October is National Depression and Mental Health Screening Month. Seasonal Affective Disorder (SAD) is a type of depression linked to seasonal changes, typically beginning when fall starts and intensifying during late fall or early winter.

What’s the difference between SAD and the “winter blues”?

Many people feel a little down during colder months because they are stuck inside, and it gets dark early. These feelings, often called the “winter blues,” are temporary. SAD is a clinical form of depression that affects your daily life, including how you feel and think. SAD can last up to five months of the year.

What causes SAD?

About 5% of adults in the U.S. experience SAD. It tends to start in young adulthood. SAD may be caused by reduced serotonin and vitamin D levels, altered melatonin levels, decreased sunlight and shorter days.

What are the symptoms of SAD?

If you have SAD, you may experience mood changes and symptoms of depression, including:

• Persistent sadness
• Increased anxiety
• Food cravings and weight gain
• Extreme fatigue and low energy
• Feelings of hopelessness
• Social withdrawal
• Sleep disturbances

What are treatment options for SAD?

Treatment should be tailored to you and supervised by a healthcare professional. Options include:

• Spending time outdoors—Getting more sunlight can help improve your symptoms.
• Light therapy—Using a light therapy box daily helps regulate circadian rhythms and boost mood.
• Cognitive behavioral therapy—This treatment helps identify and change negative thought patterns.
• Vitamin D—A supplement may help if a deficiency is present.
• Medication—Antidepressants may be prescribed for severe cases.

For more on Seasonal Affective Disorder, visit our website for National Depression and Mental Health Screening Month, MagellanHealthcare.com/Mental-Health, and be sure to check out the suicide prevention tip sheets and awareness campaign toolkit.

Sources

• Cleveland Clinic
• NIMH

The National Football League’s 58^th Annual Super Bowl ended with a winning team and fans who might be recovering from a tough season. Whether you’re an athlete or a fan watching sporting events in person or at home, the competitive nature of sports can be both exhilarating and heart-wrenching. However, what happens when the passion felt for the game triggers emotions such as sadness or depression? In this interview with Magellan Federal’s Performance Coaching Manager Meg Helf, M.S., CMPC®, we explore the concept known as “sports fan depression.”

What is Sports Fan Depression and is it a real diagnosis?

Meg Helf: Although Sports Fan Depression is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), many of us are all too familiar with the emotional rollercoaster that comes along with being a fan. Reactions to any number of life events can linger and develop into diagnosable depression, prolonged grief disorder, or an adjustment disorder with depressed mood. Just as we experience grief with the loss of a relationship or a loved one, a job or an opportunity, we may experience grief at the end of a season or when our favorite team comes up short.

For sports fans, acute grief is that initial intense feeling after a loss takes place. This may manifest in a range of complex feelings such as sadness, anger, frustration, and disappointment, which often isn’t discussed in the context of sport. When this grief is experienced for extended periods of time and starts to impact our daily functioning (e.g., work, eating habits, sleep, relationships), we might be experiencing what many call Sports Fan Depression.

What is it about sports that can trigger this feeling?

Helf: There are several reasons that sports can trigger these feelings. Fans make emotional, psychological, physical, and sometimes financial investments in their teams. There are a plethora of ways that sports can impact our wellbeing: sports can be integral to one’s identity, sports can drive our daily activities, and, sports have the ability to create communities and develop relationships.

The more someone identifies with their team the stronger they may feel loss about the outcome of the game or result of the season. These events can feel like a blow to our personal identity when we have a sense of pride and belonging. Despite superstitions and lucky shirts, socks, and routines, fans have a lack of influence and impact on the outcome of the game. This may set many up with unrealistic expectations and add a sense of helplessness. A player on the field has the ability to distinguish what went well, identify what they and the team need to develop, and maintain a future focused growth mindset regardless of the outcome. With less control, it is understandable that fans struggle with optimism because they cannot take any action to make the desired change.

