Seasonal Affective Disorder (SAD) is a type of depression that is related to the changes in the season. Symptoms typically start out mild in the fall and gradually become more severe as the winter approaches. This syndrome is often referred to as the "winter blues” because it is triggered by the lack of day light and the cold weather. Like other forms of depression, people who have SAD can be overwhelmed with feelings of guilt, anxiety and despair. They can feel like the energy in their body has been zapped resulting in sluggishness, poor concentration and little motivation to do activities that they once found to be pleasurable. Due to intrusive negative thoughts, they can easily become agitated. This high degree of irritability can make it hard to fall asleep and stay asleep, resulting in exhaustion and mood swings. One's appetite is often affected and accompanied by either weight gain or loss. Many people who have SAD suffer from low self-esteem.
Some of the factors that seem to play a role in the onset of SAD is a change in circadian rhythms. The research suggests the reduction in sunlight disrupts the body's internal clock and throws off one's sense of well-being. Not having enough sunlight can also cause of drop in serotonin, a neurotransmitter, that when lowered results in mood changes associated with depression and anxiety. The change in seasons can also disrupt the body's level of melatonin. Melatonin plays an important role in sleep patterns, affect and energy level.
There are several treatment options for individuals who suffer from Seasonal Affective Disorder. It is important to discuss your symptoms with your primary care physician (PCP) to rule out the possibility of other medical conditions that can cause mood changes. If your PCP does diagnose you with SAD, he will most likely refer you to a clinical psychologist for psychotherapy to learn strategies to identify and change negative thoughts and behaviors as well as learn relaxation techniques to reduce stress, bodily tension, and elevate one's mood.
Light Therapy, also called phototherapy is often utilized to treat SAD. Utilizing a special light box, a person sits in front of this special bright light for an hour each morning. The light therapy mimics the natural light that occurs in the spring and summer months and affects a change in the brain's chemicals linked to moods. Light therapy typically begins working within a few weeks and there are few negative side affects.
Some people benefit from medications. Wellbutrin is an anti-depressant that is often used to treat severe cases of SAD. The medication can be taken during the SAD season, from late fall until the end of winter each year. Exercise, meditation and stress management tools can also be helpful to reduce SAD symptoms.
Dr. Martin Klein is a clinical psychologist who specializes in Seasonal Affective Disorder. He has offices in Westport and Branford CT.
What Is Hypnosis?
What is Hypnosis?
When you hear about hypnosis, often you might think of an ominous figure waving a pocket watch back and forth or a stage hypnotist making people do things against their free will. While these images may be popular on TV or in the movies, the type of hypnosis I am going to discuss is not used for dastardly deeds or entertainment purpose. I promise none of my patients are turned into zombies, bark like a dog or cluck like a chicken after I hypnotize them.
Hypnosis is a deep relaxed state where you become open to intense focus, heightened imagination and suggestion. This hyper-attentive state is called a “trance.”
Counter to what many people assume, you do not lose your free will or ability to be in control of you own wits when you are in a trance. In a trance you are fully conscious and alert. You are not asleep, but rather you are intensely focused on the subject at hand. When you are in a trance, you feel uninhibited, relaxed and tune out the worries, doubts and self–conscious thoughts that restrict your ability to be attentive and focused.
Most people have experienced a trance like state. Milton Erickson, a world renowned hypnotist of the 20 century, contended that most people walk around in a trance on a daily basis. Have you ever spaced out in your car and miss your exit, day dreamed during a lecture, became so absorbed in a book or video game that you do not hear someone calling your name? Perhaps we spend more time in a trance than we would like to admit.
When done properly, hypnosis can be a helpful intervention used as part of the psychotherapeutic process. Hypnosis can be combined with psychotherapy to treat an array of psychological issues related to trauma, anxiety, stress, addictions, pain and eating.
The History of Hypnosis
Hypnosis is not a new procedure in the world of mental health. The medical community began using hypnosis to treat psychological conditions over two hundred years ago. In the 18th century an Austrian physician, named Franz Mesmer, was the first person to utilize hypnosis to treat both medical and psychological aliments. His name is still synonymous with hypnosis. A person in a trance is sometimes referred to as being “mesmerized. ”
In the 19th century, hypnosis was being used by the psychiatric community to treat psychosomatic related illness. Sigmund Freud was one of the first physicians to use hypnosis to treat patients who suffered from psychological conditions due to repressed memories. By using hypnosis, Dr. Freud was able to reduce the patient’s high level of anxiety so she could unblock and work through the past trauma that was causing her symptoms.
