Do you find yourself slipping when the days turn colder, shorter and inevitably darker? If you do, you’re not alone, NHSInform reports that around two million people in the UK are affected by seasonal affective disorder (SAD). So what is it, can we help it and how? We caught up with Nottingham CBT therapist, Laila, to decipher what it all means and how we can start working towards promoting a positive mental wellbeing in our lives…
Let’s start with Laila’s job role. Officially, she’s a Psychological Wellbeing Practitioner, or PWP for short. It means she’s fully trained in Cognitive Behavioural Therapy (CBT), to offer and support people with a variety of mental health needs, including anxiety, depression, OCD and PTSD.
Her story started when she was working in a GP practice. She was the first point of contact for people: “It gave me some insight into people’s struggles, and how many of them need help.” From here, she furthered her healthcare experience, taking a role as a support worker for cancer patients. An incredibly sensitive demeanour was needed for the work she did, but it was the depth of mental awareness that truly widened her knowledge in the field.
Sometimes the focus can be on the physical when someone is suffering with an illness such as cancer, but Laila speaks of the mental toll she witnessed. “I got to help in a way that the GPs weren’t - they give you a ten minute slot and then you’re done. I was with them for longer. It wasn’t robotic, I gave them the space to feel like they were speaking to an actual human being.” This experience gave her the motivation to apply for a trainee PWP post. “I had nothing to lose, I knew I wanted to do it, and I had a lot of experience, which is what I think ultimately gave me the edge.”
Turns out she was right. Laila’s now been qualified for a year, and working for two. If you’re not aware of CBT, it differs from a traditional talking therapy, where the patient takes on a more active role, openly speaking about their issues and hearing advice, coping methods or perhaps just using it as a space to vent.
CBT focuses on changing patterns, all of which can be found in our “vicious circle” - the aim is to notice and stop the pattern developing. “CBT covers three main areas; thoughts, physical sensations and behaviours. All of these are linked, in order to change one, you must look to the other, once you do, you can start reducing the symptoms.”
The patient can’t sit back and listen though; “we don’t spoon-feed our patients, there’s a lot of guided self-help.” In simple terms, this means homework. Patients can expect to be set a weekly task, such as writing down their thoughts. They would need to complete these over their six to twelve sessions, which is dependent on their individual needs. “It’s definitely not for everyone, some need to just talk. For those that do go down the CBT route, what is most apparent is the more you put in, then the more you’ll get back.”
Accessing the service is fairly straightforward too, there’s a choice of going through your GP, who will refer you. Otherwise, patients should search Nottinghamshire IAPT, where you can self-refer and submit an online assessment. That way, once you’re assigned a therapist, they have as much information as possible, to ensure the time together is as thorough as possible.
If we revert to the beginning, and bring the focus back to SAD, where does it fit in with CBT, and is this an area that Laila is familiar with? Its commonality is scientifically understandable; in fact, it comes down to how human beings function, on the most basic level. If you’re a little lost, don’t worry - luckily, Laila knows her stuff. “It’s about the importance of the circadian rhythm. As humans, we rely on sunlight, it gives us a natural routine, to wake, sleep and eat. If we lose that, then it can send us completely out of balance.”
Self-care is a very individual experience - it could be the more obvious taking a bath, or doing a face mask, but it can be the basics: washing, eating and sleeping
Some of us will go about our days, not seeing daylight during winter, depending on our work, or life commitments. The problem with this is that because it’s so common, paired with the inability to control the daylight, many people don’t pay enough attention to it.
“The problem with SAD is that it’s very difficult to diagnose, despite so many of us experiencing symptoms. It’s very close to depression, so many professionals overlook the time of year.” This is actually a positive when it comes to CBT, though. “Although it’s frustrating that SAD is often misdiagnosed, it is treated the exact same way as depression, meaning I can still help.”
When a person is struggling with the shift in seasons, their thought process may leave them feeling unmotivated. The combination of weather and darkness alongside your thoughts will have you opting for your bed, pyjamas and easy-watching TV. It’s clear how your thoughts affect your behaviour in this instance, which from here affects your physical sensations. You may start to beat yourself up for repeatedly cancelling plans, and so on; the cycle never ends until the patterns are broken, which is where Laila comes in.
The next step is asking for help, although, unfortunately it isn’t as quick and easy as that. Endless waiting lists may put you off, but it shouldn’t. Taking the first step is important, and whilst you’re waiting to be seen, there are some life tips to start implementing, that may make a huge difference to your wellbeing.
If we think about children, whether you have them or not, it’s common knowledge that having some sense of routine is beneficial. Adults are no different. “We thrive off of routine, whether that be going to work, waking up at the same time every day, or perhaps keeping on top of life admin. Sometimes people don’t consider the day-to-day upkeep; paying bills, attending appointments, servicing your car. They all contribute to keeping yourself in check.” It’s true - once you let one thing slip, you blink and you suddenly have an overflowing wash basket and copious bill reminders. By this point, it can become too much.
So what should we avoid? Relying on caffeine is a big one - not only does it affect your sleep, it also impacts your anxiety levels. “Caffeine increases your heartbeat, leaves you feeling jittery and on edge, which if you’re already struggling, can induce panic attacks.” Coffee lovers needn’t worry though, there’s plenty of decaf options, so you can still get that satisfying flavour.
Similarly, avoiding alcohol is also recommended. “This one often shocks people, they always tell me how great they feel when intoxicated. This is true, but only up to a point, there’s a reason that you see so many people crying on a night out, or spend the next few days in bed - it’s not just the hangover.” Alcohol is a depressant, so if you’re regularly relying on it to mask your problems, chances are you’re actually doing the complete opposite.
What about social media? How many of you have turned to endless doom-scrolling? Laila confirms what we already know we should do: “Avoid social media, and take breaks. It can be so detrimental, especially when you’re already feeling low. You will partake in unhealthy comparisons that are completely unrealistic; as we all know, it is merely a snapshot of life. People are often showing you the best version of themselves, their lives and successes.”
Now we’ve covered that, let’s finish on the positives. When your mental health is taking a hit, it can seem impossible to have fun, but this is exactly when you need it the most. Laila stresses that seeking pleasure is key; “whatever that looks like for you; seeing friends, mindfulness, planning meals ahead to avoid trying to make a decision when you’re burnt out, and practising self-care regularly.” Self-care is a very individual experience - it could be the more obvious taking a bath, or doing a face mask, but it can be the basics: washing, eating and sleeping. If you can stay on top of these, you can start to break the depressive cycle.
Ultimately, most of us will crave long summer nights and warmer weather, but that shouldn’t mean we ignore what the other half of the year brings us. There are still things we can be grateful for, perhaps we need to look a little harder. Laila talks about the benefits of having a gratitude diary, “if you can write down one thing everyday that you’re grateful for, it makes a huge difference. One thing that I’m grateful for when the seasons change is the beauty of it. I get to see the autumnal colours and the fallen leaves, which is very pretty to look at.
“It’s about finding the beauty in things. Make the most of the day where you can, even if you can only sit outside for ten minutes, it all adds up. Your body will get a hit of melatonin and serotonin, which not only makes you feel good, will also help you sleep better.” It really does arc back to giving our bodies what they need, but above all, whether you access Laila’s service or not, please ensure that you are asking for help if you need it.
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