For some, being a fan is a part-time (or full-time!) job. Between watching games, competing in fantasy leagues, and researching statistics, our daily lives are filled with something that we are passionate about. Similarly to how some marathon runners experience the “post-race blues,” when a season is over, we may feel a loss for all the time we invested and feel like a large part of our daily excitement and activities are missing. As the season comes to a close, that taste of the adrenaline, tension, energy and anticipation of each game fades and may leave us wanting.

Fans also rarely go it alone. Our favorite team has the ability to connect people, both friends and strangers alike. Fans connect across time zones for draft parties and engage in banter through fantasy leagues, spend hours tailgating before a game, and gather for watch parties. Families strengthen bonds, adorning newborns in gear and creating traditions. Strangers high-five. They hug. They share food, drinks and handwarmers. Even opposing fans engage in playful banter and share stories. Entire cities come together to support their team. We win together. We lose together. And when the season is over, we are losing these opportunities for such a meaningful part of life – connection to others.

How can someone identify if they suffer from this condition?

Helf: A couple of symptoms experienced with depression are diminished interest or pleasure in activities, depressed mood, significant unintentional weight gain or loss, insomnia or sleeping too much, fatigue or loss of energy, feelings of worthlessness or excessive guilt, and diminished ability to think or concentrate, or indecisiveness. Prolonged grief symptoms are intense emotional pain, loss of identity, difficulty moving on with life, emotional numbness, feeling that life is meaningless, and intense loneliness.

Individuals should build self-awareness about the intensity and duration of their symptoms, and the impact they have on their daily lives. Tap into your thoughts. Are they pervasive? Is the loss of the game bleeding over to other areas of your life? Be purposeful with your next steps and be on the alert for destructive or non-productive patterns that may not help you (e.g., alcohol, adrenaline/thrill seeking, substance abuse, risk-taking).

What are steps someone should take if they believe they have Sports Fan Depression?

Helf:

• Make some intentional time to mourn the loss and build self-awareness of when intrusive thoughts creep in so you can shift to more productive, optimistic style thinking.
• Expand your identity – who are you outside of being a loyal, avid fan?
• Develop and maintain healthy habits – make time to move your body, prioritize healthy eating, hydration, and sleep. These habits are always crucial, but especially helpful for individuals who are struggling.
• Cultivate connections with others – reconnect with your fellow fans in a different context and develop new communities. Diversify your portfolio on interests and discover activities that generate positive emotions and engagement.
• Unplug from your fandom. Clear your head and provide an opportunity to get a little emotional distance from the season. Taking time for yourself will sow benefits for you and those around you. If the post-season funk stays around for longer than 2-4 weeks, find a professional to talk to or take a depression screen.

It’s important to understand that it is perfectly natural to have emotional highs and lows when you are so connected and invested with a specific sports team. Just because you experience some grief, sadness, or disappointment does not mean you have depression. It is typical to have reactions when any season changes and normal to reset your compass.

Perhaps consider why you watch sports in the first place. Is it the appreciation of athletic prowess? The comradery and connection with others? Pride in your town? Understanding what is most important to you can help you squeeze every ounce of enjoyment and excitement out of the game, while arming you with strategies to cultivate your wellbeing.

For more information on depression screenings and tips on wellness, please check out: The Journey to Wellness: Do I need a Depression Screening?

And remember…there is always next season!

Resources

Online screens and helplines: 

• Anxiety & Depression Association of America: (1)
• The Reach Institute (2)
• Mental Health America (16)
• Veteran’s Administration (17)
• SAMHSA National Helpline: 1-800-662-4357
• NAMI Helpline: 1-800-950-6264

This article was co-written by David Michael 

Imagine yourself arriving at an airport, getting your ticket, checking your bags, and then heading to security. What if you arrived at the security checkpoint and there was no one there? No screening, no questions or checking your tickets… On the one hand, you might be relieved, and on the other hand, you might be more concerned about your flight! Safety screening has become a regular part of our lives. The screening is brief, systematic, and designed to maintain safety for airline passengers. But what if it was optional?

