Transcription:
Beat the Winter Blues: Recognizing Seasonal Affective Disorder and Ways to Manage it

Melanie Cole: Welcome to Bryan Health Podcast. I'm Melanie Cole. And joining me today is Dr. Tom Cardwell. He's a licensed psychologist with Bryan health, and he's here to tell us about winter blues and seasonal affective disorder.

Dr. Cardwell, your timing is perfect for a podcast like this because I think, as we're heading into this season, people are starting to realize what's common. And we all know that some people, as you and I were discussing off the air, kind of love this weather. But there are other people for whom this is not their favorite time of year. Can you tell us a little bit about seasonal affective disorder, what it is and how it's different from the winter blues and even depression?

Dr. Tom Cardwell: Sure. People might know that it was first kind of thought of by Dr. Norm Rosenthal at the National Institute of Mental Health in the 1980s. And originally, it was considered a unique mood disorder. But over time, uh, people realized it's a recurrent mood disorder that occurs seasonally. Some people experience it as kind of a manic behavior; others, hypomanic and others, depressive. And it comes on with the change of seasons. A lot of people think of it in terms of fall and winter changes in mood, but it also occurs for some people in the summer. But most people experience it in the fall as winter approaches. And it tends to occur more often at higher latitudes, for example, up in Canada or Iceland or anywhere in the northern latitudes or the extreme southern latitudes. And it also is more common in younger people. But everyone can get it and people of all ages, you know, experience it.

There are things you can do though to help mitigate it. So, people can manage it fairly well. You can't typically make it go away completely, but you can manage it pretty effectively. There's some strategies that over time we have found to work pretty well.

Melanie Cole: Well then, let's talk about those because I think that people may not even realize. So before we get into the strategies, Dr. Cardwell, talk about the symptoms just a little bit because we all feel down now and then. But how do we know if it's actually seasonal affective disorder and something that is really, truly a clinical diagnoses that, you know, we can work on those strategies, but how do we know it's not just holiday blues or having a bad day?

Dr. Tom Cardwell: Well, there's a number of symptoms that people can have and keep in mind that some people experience them a lot more strongly than others. And if it's a mild case, there are a lot of things that we can all do to, you know, help get us through the season pretty well. If it's more extreme, that's when you would want to consult perhaps your physician or maybe have a therapist or somebody that can work with you to get you through those difficult times.

The symptoms include, but aren't limited to feeling kind of listless, sad or down most of the day, nearly every day. So if it just comes and goes, you know, you're sad because somebody that you were planning on getting together with at the holidays cancels because of weather or some other reason, that's different than having this kind of pervasive feeling of sadness that is season-long.

Other symptoms are losing interest in activities you once enjoyed. You know, if you're sitting down and not getting up, you're not getting out; if you like music, you're not playing the piano; you're not walking, you're not shopping, you're not getting together for coffee with friends, those kinds of things, then that might be a sign that, you know, you're affected; feeling low energy, sluggish. Some people sleep too much. They take a lot of naps and just aren't very energetic.

Another thing that occurs with some people is carbohydrate cravings. Not just overeating, but carbohydrates in particular. You know, sweet rolls and those kinds of things can cause a person to start to gain weight. We all have a little bit of trouble with that during the holidays because, you know, there's so much good food available. But if it's more than you would typically gain, which is usually just a couple of pounds for most people, then that might be a concern.

Difficulty concentrating, feeling hopeless, worthless or guilty, those are feelings that really should be attended to. If you're feeling that way, then you should definitely talk to somebody. Certainly, a few people, not many, have thoughts of not wanting to go on living, maybe not suicidal per se, but just feeling really down, like "What's my point in being here?" That would definitely be a concern.

Sometimes, as I said earlier, they start out mild and get more severe over time. Some people just experience a fairly mild version of this. Others really, you know, should attend to it, not ignore it, and there are things you can do to make it better.

Melanie Cole: Well then, tell us about those. If you'd like to tell us about things we can do in our own homes that we can do as far as self-care, whether it's nutrition or exercise or whatever, and then really what types of therapy work for something like this.

Dr. Tom Cardwell: So, I would recommend, you know, setting the alarm and getting up and have things planned for the day, so you're not sitting around with nothing to do. If typically you'd like to get together with people, get up and do those things. Pull the blinds back or the curtains, so you have light in your home. Turn the lights on in your home. Sometimes, you know, we have conflicting, I guess, goals. We want to preserve energy because we're good citizens and we don't want to typically keep the lights on. I know when I go to my daughter's with the grandkids, they leave all the lights on and I can go around and shut them off. And during the summer, that's fine. But in the winter, you want to leave them on.

