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Throughout the Christmas and New Year period, we are inundated with holiday romance movies, overwhelming social calendars and expectations to look and feel, “Merry and bright”. But for those who are struggling with their mental health, affected by the wrath of seasonal depression, it can feel like anything, but, “The most wonderful time of the year”.

Traditionally, a time for eating, drinking and being merry, the festive season can come with a foreboding presupposition for those struggling with a mental health concern or personal crisis.

When everyone around seems to be in the festive spirit, seasonal depression can make the holidays particularly overwhelming, feeling like a period that needs to be survived rather than thrived.

The holidays have long been associated with seasonal depression, reporting a 40% increase of suicide in the days following Christmas. In accordance with a survey from YouGov,  a quarter of people say that Christmas makes their mental health worse, with an additional survey from the Mental Health Foundation, sharing that 54% of people are worried about the mental health of someone they know at Christmas. 

Whether coping with mental illness, COVID separation, grief or holiday burnout, when seasonal depression creeps in, it’s consequential to recognise and prioritise combatting the symptoms this holiday period.

Some signs and symptoms of seasonal depression include:

  • Tiredness or low energy
  • Loss of interest in activities you used to enjoy
  • Changes in appetite or sleeping patterns
  • Feelings of immense lows and depressive feeling throughout majority of the day

Estranged relationships, disappointment of the year that has passed, as well as a range of other personal battles, are just some reasons seasonal depression may present itself. This holiday season, prioritising your health is the key to combatting any form of personal exertion.

Let go of preconceived ideas of what you are “expected” to do, instead alter and simplify the season to best suit  your circumstance, regardless of what that may be.

COVID Christmas

The uncertainty of COVID-19 has protruded ripple effects, seeping into the festive period, with many Australians spending their second year in a row apart from their loved ones. With travel and border restrictions still in place, not to mention the trepidation of COVID crisis entirely, it would be ignorant to view this holiday period without the present ramifications for the majority of Australians still suffering from the pandemic. 

COVID has interrupted and ultimately reshaped this year’s festive period, leaving many feeling unstable in their habitual safety nets of workplace, financial, family or living situations. The first Christmas apart from family, can feel somewhat un-conventional in comparison to the years that have passed. Although it may not feel entirely the same, managing your expectations and mindset, as well as applying a little outside of the box thinking, will go a long way this holiday period.

No two families are the same, and that goes for no two celebrations.  If you are separated from loved ones due to restrictions, stay in touch via phone and video call, as well as inventing outside of the box ways to stay connected and show gratitude for the ones you love, even if that is from a far.

Grieving throughout the holiday season

Grieving throughout the holidays will never be easy, as many become unwontedly aware of the absence of a loved one. As the holidays are a time to come together, it can be bittersweet for those who are grieving, often feeling the missing piece of a loved one and burden of loss far greater over the December to January period.

The expectations of a “perfect” season, that come in the form of favourite Christmas movies and sitcoms, celebrations and traditions can bring about reminders for those grieving wherever they turn. When you have lost someone you love, it is normal to have feelings of painful isolation, as well as incompleteness, grief does not disappear overnight in account of it being the holidays.

Healing is not an overnight process and taking the festive period at your own pace and dynamic is essential.If you are grieving this festive season, recognise the feelings as they pass, and importantly stay present with all that you love. It’s essential to express your emotions as a healthy mechanism and substantial influence in the healing process, this includes talking and crying it out, with those you trust or an experienced psychologist.

Expression, as well as placing emphasis on feeling grateful for anything positive present in your life, will offer alleviation from the heavy emotions associated with grief and tragedy.

Another strategy when processing grief, is to focus and become aware of the time you do spend with other family members and ones you love. Utilise, as well as cherish those valuable moments, as grieving can help to reminded us how precious our time is.

Reminded of the fragility of life as whole, being  present, as well as see beauty in the small and rare moments spent with the ones we love can be utilised in time spent with family and friends throughout the holiday season.

Money and Financial Pressure during the Holidays

The festive season can come at the cost of your wallet and bank account. From presents, celebrations and a little too much cause for celebration, the December to January period can often feel like a year’s worth of spending. This financial whirlwind, however, can be combatted with a little strategic plan and preparation.

