If you’re a fan of the Game of Thrones books by George R.R. Martin, you’ll recognize “Winter is Coming” as the motto of the House of Starks. As Lords of the North, they know that they have to be ready for the hardships winter will bring. For those of us in the real world, our hardships might include colder temperatures, snow and a lot less sunshine. This change in our environment can cause us to feel down, or depressed, sometimes so much that our quality of life can be affected. This change in mood is called Seasonal Affective Disorder, or SAD.
Symptoms of SAD may include:
- Increased appetite with weight gain
- Loss of interest in work or other activities
- Less energy and ability to concentrate
- Unhappiness and irritability
- Increased sleep
- Sluggish movements
- Social withdrawal
Instead of hibernating this winter, take action to lessen the impact that SAD has had on you in the past. Consider these great suggestions by Alex Orlov, a writer for Life by DailyBurn, in his article, “9 Ways To Cope With Seasonal Affective Disorder:”
1. Soak up morning sunshine.
According to Kalayjian, winter blues will be worst in the mornings when you’re rousing yourself from bed. She tells clients to open curtains as much as possible to get exposure to natural light right when the body is waking up.
2. Maintain your routine.
“The most helpful thing is to try to keep up everyday activities,” says Rohan. Once daylight savings time occurs, don’t neglect your favorite hobbies just because winter spurs an impulse to hibernate. You’ll feel better knowing you’re still making it to your weekly book club, basketball game or brunch with friends.
3. Work it out.
During a killer gym session, the brain works hard to override the temporary feelings of discomfort by telling the body to keep pushing. You’ll naturally release endorphins, which will make you feel happier and even euphoric. A meta-review published in the American College of Sports Medicine Journal in 2013 suggested that, for some individuals, exercise might be comparable to therapy or anti-depressants as an effective treatment for depression.
4. Flip a switch.
Research suggests that light boxes can help up to 50 percent of people who suffer from SAD. The bright light emitted from these devices helps the body awaken in the morning and decreases the hormone melatonin that keeps us asleep at night. And for those seeking a quick fix: Studies show that light therapy can spur a mood lift in just several days. “Based on the literature, [light therapy] is a very effective treatment,” says Rohan. However, since the FDA does not regulate light boxes, she recommends consumers pursue light therapy under the supervision of a professional. “It takes some trial and error to get it just right,” she says, emphasizing that timing, positioning and potential side effects should all be discussed with an expert before you begin treatment.
5. Ditch the sugar.
It’s common knowledge that too much of the sugary stuff will make us gain weight and puts us at risk for developing diabetes and certain cancers. And research shows that sugar has a sour effect on mental health, too. Countries that consume the most sugar have higher rates of depression, and scientists hypothesize that it hinders the body’s ability to cope with stress and can worsen anxiety. Many people crave sweet and starchy foods in the wintertime because they provide a temporary energy boost, but these treats will ultimately leave you just as sluggish as before. Instead, opt for eating complete meals with good sources of protein and fiber.
6. Get outside.
Both Rohan and Kalayjian recommend breathing in some fresh air each day. Studies confirm that spending time outside can relieve stress, so bundle up and brave the cold for at least five minutes to lift your spirits. “It turns out that going for a walk in the morning after sunrise can be especially effective,” says Rohan. “It gets light to the retina, but it’s also physical activity.” Two birds, one stone!
7. Develop wintertime interests.
Bummed that you can’t play beach volleyball every weekend? Rohan recommends finding substitutes for the mood-enhancing activities you enjoy in the summer. “Having fun is central to having a good mood,” she says. “What are things to do in winter that are fun to do?” Strap on some snowshoes, check out a new fitness class, take a spin on an ice rink or step up your game in the kitchen — you just might find a new passion.
8. Practice relaxation.
Some down dog could help you get out of the dumps. Practicing yoga, studies show,can alleviate symptoms of depression and anxiety. Plus, preliminary research on meditation reveals that breathing exercises and mindfulness exercises can actuallychange neural networks and decrease stress. Kalayjian also recommends progressive relaxation, a technique that promotes body awareness by tensing and relaxing muscle groups throughout the body.