The Importance of Depression Screenings

There are many optional health screenings that we know to be beneficial and yet we still try to avoid them … everything from annual exams to the blood pressure cuff machine in the pharmacy. Screenings seem to have gotten a “bad rap.” A health screen is designed to be a preliminary tool for providing information at pivotal points when interventions may be crucial.

Learning that depression is more unpredictable and widespread than once thought can produce mixed emotions that reflect on how one conceptualizes depression and its many levels and possible stigma. Depression affects everyone differently; it might surface in the life of someone who has been diagnosed or it may emerge in someone who looks like they have it all together. It is known that most people will face depressed feelings at some point in their life. Life circumstance is bound to “throw a curve ball” and offer the personal support system an opportunity to employ coping skills and reflexive responses to tough situations.

Why get screened for depression?

Here are some ‘Depression Flags’ or Indicators that combined, provide a “road map” recommendation towards further care: (2) (3)

• You have been through a series of tough events or situations and cannot seem to get back to feeling normal again.
• You cannot remember the last time that you felt happy.
• You are irritable and feel down a lot.
• Intrusive negative thinking.
• Change in appetite.
• Change in sleep patterns.
• Change in energy level or motivation.
• Lowered ability to concentrate.
• Change in daily behavior or moods.
• Increased irritability, feelings of helplessness or hopelessness.
• Lowered self-esteem.
• Thoughts about suicide or a desire to have life over with.
• Social withdrawal or isolation.
• Refusals by a child for normal activities such as social gatherings, foods, school attendance.
• For Children: A regression in skills already gained and increased need for reassurances.
• For Teens getting into trouble, concerning behavior changes, or self-harm.
• For Men: irritability, tiredness, anger
• For Women: sadness, worthlessness, guilt.

How to Get a Depression Screening

• Most medical providers or pediatricians will offer a basic depression screen when needed or requested during an office visit.
• Local mental health professionals offer screenings with an office appointment or intake process and can follow up with therapeutic interventions as needed.
• Online screens and helplines:
• Anxiety & Depression Association of America: (1)
• The Reach Institute (2)
• Mental Health America (16)
• Veteran’s Administration (17)
• SAMHSA National Helpline: 1-800-662-4357
• NAMI Helpline: 1-800-950-6264

Tips for Your Wellness Journey

Assemble a Care Team:

• Bring the Guide: A medical professional can provide a depression screening and can also screen for another underlying medical condition exhibiting symptoms of depression, as well as a discussion of the possibility of vitamins and supplement use to balance any deficiencies. A wellness coach, naturopath, chiropractor, or other medical professional can also be consulted. A good first step for support would be to check with the Employee Assistance Program (EAP) provided through your employer for available mental health services.
• Phone a Friend: Talk to a mental health provider, Chaplain, or someone you trust about your inner thoughts and feelings who will offer loving encouragement. Looking for ways to reduce isolation and increase connectedness can be an important step toward wellness.

Bounce Toward Wellness: (13)