How Does Hypnosis Affect You Physiologically?
Most scientists today believe that hypnosis subdues the conscious mind so that it takes a less active role in your thought process. By calming your conscious mind, the psychologist can have greater access to your subconscious thoughts and be attuned to your deeper thoughts and emotions that affect who you are and how you think and feel. It can bring up past memories and experiences that you have either repressed because they were too painful or anxiety provoking.
There is ample evidence in the literature that hypnosis does in fact make significant physiological changes to one’s body and state of mind. Like many forms of deep relaxation, research has shown that hypnosis lowers heart rate and slow down respiration.
Utilizing electroencephalographs (EEG), researchers have demonstrated when in a trance there is a boost in the lower waves associated with sleep and dreaming and a decrease in the higher frequency waves associated with full wakefulness.
In addition, neurologists studying the cerebral cortex have demonstrated that hypnotized patients show a decrease in left hemisphere activities and an increase in right hemisphere activities. The left hemisphere controls logical and deductive reasoning and the right hemisphere controls the creative and imagination functions of the cerebral cortex.
Can I Be Hypnotized?
The literature suggests that 75 to 80 percent of the general population can be hypnotized. In my own practice, I have found most people are able to hypnotized, if they are opened to the process and do in fact want to be helped by the intervention. Motivation is an important factor in determining whether hypnosis will work.
Unlike a fixed gaze induction -- the method you often see on TV -- in my Westport, CT office I do a progressive relaxation and imagery induction that gradually relaxes the patient, keeps their conscious controlling mind busy, so he or she can relax into the trance in a non-defensive manner. The progressive relaxation and imagery method works well with individuals who are anxious, and have a hard time shutting off their minds or fear losing control. It works like the magician who has the audience focus on what they are doing with their right hand to distract them from the actual trick being done with their left hand. It is my experience that even people who find it impossible to meditate are able to relax with hypnosis because their active mind are being occupied by the continuous verbal cuing of the hypnotist.
In order to achieve a decrease in symptoms or a reduction in bad habits, I utilize a combination of hypnosis and behavior modification. Like cognitive behavioral therapy (CBT), the patient learns techniques to reprogram negative thoughts and behaviors while in a trance. For example, the cigarette will taste bitter or take 3 sips of cold water and you will not feel anxious when you cross the bridge.
Will Hypnosis Help Me?
Prior to utilizing hypnosis, it is important for the clinician to do a comprehensive psychiatric assessment to determine if the person has the mental stability and ego strength to undergo such a procedure. Hypnosis is not for everybody. Hypnosis is not for individuals who suffer from severe thought or mood disorders. If a person is not psychologically stable, hypnosis, like many forms of deep relaxation, can have negative consequences, and lead to psychotic breaks or mood instability.
Hypnosis can be an excellent tool used as part of the psychotherapeutic process. I find it particularly helpful for individuals who suffer from anxiety. Many primary care physicians and psychiatrists refer their patients to me after all else have failed. Their patients tried all different types of psychotherapy and medications, but they are still anxious. In addition to general anxiety, panic attacks, phobias, obsessions and compulsions, hypnosis is an excellent tool in working with people who suffer from Post-Traumatic stress Disorder (PTSD). Hypnosis allows the psychologist to work on the traumatic issues in a safe and contained manner. By limiting the trauma work to the hypnotic session, the individuals gets to work through the trauma, while still being able to function normally when not in the doctor’s office.
How Long Does Hypnosis Take to Work?
I can often tell if a person will benefit from hypnosis in a couple of sessions. If the suggestions work, you should have results right away. However, hypnosis is an accumulative process and often takes numerous sessions to have a long term affect. Hypnosis alone cannot stop an addiction, eliminate an irrational fear, or modify how one thinks or behaves. Change takes insight and cognitive and behavior modification. In many cases hypnosis works best in conjunction with insight psychotherapy, cognitive behavioral therapy (CBT) and/or medication management. When it comes to anxiety, learning how to relax one’s body is essential. I often tell my patients how important it is to do both aerobic exercises as well as yoga or stretching to loosen bodily tension. As part of hypnotic exercise, I relax each part of the patient’s body and can see first-hand where they hold tension in their bodies. An important component of hypnosis is self-hypnosis; learning exercises to do at home on a daily basis in order to achieve behavior modification, symptom relief and significant reduction in daily stress.
