiday meal, give yourself room to breathe and permission to administer some self-care.
• Check out depression apps, which can offer a wide variety of tools, from fitness to Cognitive Behavioral Therapy to meditation, and investigate those that speak to you.
• If you are having trouble dealing with daily activities and responsibilities, add structure to your day by setting reminders on your phone—even such basic things as rising, showering, and going to bed at the same time every day can help.
• Find a way to vent and explore your feelings of sadness, anger, or fear through journaling. If writing isn’t your natural way of expressing yourself, again, turn to your phone, find a quiet place, and talk rather than write.
• Eat well balanced, nutritious meals consisting of real food (quality sources of protein, whole grains, plenty of fruits and vegetables) at regular intervals. Your body’s micronutrient and blood sugar levels can contribute to your overall mood.
• Get outside and get some exercise. It may seem counterintuitive—even cruel—to advise a person who feels as if he or she can’t even get out of bed to go for a long walk, but endorphins (the body’s natural antidepressants) are released when we get our blood flowing and our limbs moving.

A Place for Cannabis

Cannabis, as a natural actor on the brain’s endocannabinoid system, helps the brain to release dopamine and anandamide, which has been dubbed the “happy” molecule.

While vigorously designed double-blind research has not yet been performed to investigate a role for cannabis and depression, a case-study-based review confirmed decades ago what many patients already know anecdotally; marijuana can help people who are suffering from symptoms of depression. And for most people, cannabis can help without the kinds of side effects that have led activists to track thousands of stories—not only about suicide, but also about violence, road rage, and spree-stabbings and shootings that seem to be associated with SSRI pharmaceuticals.

There are a few caveats to keep in mind when it comes to using cannabis to treat depression. The strain and the dose of cannabis used to help manage symptoms of depression are both important. With depression, less is more, because too much cannabis can deplete the brain’s natural serotonin levels and actually exacerbate depression symptoms.

As far as strain selection goes, for some depression sufferers, pure sativa strains may provoke unwanted feelings of anxiety, while pure indica strains may compound feelings of lethargy. Numerous self-reports suggest that hybrid strains high in the terpene limonene are mood-boosters.

Finally, an association between cannabis use and increased/exacerbated episodes among those with schizophrenia or psychosis have been observed in several studies. While these studies are correlational, not causal (there is no reason to suspect cannabis caused psychosis or schizophrenia, only that use is correlated with an increase in symptoms), those who know they are prone to such episodes should be aware of this correlation.

If you or someone you know is suffering from chronic depression or is having suicidal thoughts, there is help! The Suicide Prevention Hotline has confidential support for people in distress, prevention, and crisis resources for you or your loved ones and best practices for professionals. 800-273-8255 or www.suicidepreventionlifeline.org