• Discover Yourself: Journal your thoughts and feelings to help you get to the bottom of what is bothering you. You may want to discuss this with a trusted professional as old losses or traumas can accumulate and catch up to the one who feels they are well within the rear-view mirror. This can feel overwhelming or like having a lingering ‘emotional cold’ draining your resources.
• Eat Smart: Consuming quality protein and fruits and veggies improves the gut and brain’s ability to provide the neurochemicals needed for feelings of wellness. Junk food and low-nutrient foods increase feelings of depression or low mood in most people. While fast food seems easy, it is the rougher road in the long run. Hydration and taking deep breaths can help your brain have what it needs to perform and calm.
• Pump the Breaks: A daily and weekly break from stress through recreation, creativity, reading, athletics, or other restorative activities can help the body regenerate. Too much stress can produce other physical maladies and drain your emotional and physical batteries. Limiting your schedule can help you regain balance during a stressful time.
• Power Down and Reboot: To drain the body is to drain the mind. Sleep, exercise, and movement increases self-esteem and the immune system almost immediately; the lack of which can produce other urgent issues. While joining a gym might be ideal, even a minimal hour of ping-pong a week or a 10 minute walk a day can have a positive effect on mood and body. Depressed feelings often follow a weary body.
• Screen the Screens: Limit use of devices and time on social media as these influences can contribute to isolation and low self-esteem through comparison, especially at night. Melatonin, which is needed to help one sleep, is depleted with blue light used in devices and the light used can trick the brain into thinking it is time to be awake. Limiting parental screentime and finding ways for family connection through games, conversation, or activities can help kids feel less isolated and more connected providing some protection from depressed moods for all.
• Avoid the Mud: Negative thoughts get one stuck in a negative mind frame. Positive self-talk and optimistic thinking can go a long way to help reduce depressed feelings as evidence of the corresponding relationship between negative thinking and depression. Though it might feel difficult, finding something good in a situation can break up the mire to help one move in the right direction toward wellness. Follow the rule of thumb of thinking and speaking kind thoughts and words to oneself just like a good friend would do. Finding positive and meaningful ways to celebrate wins, whether big or little, can add fuel to the journey.
• Embrace Your Natural State (15): Stimulants and depressants, and other mood-altering substances (even immoderate use of alcohol, sugar, and caffeine) can be addictive, impact the gut, and worsen feelings of unwellness. Alcohol can worsen depressed feelings and interfere with sleep as it turns to sugar in the bloodstream.
• Pack the Jams: Positive or upbeat music and media can go a long way to lighten the mood and lighten thoughts; conversely sad or negative music or media should be used with caution.
• Believe: Research points to many benefits of praying and the belief that there is a purpose to life, a Higher Power and that one is loved. A return to one’s faith and values can help that purpose and meaning to be rediscovered. (13)

Benefits of a Depression Screening

Ultimately, a depression screening is not mandatory like airport security. It is brief, systematized and can be a good measure of your current state so that you can make the best decision for your wellness. At a minimum, it is designed to give you a ‘snapshot’ of your current resources and your ability to find balance. It can offer some perspective for what might be needed to manage feelings and what kind of support would be best suited to help.

The late Jimmy Buffet’s last song, “Bubbles Up” (12) written during a time of great challenge, reminds the one who is under water to follow the air bubbles as they float to the surface to help re-orient oneself and find the exit where life, air, and light reside. It is a metaphor for life when facing a challenge as negative thoughts are intimately tied to negative feelings and increase feelings of overwhelm. Focusing on the positive can be a necessary lifeline for one who feels life is dark and confusing.

A valley of depressed feelings is not the destination. Regardless of which road brought you or a loved one to it, life does not have to be lived there. With some help and support, one may find themselves on a journey to self-discovery, healing, and hope.

References and Resources:

Depression Screens:

1. https://adaa.org/understanding-anxiety/depression?gclid=EAIaIQobChMIzoWE2f3PgQMVEYvCCB2aEACeEAAYASAAEgJUKfD_BwE
2. https://thereachinstitute.org/reach-and-adaa-anxiety-in-children-and-teens/?gclid=EAIaIQobChMIzoWE2f3PgQMVEYvCCB2aEACeEAAYAiAAEgJwYfD_BwE
3. https://www.mhanational.org/national-depression-screening-day
4. https://adaa.org/living-with-anxiety/ask-and-learn/screenings/screening-depression
5. https://www.myhealth.va.gov/mhv-portal-web/depression-screening

Other References and Resources

6. https://adaa.org/
7. https://thereachinstitute.org/
8. https://mhanational.org/
9. https://mentalhealth.va.gov
10. https://www.samhsa.gov
11. https://www.nami.org
12. https://youtu.be/6j3jDTOG7yI?si=eJQ4Qa5YHlLBcVI_
13. https://www.amenclinics.com/
14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713100/
15. “The Godfather | Plot, Cast, Oscars, & Facts | Britannica”. www.britannica.com. Retrieved December 31, 2021.
16. Mental Health America. https://mhanational.org/
17. Veteran’s Administration https://www.mentalhealth.va.gov/

Discussions about mental health in the Black community shouldn’t be limited to Black History Month in February and BIPOC Mental Health Awareness Month in July. The conversations and action steps geared toward providing education, support, and resources require a year-round effort.

