This time of year—with all its inherent good cheer—can be a challenging season for anyone struggling with depression. “While people’s paths to depression tend to be unique, there are some things about the holidays that tend to be triggers for anyone suffering with it,” says Dr. Joseph Flynn, medical director for Psychiatry and Behavioral Health at Greenwich Hospital.
“It can also be a terribly hard time if you are depressed and dealing with illness, don’t have family or have recently lost someone you cared about,” says Maud Purcell, a Fairfield-based marriage and family therapist and founder of Life Solutions Centers in Darien.
Shopping, planning and holiday festivities can also feel pressure-filled to someone who is depressed, says Dr. Flynn. Mix in alcohol (a known depressant), and you have a cocktail for a worsening condition for anyone with a clinical diagnosis, he adds.
The good news is there are ways that sufferers can cope using medication and lifestyle modification. We asked the experts—who recommend combining both approaches—to clue us in on the latest, and in some cases, controversial treatments.
For many people with a medical diagnosis of depression, medication is necessary. Here’s what you need to know when you fill your prescription:
PATIENCE IS KEY
Taking medication as it’s prescribed can be frustrating for some sufferers, says Purcell; many patients complain about side effects or slow results. “Even if you are on the right medication, it can take weeks for it to work,” says Dr. Flynn, who encourages a “stick-with-it approach” to patients.
A PERSONAL TOUCH
Purcell is an advocate of a relatively new but increasingly popular approach to prescribing antidepressants that involves testing a patient’s DNA through cheek-swab analysis and using the results to match that person with the best possible prescription. “There can no longer be a one-pill-fits-all approach,” says Purcell, who refers patients to psychiatrists for this testing. “There are different pathways in our brain and different ways we all metabolize medication, and this testing helps determine how you do that.”
Dr. Flynn says DNA testing for antidepressant medication matching is still not a standard practice and not supported by a strong body of clinical data. “Right now, it’s kind of a trial and error approach that tends to be popular in boutique practices, but I see it having potential to becoming mainstream in the next ten years.”
Although ketamine has a risky reputation for its hallucinogenic effects, Dr. Flynn says that there are some small studies that suggest clinically supervised infusions of the drug can be helpful to people suffering from depression when other treatments have failed. While there are clinics popping up that offer walk-in ketamine therapy, Dr. Flynn stresses it should be approached with a “high degree of caution” because of potential side effects and the need for more research. “What needs to be stressed is it is probably something that should only be considered when other things have failed,” he says. “It should never be someone’s first course of action.”
On top of medication, behavior modifications can elevate depressed moods. These include:
“There is real, clinical proof it makes a difference in the lives of people with depression,” says Dr. Flynn. He believes so passionately in its benefits, he frequently writes “prescriptions” for exercise and hands them to patients to emphasize its importance.
“I often counsel people to feel less obligated during the holidays,” says Purcell. “It is perfectly okay to opt out of stressful family obligations or situations that push your buttons.”
“People get a tremendous high out of getting out of themselves and being of service to others,” says Purcell. “It’s the best way I can think of for someone struggling with depression to get a lift at the holidays.”
EAT AND REST WELL
“People tend to eat horribly around the holidays and not get enough sleep,” says Dr. Flynn. Eating nutritious food, avoiding alcohol and maintaining a sleep routine can help manage moods.