Identify what is causing your financial stresses, and begin to take necessary action to alleviate as much worry as possible this Christmas. Communicating your financial worries to family and friends, is also important throughout the holidays. Not to be mistaken for complaining,  suggesting alternatives for gifting such as secret Santa as well as free alternatives when spending time celebrating, will go a long way when budgeting this holidays.

Head to Christmas on a Budget if you’d like more tips and suggestions for financial planning throughout the festive period.

Mental Health throughout the Holidays

Depression is the leading mental health condition treated by general practitioners in Australia. With Beyond Blue reporting a staggering 3 million Australians are living with anxiety or depression. With stress and depression said to arise in approximately 1 in 5 Australians as a direct result of the festive season,  it is evident mental health is fragile, and needs to be protected even at the best of times. Seasonal depression or holiday depression can occur due to the added pressure, expectation, and stress of the festive period. Typically characterised by low mood, self-criticism and low self esteem. 

Feeling low around Christmas is especially common among people who are unemployed (38%), divorced (35%) or widowed (31%).  Anxiety and loneliness are most prevalent among people who are aged from 25 to 34, at between 31% and 40%. People who are out of work also struggle more than other groups: 47% say they’ve felt stressed, 42% depressed and 39% anxious.

Visit https://www.healthdirect.gov.au/symptom-checker/tool/basic-details on advice for when to seek professional help when these feelings arise.

Managing and aiding seasonal depression 

Seasonal Depression may leave sufferers wanting to retreat and isolate themselves throughout the whole of the holiday period. However, withdrawing from social activities and situations will often only lead to feelings of disconnection, loneliness and worsening of symptoms of depression.

Connection and belonging are the most important ways to regulate your mental health. Combatting seasonal depression includes reaching out to close friends and loved ones, volunteering, or even simply being kind to strangers. These small strategies are proven to strengthen positive mood and reprogram feeling grateful this holiday period.

Be aware of personal strategies to combat the season such as staying healthy through eating well, exercise and relaxing when possible. Although it is the season for over-indulging, many find that binge eating or drinking take a toll on their mental and physical health. Moderation is key for surviving the holiday period, when normal routines are interrupted.

Although labelled  “the most wonderful time of the year”, the festive season, like any other period is improbable to be problem-free. Coping with any form of seasonal depression is best to be approached with realistic expectations. Whatever you or your loved ones are facing or struggling with over the holidays, remember that it is just one season of your story. You can plan and re-coup for the new year, re-writing your narrative, beginning with a new chapter called 2022.

If you or someone
you know is in crisis and needs help now, call triple zero (000)

Lifeline:  Provides 24-hour crisis counselling, support groups and suicide prevention services. Call 13 11 14, text on 0477 13 11 14 (12pm to midnight AEST) or chat online.

Beyond Blue: Aims to increase awareness of depression and anxiety and reduce stigma. Call 1300 22 4636, 24 hours/7 days a week, chat online or email.

Breaking down insomnia by looking at different types of insomniacs, what are the main causes for loss of sleep, and key tips to overcoming a series of sleepless nights.

For many, tucking themselves into bed is an exciting, if not the most exciting, part of the day. People look forward to the comfort and relaxation sleep provides. But what if sleep was something one feared? For insomniacs, the bedroom can be a constant reminder of countless sleepless nights, a place for overthinking embarrassing moments, and where one fears the prospect of losing sleep.

How common is insomnia? Can anyone be an insomniac? What is it.

Insomnia is the world’s most common sleep disorder, with 60% of Australians suffering from at least one symptom of Insomnia, occurring three to four times a week. Symptoms of insomnia are common. This might be because their causes are equally as common.

A woman sitting at the edge of her bed.

Insomnia disorder is associated to someone who has difficulties with:

  1. Falling asleep: known as onset/early insomnia.
  2. Consolidating sleep: the inability to enter a deep sleep, known as middle insomnia.
  3. Sleep duration: waking up too early and not being able to fall back asleep, known as terminal/late insomnia.

Insomniacs can experience some of these symptoms or in more extreme cases, suffer from all of them. Such symptoms  occur despite having adequate opportunity to sleep (i.e. a bedroom, the absence of daylight, a quiet space).