There is something called light therapy that some people have taken. It's been shown to be effective where you can actually buy a light box and you can have a very bright light for about 30 to 45 minutes during the day and 10,000 lux or more. And if you don't have access to that, just having the lights on and having brighter lights, you know, are helpful. But these light boxes help because we don't get enough, that's why people are more subjected to seasonal affective disorder in northern latitudes because they just have less access to light. And so, that cognitive behavioral therapy can help and, essentially, a therapist would help you plan to do the things that you want to do, that you would normally do if you weren't, you know, feeling down. So, having somebody, like a third party to talk to who kind of is a coach for you and encourages you to do the things you want to do, but you can't quite get up the energy to do can be really useful. So, I recommend that.

There are medications that people can take. Sometimes serotonin levels are down. That's a neurotransmitter that is affected by light and vitamin D, so medications can help. Typically, they say if you're going to start the medications, if you know you have seasonal affective disorder, to start it in the fall because it takes four or five weeks before those medications sometimes take full effect. And you want to be, you know, ready to go when the sun is out there less or, you know, there's a lot of cloudy weather and you're starting to feel down. So, vitamin D is another thing. Melatonin sometimes levels are too high, which is why people want to sleep more during the winter. So anyway, there are medications that can help as an adjunct to therapy, as an adjunct to the light therapy.

What I recommend, more than anything is getting out and exercising, getting out and walking or bike riding or, you know, if it's too cold to go outside to go to a gym or use a treadmill, I much prefer being outside when possible to being in a gym because, you know, there's something about nature that, you know, is invigorating for people. I will myself go to a lake and walk around that these days, just because I enjoy, you know, the nature. But you know, each to their own. But I think exercise is important, having a schedule, you know, planning activities with friends, doing kindnesses for people this time of year. You know, there's a lot of people that are affected still by COVID and aren't as active as they used to be or as socially engaged. And if you can call a friend or, you know, visit a shut-in, something like that, that makes them feel better and also makes you feel better and it keeps you active.

Melanie Cole: All of these are such great bits of advice and true. As far as exercise, I agree with you completely and getting outside, taking that walk can help. And gratitude, always at this time of the year, but really all year round, really does help with those feelings of sadness and depression. And sometimes I feel sorry for myself and then I think of how lucky I am, and that really does help so much.

Dr. Cardwell, as we wrap up, please give us your best advice. We know there is a real mental health epidemic going on right now in our kids, in our teens, and as adults. It's really pervasive and we're all kind of feeling it, but this is just a little bit different than that. So if you would give us your best advice for how we can deal with seasonal affective disorder, the winter blues and make ourselves feel better, because if we don't take care of ourselves, we cannot take care of the ones that we love. You know, it's that old adage, put your own mask on. So, give us your best advice about self-care and helping ourselves to get out of that rut at this time of the year.

Dr. Tom Cardwell: I think if you can plan in advance to have activities so you're engaged during the holiday season with people that you love and, you know, expressing gratitude to people, also being aware of yourself and risk factors that you may be subject to. Like some people, we might have a glass of wine or a beer or something like that during the holidays. Some people use it as a method of self-medicating because they're feeling down, that's a bad idea, you know. Really limit alcohol consumption. It also makes people, you know, sleepy and not want to engage with people. So, be aware of your tendencies regarding substance use and abuse or any kind of addictive tendencies that you might have, like eating too much chocolate. You know, there's nothing wrong with chocolate and those kinds of things, but be aware of your limits and take care of yourself. You really need to fill your bucket a little bit, so you can be fully available to others. Get out there among people. Call up, you know, family and friends and wish them well.

Actually, last night, I called three friends of mine, that are good friends just to chat with them, and that's not something I would normally do, but I think all three of them appreciated it. And males in particular are probably less likely to engage.

Melanie Cole: I was just going to say that. Men don't seem to do that, right? They don't pick up the phone and call somebody, my goodness.

Dr. Tom Cardwell: Well, there are people that lived out of town, one's in Seattle and so on. And so, it was really good to connect with them and wish them well for the holidays.

Melanie Cole: That's great advice. Dr. Cardwell, thank you so much. You're an excellent guest and I hope that you'll come and join us again and keep giving us all of that great advice because people could really hear it and they could really use it right now.

And you can find mental health screenings@brianhealth.org slash mental health screening. That concludes this episode of Brian Health Podcast. I'd like to thank our Brian Foundation partner, Davis Design and nmc. Please visit our website@brianhealth.org for more information and to get connected with one of our providers.

I'm Melanie Cole. Thanks so much for joining us