[Two Pronged] Seasonal Affective Disorder hits, but my therapist’s dead. What now?

The letter from Ana discusses her long-term struggle with depression and bipolar disorder, highlighting the impact of her late psychiatrist on her mental health. Dr. Holmes advises Ana to seek a new psychiatrist while emphasizing that her feelings of sadness during the rainy season may be linked to Seasonal Affective Disorder. This is AI-generated. Read the article for full context. Report any errors. Rappler’s People section runs an advice column by couple Jeremy Baer and clinical psychologist Dr. Margarita Holmes. Jeremy has a master’s degree in law from Oxford University. A banker of 37 years who worked in three continents, he has been training with Dr. Holmes for the last 10 years as co-lecturer and, occasionally, as co-therapist, especially with clients whose financial concerns intrude into their daily lives. Together, they have written two books: Love Triangles: Understanding the Macho-Mistress Mentality and Imported Love: Filipino-Foreign Liaisons. Dear Dr Holmes and Mr Baer, I was 12 years old when I took my first antidepressants under the psychiatrist’s guidance. Before that, I was taking whatever my mother was, with her blessing. By that time, my father could see that my mother was right: I was always sad. This sadness never seemed to leave. Sometimes it was worse than my ordinary sadness like when our kasambahays left without being told why or it rained very hard for several days. My mother told my father she was the same when a child so he finally agreed to my seeing a psychiatrist too. My psychiatrist, “Rebo,” was my mother’s psychiatrist and also became my younger brother’s. He saved my life many times. With my particular depression, it took many years before we realized I was also bipolar. As soon as he prescribed a mood stabilizer, things seemed to make more sense. We had to try many different mood stabilizers before we found a combination of medicines that finally worked for me day in, day out. Once we discovered what we called the “elixir” life became bearable. Sometimes even more than that. My biggest success was not changing medication during the pandemic despite the isolation, the mistrust, and the constant loneliness. Rebo promised I could increase my meds if I needed them increased. But he hoped I wouldn’t need to. He said that my brain might get used to this higher dosage that was really only needed for the pandemic.I managed. I am still on the same meds I have been for the last 16 years. But this weather is worse than the pandemic. From the time I wake up to the time I go to sleep the rain never stops. I wake up in a cold sweat every morning ever since this ceaseless rain began. I know sunny days appear, but they never last long enough to lift my depressions. I see no end in sight. I fear that, if my brain gets used to constantly feeling this down, it will consider this the “new normal” and I have to be on a higher medical regime forever after this. What is wrong with me? Should I look for another psychiatrist? Someone who can be my next Rebo? He is no longer (around). He died 2 years ago. – Ana Dear Ana, As Dr Holmes has written an entire book on clinical depression I think it would be foolhardy of me to do other than to defer to her in this instance. Best wishes,– JAF Baer Dear Ana, Thank you very much for your letter. Let me answer your immediate question first: “Should I look for another psychiatrist?” Yes. Second question: “(Should I look for) someone who can be my next “Rebo”? Absolutely not. True, Rebo was extremely helpful to you; not just for weeks or months, but for more than 16 years, including the years you were both trying to find the cocktail of meds that could work for you. There is no doubt in my mind that your prognosis would not have been as good were he not your psychiatrist then. However, sadly, Rebo is no longer around. To look for another Rebo would not make sense, although looking for someone with the qualities you found most helpful would be wise. Very wise.I may be wrong (and if so, please correct me), but I feel Rebo had this rare gift and you were one of the ones blessed enough to have received it. EXAMPLES: You were right alongside him in your joint quest of getting you better. He was not the one who always knew more than you and thus merely told you what to do. He actually listened to you, and took everything you said, felt, and feared into account. He was not focused on helping you merely with your immediate problem. He was aware that any decision you made now (like upping your meds) might affect the rest of your life. But much more than that, he showed you the potential implications/ consequences of each action but left you to make the decision. He treated you like a grown up. Rebo may have been the best psychiatrist for you then, and may even have been one of the best psychiatrists for you now – if he were around (which sadly “he is no longer”) AND if he would have still been as responsive to this new you, with your new insights, new experiences, new fears, new achievements, new anxieties, etc. Your job now is to find a psychiatrist whom you can work with smoothly – because you both have the same respect for truth, hard work, facts and wisdom. Finally, the question which may have been asked merely rhetorically): What is wrong with me?!!? Nothing that can’t be “fixed.” But this fixing is more of a change in perspective rather than an outside change. SAD (seasonal affective disorder) is a type of depression linked to changes in seasons, usually starting late fall or winter. Some people suffer from a real depression, SAD, once or more times in their lives. This can be due to several reasons, such as: a disruption in our circadian rhythm. When things are out of sync, life gets harder… worse if it’s something as major as our biological clock! a drop in serotonin. Heathcliff lovers may adore dark clouds and cold rain but us ordinary run of the mill lovers can get affected by the lower serotonin levels that we get this time of year; a Vitamin D Deficiency due to less sunlight. Low vitamin D can negatively affect serotonin levels and worsen mood. In my opinion, SAD is the West’s answer to our (the East’s) HAD (Habagat affective disorder) or to MAD (Monsoon affective disorder) Research also shows that SAD is more common in women, young adults, people with a family history of depression, and those living far from the equator where winter days are much shorter. So you have been DOUBLE-WHAMMIED, Ana, by belonging to two risk groups! Not the best state of affairs, but not the worst either…especially because you know that to be a fact. Thus, being depressed during cold, dark days does not mean something is wrong with you; it merely means you have SAD. Might I also add that being double-whammied puts you in excellent company. We are now “double-whammied” classmates, Ana!! All the best, – MG Holmes – Rappler.com Life got complicated? Write to our Two Pronged duo at twopronged@rappler.com.