Melanie Cole, MS (Host): Do you go through periods where you just feel down and really can't pinpoint and does it seem to come and go with the seasons? You might be suffering from seasonal affective disorder. What can be done about it? Well, we got you right here on It's Your Health Radio with Henry Mayo Newhall Hospital.

I'm Melanie Cole. And joining me is Karen Warmack. She's a registered nurse and the Program Director of the Behavioral Health Unit at Henry Mayo Newhall Hospital. Karen, welcome back. I'm so glad you could join us. So, tell us a little bit about SAD, or seasonal affective disorder. How does it differ from depression or the winter blues?

Karen Warmack, RN: Good morning, Melanie. And thank you again for having me. I'm so excited to be able to share this information to all the listeners. So SAD, isn't that such an ironic name for seasonal affective disorder? You know, SAD is a real thing. They don't really know what fully causes seasonal affective disorder, but what they do know, that when the days become shorter, when the sun becomes less, we tend to get they call that winter blah. We don't feel good. And ironic enough, some people experience it also during spring and summer. And really what it does is just creates us to feel less energy. We're sleepy. We're lethargic. We don't want to get up. We don't want to move. And there's so many things out there to treat it. And it is, it can have symptoms, Melanie, like depression. Because it is a mood disorder, it affects our mood. But as we continue on in talking together, I can share with you that if these symptoms continue and persist, then it is important to go see a clinician or psychiatrist or psychotherapist because those depressive symptoms can be very agonizing for a lot of us that are experiencing what they call the winter blue or the winter blah or "I just don't feel good."

Melanie Cole, MS: Well, thank you for that, Karen. So, does the time change have any effect on this? Is it good or bad, positive or negative? Cause we wake up, it's dark out. In a couple of weeks we wake up, it's going to be a little bit lighter. Does any of that have effect?

Karen Warmack, RN: It really does. You know, it is SAD or a seasonal affective disorder, it does create us to experience some type of chemical. It triggers something in our brain, a chemical in our brain, and I won't get deeply into it. It has to do with melatonin. But the real thing is that it actually will create these symptoms. And it is because we have less daylight, we have less sunlight, and our days really become shorter, and they are definitely finding that because of that, we do have symptoms of depression. And because of the less sunlight, because of the less daylight, it does trigger a chemical change in our brain. Isn't that interesting?

Melanie Cole, MS: It really does. And I know some people wish we wouldn't be going back and forth like that. But I mean, I never really mind falling back. Now, let's talk about symptoms. So, what are we looking at as far as symptoms? Because we all feel down sometimes, Karen. We all feel, you know, you said tired, lethargic, you don't want to get out of bed. Well, that could be normal. Is there something that specifically would tell us this is what's going on?

Karen Warmack, RN: So, one of the things they say that you start feeling just sad. You feel down most of the day, sometimes every day. You begin to lose interest in some of the activities that you really did enjoy. Some people express having low energy, they kind of feel, as I said, lethargic or sluggish. You might be sleeping more or too much, but then drowsy during the day. Sometimes people experience difficulty concentrating. They even might feel hopeless, guilty. They might not want to participate. You find yourself isolating or withdrawing. You even feel maybe irritable or a little anxious. And what's interesting is those are very similar symptoms, a symptomology to depression, right?

Melanie Cole, MS: It certainly is. This is so interesting to me. Now, what can we do about it? Because we know, Karen, with depression, this is a clinical diagnosis in most cases, and it requires Medication, or professional help, or behavioral therapy, cognitive therapy. There's all these things, but for seasonal affective disorder, it's not always that same level of treatment. There are other things we can try, yes?

Karen Warmack, RN: Correct. Very good, it's very true. Major depressive disorder is a disease. And seasonal affective disorder, you find that will last three, four, five months. It lasts during the course of a season. So, there is a real big difference between major depressive Disorder versus seasonal. But there are people who are experiencing major depression. And so, it really just makes it worse and just more at risk.

But let's talk about the treatment and the things that we can really do. One of the things that they talk about is., getting light therapy and there are light boxes. It gives a full spectrum of light that will help you. And also sometimes, I call them snowbirds, there are people who literally will leave the east coast and go to areas that are nice and warm where they can get sun. They find themselves in Nevada or Arizona. Getting in the sun as much as you can is another. I'm going to talk about just natural treatments for yourself. Just getting the sun as much as you can.

And then the other treatment, it is getting in touch with someone who is a therapist, a psychotherapist. And you brought it out, because there are different type of modalities of treatment that can even help us view the world around us and our environment to help us get through that blah moment. And there's also medications at the end of the day, you know, that will help you if those depressive symptoms really bother you.

But there's another thing that I really do want to talk about during that blah season. You know, the holidays, there's a lot of pressure, especially during Christmas. And I know we've heard this, it becomes busy, hustling. It's become so commercialized. As we have said over and over, we've lost the true spirit of Christmas and the holidays. And I would want to say to the listeners, let's try to be intentional and mindful not to get so caught up that everything has to be so perfect that we got to go out there and get the biggest gift, the greatest gift. I mean, all that anxiety does not help when we are dealing with some of that blah, don't feel good moments during the season. It just exacerbates it to worse.

