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Managing Difficulties with Mental Health Care During the Darkest Part of the Year

As the nights grow ever longer and reach their apex on the winter solstice (December 21), it can be easy to revert to patterns of inactivity. Some slowing down and increased inactivity is natural and necessary during winter, just as we discussed in last week’s post. But for some, the state of the outdoors — including freezing temperatures, decreased sunlight and increased isolation — can downslide us into experiencing increased depression, anxiety and other worsening mental health conditions. Is it just inevitable to feel this way? Or are there things we can do?

Know that you are not alone in this, and luckily, there are some strategies for those who are really struggling. If you don’t have the time or energy to take a brisk walk outside during the very limited daylight hours, please consider purchasing a 10,000 IU lightbox (average price $25-50) and using it every morning (or whenever you remember). This can replicate natural light and take the guesswork out of the puzzle right now. It may not be as good as the real thing, but your brain will be boosted by even a 15-30 minute exposure to the lightbox, which can really help us out naturally with regards to mood, anxiety and other concerns arising from decreased light. The lightbox is a small, portable thing you can just turn on and sit in front of, which is not too bad. I also struggle with the decreased light, so I use my lightbox in the mornings when I’m eating breakfast, and if I forget, I’ll put it on the side of my computer while I’m in a session.

Studies show that exercise can treat less severe forms of depression literally as well as antidepressant medication. It can help PTSD, ADHD, anxiety, social anxiety, OCD, self-esteem, stress, sleep and cognitive function. It’s also worth considering how to get it even during these dark days. One of my former clients used to lament that every winter he could not exercise the whole time (which led him to feel more depressed). He said if it just wasn’t cold or snowing outside, he could go for a long walk or a run. Of course, putting on your snow boots sucks and takes more time, and might be beyond the activation energy you have right now, which was one of his problems.

But what if you were to explore what exercise really means? Perhaps we could redefine exercise as intentional movement. Does it always have to be a walk or a run? Could it be a dance to one favorite song in your room? Could it be a quick walk to the nearest corner store to grab hot chocolate or a coffee? Could it be taking the stairs down to your porch to quietly watch the snow falling for a few minutes? Could it be light stretching with a cup of tea in your favorite corner of your apartment? If any of these activities sound doable to you this week, try one out. See if you can commit to smaller forms of movement, while still embracing the needs of your body. When we’re depressed or anxious, doing something all the way or perfectly might be our focus, but this actually gets in our way sometimes. Maybe today you just can’t muster the energy to go on that snowy walk. And instead of giving up and seeing it as all or nothing this time, know that you are truly capable of so much, including finding a manageable alternative.


Melissa Lee Nilles, LMHC is a licensed mental health counselor and expressive arts therapist with a Master's degree from Lesley University’s Mental Health Counseling and Expressive Arts Therapy program. She is deeply passionate about self-exploration through the arts, mindfulness practices and therapy. She seeks to collaborate with her clients using the tools of person-centered therapy, mindfulness, meditation, trauma-informed body-oriented psychotherapy and expressive arts therapy (through music therapy, art therapy, and poetry/writing therapy). Melissa also employs CBT and motivational interviewing to help you transform your life. She prefers a holistic, eclectic and interdisciplinary approach to addressing client concerns.

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