The Holiday Blues
I look inside myself and see my heart is black
I see my red door and must have it painted black
Maybe then I'll fade away and not have to face the facts
It's not easy facin' up when your whole world is black
The Rolling Stones
The Holiday Blues
The holiday season is typically a joyous time. We are often surrounded by loved ones exchanging gifts and good cheer. However, the holiday season can also be a stressful time. Shopping for gifts or sending out cards can be time-consuming and a financial strain. Many people travel to be with families, which can be tiring. Those who travel far might even suffer from jet lag. Being with one’s extended family can be emotionally draining. Dysfunctional family dynamics that have been dormant all year can rear their ugly head. Our expectations don’t always match up with the idyllic representations we see in the movies or on tv. New Years can bring up feelings of remorse and failure. To some the tinsel and bright colorful lights are nothing more than a reminder of the darkness and cold of winter that looms just below the ornaments.
During the holiday season many feel isolated, alone or unhappy with their current relationships. They might hate their jobs or even be unemployed. They might be physically ill or are close to someone who is sick or even dying. As we get older, the holidays can become an annual reminder of the loved ones we have lost over the years. We are flooded with childhood memories, some good and some bad. Many of the loved ones we grew up with are no longer with us.
When we gather with family and friends, we often over eat, drink too much, skip exercise routines, and don’t get enough sleep. It is common to feel exhausted and a bit grumpy around holidays. Moments of depression are not uncommon. It is easy to see how you can suffer from the holiday blues.
For many getting through the holidays can be a relief. Once you get back into your daily routines, much of the holiday malaise tends to pass. You are aware that the days will get longer, there will be more daylight, temperatures will warm up, and spring will soon be in the air — and you have 365 days until your next family gathering. You begin to exercise again, eat healthy and are glad to be back to work and your daily routines. But this is not the case for everyone. Depression can drag on beyond the holidays. Some people experience bouts of depression that can last the entire winter season, and in some instances even longer.
Dr. Martin Klein is a clinical psychologist who specializes in the treatment of depression. He has offices in Westport and Branford CT.
I Tell It Like It Is
Expressions people use can tell you a lot about how they think, act and relate to others. One expression I often here in my work is: "I tell it like it is." On the surface, what I think the person is trying to convey is that he or she is a " straight shooter" -- honest, does not play games and only speaks the truth.
But if one digs a little deeper, and explores the psychological assumptions that underlie such a statement, a more revealing meaning of how the person sees and understands his or her surroundings becomes apparent. The expression: "I tell it like it is" signifies that the person truly believes that he or she is seeing things how they really are -- i.e., objectively.
Common Sense Verses Subjectivity
Many people who say statements like "I tell it like it is" also believe they possess what they refer to as "common sense." They believe they are able to see things the same way other people see things who are down to earth, level headed and don't have their heads up in the clouds. But are these people actually seeing things as they truly are in an objective manner?
As a psychologist, the idea that someone believes they see things "objectively" is always suspect. Can a person actually see things as they are or does each person have a particular perspective?
Existential philosophers refer to the concept of perspective as "subjectivity." They often use the analogy that each individual sees the world through a tinted lens. We all know that some of those lens can be dark, others grey or red, and for the fortunate ones perhaps rosy.
When I contemplate the concept of "common sense" I always think of the proverbs my parents and grandparents taught me. They spoke as if they were fundamental truths and rules to live by. However, If you analyzes these proverbs, one discovers that many of them actually contradicted each other and did not have much in common . To make my point, here is a short list of some common sense proverbs that contradict each other:
He who hesitates is lost.......................................All good things come to those who wait
You are never to old to learn...............................You cannot teach an old dog new tricks
It is better to be safe than sorry'..........................Nothing ventured nothing gained
The best things in life are free.............................There is no such thing as a free lunch
Opposites attract ................................................Birds of a feather stick together
Actions speak louder than words.....................The pen is mightier that the sword
A rolling stone gathers no moss..................... Stop and smell the roses
A penny saved is a penny earned...................Penny wise and pound foolish
As you can see, the wisdom of common sense is not always consistent or objective. There are many perspectives and some of them are contradictory. When someone says "I tell it like it is" what they are really doing is telling it as they see it -- and how they see it is colored by their own subjectivity. When someone say "I have common sense" what he or she really is saying is that they believe their perspective is the right one -- the point of view that others should also take as truth.
Copyright July 2016, Martin Klein, Ph.D.
Dr. Martin Klein is a clinical psychologist who practices in Westport, Stamford and Fairfield CT. He works with children, adults and couples.