A recent article published by the Kaiser Family Foundation, shares that although Black people have made great contributions and achievements in the United States, “they continue to face many health disparities that adversely impact their overall health and well-being,” which have been “exacerbated by impacts of the COVID-pandemic, ongoing racism and discrimination, and police violence against and killings of Black people.”

What impact do these factors have on the mental health of individuals in the BIPOC community? Magellan’s medical director Rakel Beall-Wilkins, M.D., MPH shares her perspectives on depression and suggestions on ways to be supportive.

What is depression and what are some signs or symptoms?

Dr. Beall-Wilkins: Depression is a clinical illness characterized by:

• Prolonged periods of low or sad mood.
• Loss of interest or pleasure in activities.
• Changes in appetite, sleep or energy levels.
• Feelings of worthlessness or hopelessness.
• Thoughts of death or suicide.

Depression can be caused by medical illness, substance abuse, and stressful social, academic, or occupational situations, but it can also develop more readily in individuals who have a family history of depression or other mental health conditions.

Other signs of depression may include:

• Withdrawing from social activities, relationships, or hobbies.
• Escalating drug or alcohol use.
• Declining self-care in the form of poor personal hygiene and grooming.
• Expressing feelings of hopelessness, worthlessness, and/or helplessness.
• Neglecting to attend to chronic medical conditions or maintain follow-up with healthcare providers.

How does depression impact individuals in the Black community?

Dr. Beall-Wilkins: As of 2020, the National Survey on Drug Use and Health found that 6% of Black American adults and 12.9% of Black American adolescents experienced a major depressive episode within the last year. Despite increasing levels of depression within the Black community, studies also show that Black Americans are less likely than their White counterparts to receive psychotherapy or medications for their depressive symptoms. This disparity is largely attributed to limited access to healthcare coverage and culturally competent behavioral health providers, as well as pervasive cultural stigma.

Is it possible for someone to experience depression that is triggered by external factors and societal issues, such as violence, police brutality, political unrest, and racism? If so, how?

Dr. Beall-Wilkins: Yes, it is possible for depression to develop as a result of exposure to sociopolitical strife. In fact, during the week following the highly publicized death of George Floyd in May 2020, rates of depression and anxiety spiked from 36 to 41% among Black American respondents to the Census Bureau’s 2020 Household Pulse Survey.

Likewise, a 2018 study published in The Lancet found that police killings of unarmed Black Americans resulted in an increase in poor mental health days among Black American respondents. Though they may not know the victims of these circumstances personally, it is very common for Black Americans to collectively internalize the trauma of these events and feel despair over the possibility that a similar fate could befall them or their close family members and friends. Moreover, the repeated nature of these events can elicit sadness, hopelessness, and fear that things will never change.

What are tips for an individual that recognizes they are showing signs of depression?

Dr. Beall-Wilkins:

• Visit your doctor and seek treatment: Regularly follow up with a primary care provider to ensure there are no untreated or undertreated medical conditions that may contribute to the development or worsening of depressive symptoms.
• Stay connected: Stay connected to close friends, family, and spiritual community for support.
• Diet and exercise play a role: Eat a balanced diet and engage in physical activity for at least 30 minutes a day, three times per week.

Resources:

• National Alliance on Mental Illness’s (NAMI) cultural dimensions website for BIPOC/AAPI communities.
• DSM-5 (American Psychiatric Publishing, Copyright 2013 (American Psychiatric Association) 
• Stanford University 
• Anxiety and Depression Association of America