As the days become darker and the weather becomes colder, many of us are preparing to experience the annual “winter blues”, a seasonal funk of feeling down, anxious, and depressed. It can be a daunting feeling, and some folks who experience this change may actually be dealing with Seasonal Affective Disorder. I wanted to learn more about these “winter blues” and how they impact the creative community so I chatted with Anastasia Assuras, a Toronto-based psychotherapist and artist, to get some advice on self-care tips for artist.

Tell me about yourself, your creative background, and your work as a Psychotherapist. 

I am a Registered Psychotherapist in Toronto, Ontario and I offer psychotherapy for adolescents, adults, couples, and families experiencing difficult life transitions, emotional challenges, mental health issues, and relationship concerns. I have a strong background working with families affected by behavioural and substance addictions as I strive to help family members engage in their own healing and recovery. I have worked closely with youth and adults experiencing mood and anxiety disorders, personality disorders, traumatic experiences, and other mental health challenges. With the ongoing pandemic, I have been fortunate enough to continue seeing clients virtually and by phone. 

On a personal level, I enjoy being creative as much as possible in my downtime. A lot of my self care and hobbies involve drawing and painting, and during the pandemic I have found that I needed to find other outlets such as exploring new music and cooking new recipes. I have deep compassion for those in the arts during this time because it can be extremely challenging to feel motivated or inspired to create when we feel so closed off from the world. Many of my clients are expressing that each day brings a new wave of emotion due to new dynamics in their home life, work life, and social life.

What is Seasonal Affective Disorder (SAD) and why does it occur for some people? What are the common symptoms of SAD?

SAD is a non-diagnostic term that stands for Seasonal Affective Disorder. In the Diagnostic Manual of Mental Disorders (DSM-5), SAD is diagnosed as Major Depressive Disorder (MDD) with Seasonal Pattern, therefore falling under the umbrella of depressive disorders. SAD can occur for some people and not others because some are more affected by seasonal changes and deprivation of sunlight. It is worth noting that SAD is not just the winter blues; SAD includes many symptoms of major depression and can drastically affect one’s ability to function. Some of the symptoms of SAD or MDD with Seasonal Pattern include: 

• Low mood, feelings of sadness, hopelessness, and/or emptiness most days
• Loss of interest in activities that you once found enjoyable 
• Weight loss or weight gain 
• Sleeping too much or too little 
• Feeling restlessness or sluggish 
• Fatigue or loss of energy most days 
• Feelings of worthlessness or guilt 
• Unable to make decisions or concentrate 
• Continuous thoughts of suicide or death

These symptoms must be persistent and must have the feature of onset and remission with the change of seasons, and for a true diagnosis people have experienced this shift in mood and functioning for a two-year period. It may also be helpful to know that the American Psychiatric Association does state that younger people are at higher risk of winter depressive episodes (DSM5). 

It is also worth mentioning that you should always consult with a medical professional if you are wondering if what you are experiencing is SAD, as the symptoms may be attributable to other medical conditions. 

What is your advice for someone living with SAD? 