And I would even say learn to cultivate some activities that you can do in the winter that will keep your mind busy. It's being mindful of being well. You know, it's the same thing that we talk about. You want to eat well and have a balanced meal. You want to try to get out there and exercise or at least walk 10 or 15 minutes a day. Do those things that will make you feel better about yourself in the midst of just this seasonal affective disorder that should only last three, four, five months at the most.

Melanie Cole, MS: I agree with you on so many of those suggestions. And gratitude is another one. And when you talk about the holidays and everything doesn't have to be perfect, that's so important for us all, because the holidays really do stress everybody out. And I try and use as much gratitude. And when I'm giving myself a pity party, I kind of look around and say, "My goodness." And especially with what's going on in the world, I just thank my lucky stars and I hug my kids and I say, "This is a blessing what we've got." So, that does help as well. And what about things like herbal remedies? People try all kinds of things. Are there any mood enhancers that you would recommend?

Karen Warmack, RN: That's a really good question. I'm very mindful of saying things like that, but there are. I was just reading the other day just about aromatherapy. It is so great for our senses, so lavender and peppermint and infusing those things in your home. And when you talk about what's natural remedies, it's practicing wellness. It is meditating and taking that time and journaling of gratefulness and attitude change and getting around friends. But those natural remedies, you know, with the chemical change, and they're saying that it's too much melatonin. It's things that you can shift for yourself. And try not to sleep so much during the day and set your alarm clock to get up earlier.

Here's another thing. This is not a natural remedy, but it's common common sense. When we feel blah, we tend to sometimes increase our alcohol consumption. We'll have a little hot toddy at night or a little cocktail to relax us and I would want to share that those are the things that are not the best things to do because alcohol does depress our central nervous system. And so, what you think might be relaxing might make it worse. So, I would say decrease, if possible, your alcohol consumption. You know, if you like your eggnog with a little brandy, maybe do one cup versus three cups. It's just all those things that we already know about practicing wellness and all of us at some time just don't have the energy.

But I say surround yourself with people that love you. Surround yourself with friends. Continue to talk about it. It's not abnormal. We're finding that over 20 percent of the population actually is affected by seasonal affective disorder. So, just to know that it is normal, you're not abnormal, what you're feeling is not abnormal. But really work hard and be intentional in putting yourself in environments and places with people that bring you joy, that give you a sense of peace. As you get through this, surround yourself with people that love you and do those things that will help you feel better about yourself and loving yourself.

Melanie Cole, MS: I mean, you're just going to get me all verklempt here. You are so lovely, Karen. I know there's a reason you and I like to talk together. It really is. You're just such a lovely woman and I can hear the compassion and the passion for what you do for a living. And I imagine your patients just love you.

Do you have some final words for us? You mentioned light therapy. You mentioned when it's time to really maybe seek professional help for something like this and all the gratitude and finding our spiritual guide, whatever it is we need to find to tell ourselves that this is just one Little time slot in our journey. And to look to yoga and exercise and nutrition and cut down on some of the depressant things that we're doing, alcohol and other medications and drugs and such. Wrap it up with your best advice because you deal with this every single day.

Karen Warmack, RN: I do, and thank you again for having me. It's this, that this is not abnormal, that all of us, even I've experienced it, that you just feel blah. I think knowing that it's normal and it's okay is number one. And be aware of the symptoms. If you're finding yourself in the bed longer than others, if you're crying, if you're feeling like you can't live or you can't go on, if it's creating you to not do your regular activities of daily living, that's when I highly encourage you to go seek professional help, whether it's a psychotherapist, a psychiatrist, because there are antidepressants that can help that chemical in your brain that will make you feel better. And if it's not to that point, just live the moment.

Life is so short. Recognize that it is something that we all experience. Work on being intentional, getting yourself in the sunlight every day. Do your homework and maybe get a light box. You can get them on Amazon. And exercise. Go swimming. Laugh. Talk. Don't feel that you're all alone, that this is something that is only for a short while, and to just continue to seek peace and surround yourself with friends and love and know that this too shall pass.

Melanie Cole, MS: Wow, that was beautifully said. Karen, thank you so much again for joining us and sharing your incredible expertise and great advice for people that are suffering from seasonal affective disorder. It's really an important topic. And I thank you so much for coming on and highlighting that and for more information about seasonal affective disorder, you can visit our free health information library at library.henrymayo.com. That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Please remember to share this show on your social channels with your friends and families because we're all learning from the experts at Henry Mayo Newhall Hospital together. And they're giving us such usable, great advice, and we are all getting all the health advocacy that we really need to keep ourselves healthy and strong. I'm Melanie Cole. Thanks so much for joining us.