'For some it can be hard to channel the energy we get in spring'

April is here. Sleep patterns and appetite have changed, and for some, feelings of hopelessness and even thoughts of suicide appear. To feel down for a few days or even weeks is normal, but if you see that it has an effect on your everyday functioning over time, and you no longer have the energy to do activities you normally enjoy, experts recommend consulting a GP or seeking help from a psychologist. We met Marie Strandberg, a psychologist from Sweden who has a Spanish and a Swedish degree, at her clinic in Marbella.

In the spring most people feel more energised and vital. Who doesn't feel like that?

People who tend to suffer depression or who are already experiencing depression might feel pressure (from others and themselves) to go out and "meet the world" in spring. The pressure might backfire, leaving the person self-critical, in a downward spiral, feeling more depressed. Studies show a peak in suicide rates in April. For some people it can also be hard to channel the extra energy we get in spring and it can lead to a kind of restlessness and lack of productivity, making some people feel more anxious and/or tired.

Is 'spring fever' a real illness?

No, it is not a diagnosis and it often goes away by itself after a few weeks. Seasonal Affective Disorder (SAD) used to be diagnosed but has now been changed in the diagnostic and statistical manual (DSM V) to depression with seasonal patterns. A person who suffers from this meets the criteria for depression or bipolar disorder and you see a covariation each year with the symptoms beginning and ending at around the same time. Most common is depression in winter.

Does it mean there is a sort of emotional calendar?

Yes. Even if this is more obvious for some people than others. I would say we are more or less sensitive towards this as individuals, although we do not know exactly why that is. Another important factor is of course where we live, closer or further from the equator, affecting the hours of darkness and daylight we are exposed to.

So, I guess the sunny Costa del Sol would normally be very beneficial, but with pandemic restrictions it could be compared with dark and less lively places?

Well, I guess partly it could, but more due to similarities in our behaviour changes. Meaning we are less social, staying more at home, getting less sunlight exposure, for example. One important difference to note is the added stress and anxiety in the pandemic due to a real threat but also a great deal of uncertainty which makes it "riskier" in terms of mental illness.

Could you give some advice about what someone can do, if they feel low, before falling into depression, especially in a pandemic?

Number one, I would say, is to try to keep healthy routines. Sleeping patterns; eating healthily; not drinking too much alcohol; trying to stay connected socially, even if in these times it needs to be over a video call; physical exercise - just a 20-minute walk a day can make a difference (even if you feel tired and your body says no, try to get out). It's also important to do things that make us feel good. When we are feeling low we might look over our life and see if we are prioritising in the right way. We might need to make different choices more inclined towards fun.