1. Carve out some time for your self care. Self care can be so much more than pampering ourselves and there are many ways to adjust our self care to fit within the limits of this pandemic. We can implement self care into all realms of our lives, such as our work life (organizing and tidying your workspace, decorating it, setting work boundaries) and social life (scheduling zoom calls with friends, taking social breaks when needed). Take a look at the self care assessment resource I have listed for some assistance. 
2. Self care does not have to be productive. You may feel the pressure to produce something, but self care is all about letting go of that. Let yourself do nothing when you need it! For example, if painting/ drawing/ etc. is one of your main outlets for self care, try creating something that feels good without editing yourself, without making it marketable.
3. Try out a sun lamp for true SAD as light therapy is highly recommended.
4. Experience a change of scenery! Get outside, even for a few minutes, notice your surroundings, and try paying attention to things you would otherwise ignore. Be present. 
5. Reach out to others AND maintain boundaries when you need your space. You are not offending anyone by taking time for yourself. 
6. Do a body scan. Notice your own emotions, name them, and really allow yourself to feel them. Notice feelings of burnout and identify what your needs are. Your body may be telling you something and it can be very easy to ignore the signs of oncoming burnout. 
7. Routine is key for emotional wellbeing. We often get stuck in negative spirals when we lose this sense of routine which is lost for many during this time. Building back a sense of routine in your schedule and having small things to look forward to can be a big help. For example, try the CBT activity scheduling tools to plan for a few things during the week for your self-care, and try to start your day with the things that you know make you feel more grounded and centered. 
8. Use some self soothing skills to help yourself feel better. This is one of my favourite DBT (Dialectical Behaviour Therapy) skills. Self-soothing involves each of the five senses and how they can help us tolerate distress. For example, if touch and smell are soothing senses to you, perhaps try curling up on the couch with your coziest blanket and pillow, and light a candle that smells comforting to you, and immerse yourself in how those sensations feel. 
9. Another favourite set of DBT skills for tolerating distress are the distraction tools. Sometimes our emotions are intense and hard to manage. Sometimes we are unable to process emotions or benefit from sitting in emotions because they are activating us too much or bogging us down.  At these times, we can use distraction skills to help bring us out of unhelpful emotional states and focus on other things for the moment. This is not a permanent strategy for combating emotional distress, but it can help us get through the tough times. 
10. Lastly, I recommend psychotherapy, including art therapy or dream therapy. Talking to someone unbiased and nonjudgmental can be a huge release for mental distress. Some therapists practice and specialize in certain types of therapy that are on the creative side such as art therapy or dreamwork therapy. These forms of therapy can be a wonderful way to explore deeper-rooted emotions and may also lead to insights that help to make sense of your moods, thoughts, and behaviours. I practice dreamwork therapy which is an interactive way of exploring why certain feelings and memories in dreams may come up for us in the present. Take a look into creative therapy modalities and see if any of them feel like a good fit for you as you might find that you resonate with a creative therapy style.  

What are some free or low-cost activities/rituals that might help someone feeling depressed?

Look after your basic needs. Things like eating regularly, drinking water, limiting intake of alcohol or other substances, sleeping well, and maintaining social connections go a long way. 

Try using a values wheel (resource below) to assess how you are spending your energy. How much time and focus is spent on the things you actually care about, and how would you like to adjust this to align with your morals and values? 

Follow some therapists that you like on social media. There are tons of therapists releasing amazing content online through Instagram and other outlets. Sometimes seeing posts reminding us to engage in self care and giving positive affirmations and nuggets of insight can brighten up your day, especially if you find you are scrolling through social media often. 

If you are interested in psychotherapy, reach out to therapists and ask if they offer sliding scale fees as you will likely qualify for a lower rate of therapy if you express that you have been financially impacted by Covid-19. Psychotherapists often offer complimentary phone consultations so you can chat with a therapist before committing so you can see if you might be a good fit together first. 

Check out low cost group therapy. Here are some resources in Toronto that offer affordable individual and group therapy services: 

1. Family Services Toronto for sliding scale services, there is often a wait list. 
2. The Toronto Institute for Relational Psychotherapy (TIRP) – Low-Cost Therapy service please call 416.465.2392, 918 Bathurst Street,Toronto, ON M5R 3G5

Since I work with addiction-related issues often, I am mindful of resources that are available to those struggling with substance abuse or behavioural addictions. There are always virtual SMART recovery or Alcoholics Anonymous (AA) meetings available for those struggling with addictions as well. Take note that you can often find groups for specific addictions which can really help if you are feeling alone in your experience (Narcotics Anonymous, Sex & Love Addiction, Gambling Addiction, etc.).

If you are already meeting with your family doctor to discuss SAD-like symptoms, ask them about referrals for low-cost individual and group therapy. 

Do artists and creatives have a higher chance of experiencing depression? 

This question has been circulating in the world of psychology for quite some time. Unfortunately, researchers are finding that “creativity” is extremely broad and difficult to assess in a clinical trial, therefore making it quite challenging to determine any correlation between depression or other mood disorders and creativity (Taylor, 2017). On the other hand, we do know of many infamous artists and creatives that have struggled with mood disorders such as Van Gogh. Though there is much debate over the potential correlation and/or causation between depression and creativity, the association does appear strong. 

Are there self-care resources you can share? 

• • You can visit the CCI website for their self help modules: https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself
  • Self Care Assessment Tool
  • CBT Weekly Activity Schedule (can explore deeper in therapy)
  • DBT distress tolerance skills (explore in therapy)
  • Wheel of Values (below)

• • If you are noticing that you are experiencing any of the above symptoms and they are impacting your ability to function socially, mentally, or in other ways, you may want to talk to your doctor. 

To learn more, you can follow and contact Anastasia through these channels:

https://www.anastasiatherapy.com/

Instagram: @therapywithanastasia 

Phone: (437) 703-1571

Email: asapsychotherapy@gmail.com