There are two main types of insomniacs. Firstly, those that suffer from acute insomnia disorder: this is when someone experiences symptoms of insomnia at least three or four days a week for several weeks, but never regularly over a period of three months. Secondly, is chronic insomnia disorder: when someone experiences symptoms of insomnia over a long term, lasting over the three month threshold.

What causes insomnia?

A woman lying awake.

The causes of insomnia are different for everyone but are common enough that most people can experience its symptoms at different stages and degrees throughout their lifetime. For example, according to the SHF’s report, older people will more likely have trouble maintaining sleep, whereas young adults and teenagers have more trouble falling asleep. Luckily, sleep deprivation for most people is short term, as exhaustion has a way of overpowering an overthinking mind, a sore leg, a buzzing fly, or even disruptions to our circadian rhythm (our biological clock) from things like jet lag. For insomniacs however, severe causes trump the power of exhaustion and maintain a state of wakefulness.

A woman struggling to fall asleep.

There are two main causes of insomnia:

  • Primary insomnia: when long-term medical conditions (i.e. respiratory or cardiac disorders) cause physical and mental pain by reducing the quality of life and productivity of someone. This mainly results in difficulty falling asleep or maintaining sleep.
  • Secondary insomnia: when psychological disturbances such as mental trauma, depression, and anxiety cause symptoms of insomnia.

Please note that this is a simplified explanation of the possible causes for insomnia and a full list of physical, cognitive, and risk factors can be found here.

So, yes. Anyone can experience symptoms of insomnia at different stages of their life, but insomniacs suffer from these symptoms on a more regular basis that calls for certain lifestyle changes to overcome them.

3 top tips to overcoming a sleepless night

Someone suffering from a restless night.

From medical to psychological tactics, there is no single cure for overcoming a sleepless night. Here are some tips on how to minimise a case of insomnia:

  1. Sleep Restriction: This is a technique involving following a strict sleep schedule and wake up time (i.e. if desired sleeping time is 8 hours and the alarm is set for 7am, the patient must go to sleep at 11 pm). More time in bed does not necessarily mean effective time falling asleep.
  2. Establishing good sleep practices before going to bed: i.e. no use of blue-light electronics, no TV directly before bed, shutting the blinds, and keeping the room at a cool temperature.
  3. Only use the bed for sleep. If one finds themselves unable to fall asleep, leave the room and tire yourself out by doing relaxing activities such as reading or writing.
Young woman fallen asleep while reading a book.

 Side note: Drugs such as melatonin can also be used to increase the chances of falling asleep. They can be however, highly addictive and can lose effect if used regularly over a certain period of time.

Dear Doc, 

I have a gallstone that is 2 cm which isn’t causing me any problems.

My family has a strong history of gallstone problems and my mother and younger sister have both had their gallbladder removed. 

Why is the gallbladder removed and not just the stone?

 

 

 

 

 

 

 

 

 

My sister’s gallbladder problems only began when she was pregnant, and my doctor has advised me to have my gallbladder removed before trying to conceive.

Is there any alternatives? What should I do? 

Confused

 


 

Dear Confused,

There’s two parts to this question.

First, when gall stones are causing problems why is the entire gallbladder removed rather than just the stone? This is because the gallbladder would almost always form more stones that would again cause more problems, since it has already done so once.

Given that the gallbladder has only a minor function anyway, and its absence is hardly of any significance, it makes sense that it be removed in order to reduce any future episodes.

Second, when is removal of the gallbladder indicated? Simply the presence of stones in the gallbladder is not an indication for its removal. This is because a significant proportion of the population have gallstones without ever causing any problems, so a lot of gallbladder surgery would end up taking place unnecessarily.

The only reason to have the gallbladder surgically removed (called a cholecystectomy) is if gallstones proven on ultrasound are causing symptoms.

Such symptoms include intermittent episodes of pain (biliary colic), acute inflammation/infection of the gallbladder (cholecystitis), or the even more serious possibility of stones blocking the pancreas resulting in pancreatitis.

So given that your gallstones aren’t causing you any problems (that is they are asymptomatic), it would be advisable for you to do nothing – especially not surgery – and you would have great difficulty in finding any good surgeon who would be prepared to remove it in your case anyway!

They could cause your problems one day, but then again statistics would say they will more likely not … so why go through surgery unless you actually need to?

Dr Ben