9. Book a trip.
Prepare for takeoff, because quality vacation time will certainly boost your mood. Those that suffer from seasonal depression will benefit from additional sunshine if they head south, but taking a break from work is important for anyone’s mental health. Studies show that people even experience pleasure from anticipating trips. “Across the board, SAD patients will tell you they feel better [after vacation],” says Rohan. But she cautions against depending on getaways for happiness. “I think it’s important to learn to tolerate the place where you live instead of jumping on a plane.” While you count down the days ’til your beach holiday, find ways to get joyous about the winter wonderland in your own backyard. (See full article here.)
Winter is coming. Be Ready!
Martin, George R.R. Game of Thrones. New York: Bantam Books, 1996. Print.
So, your significant other begs to be allowed to fall asleep first. You avoid camping or sharing a room with anyone because when you fall asleep, you’ve been told that you saw logs. You could have sleep apnea. Sleep apnea is when you stop breathing repeatedly during sleep, and is considered a serious disorder.
If left untreated, sleep apnea can result in a number of health problems, including:
- High blood pressure
- Heart failure, irregular heart beats, and heart attacks
- Worsening of ADHD
Untreated sleep apnea may also be responsible for poor performance in everyday activities, such as at work and school, car accidents, underachievement at school in children and adolescents, and having to sleep on the couch…or elsewhere.
A sleep study, or polysomnogram, is needed to diagnose sleep apnea. This is a multiple-component test that electronically transmits and records specific physical activities while you sleep. The recordings are analyzed by a qualified sleep specialist to determine whether or not you have sleep apnea or another type of sleep disorder. Most of the time, this study is done at a sleep disorder clinic or sleep lab.
If your sleep apnea is mild, you may be asked to:
- Lose weight
- Avoid alcohol and sleeping pills
- Change sleep positions to improve breathing
- Stop smoking. Smoking can increase the swelling in the upper airway, which may worsen both snoring and apnea.
- Avoid sleeping on your back
Sometimes sleep apnea is severe enough that other measures are needed. Continuous Positive Airway Pressure, or CPAP, may be prescribed. This involves a mask that you wear over your mouth or nose. It’s hooked to a machine that blows air into your airway. This way your airway stays open, preventing you from snoring or holding your breath. Depending on the person, a dental device may be a better option, or even surgery, if an anatomical problem is causing the airway to be blocked.
Consider these questions:
- Are you a loud, habitual snorer?
- Do you feel tired and groggy on awakening?
- Are you often sleepy during waking hours and/or can you fall asleep quickly?
- Are you overweight (BMI > or = 35) and/or do you have a large neck (> or = to 16in)?
- Have you been observed to choke, gasp, or hold your breath during sleep?
If you or someone close to you answers “yes” (or plays you a recording of your snoring!) to any of the above questions, you should talk to your healthcare provider about getting tested for sleep apnea. ¡Salud!
“I just feel so tired all the time.” I hear this usually once, if not two or three times a day from different patients. Depending on who I’m looking at, here are a few of the conditions I consider:
- Hypothyroidism–A blood test is used to determine if the thyroid is functioning the way it should. Besides fatigue, it can also cause constipation, cold intolerance, and dry skin.
- Iron Deficiency Anemia will cause fatigue in men and women. Women who have heavy periods are at risk for this. For men, a blood count, or hematocrit, of less than 40 is generally considered low, and should be seen by a Gastroenterologist (GI) for evaluation of possible bleeding in the gut. Women who have stopped menstruating , but are anemic, should also be considered for referral to a GI doctor.
- B12 Deficiency Anemia— Most B12 deficiencies are caused by not eating enough foods with B12 in them, such as meat, fish, poultry, shellfish, eggs and dairy products. A blood test is used to find out the B12 level in the blood; lower than 300 ng/ml means a deficiency. The quickest way to replace B12 is through an injection once a week for four weeks, then once monthly after that. Any person who has any kind of gastrointestinal disease, such as Crohn’s or Celiac Disease, or who has had any part of their gut removed such as with gastric bypass or colon resection, will need to replace their B12. Alcoholics also need B12 replacement.
- Diabetes— High blood sugars cause fatigue. Any person who is obese, has high blood pressure, high cholesterol or a family history of diabetes should be screened for this.
- Depression— There are two questions used to screen for depression:
- “In the past two weeks, have you felt down or sad on more days than not?”
- “In the past two weeks, have you lost interest or pleasure in doing things you used to enjoy?”
If the answer is “yes” to either of these two questions, than a more thorough evaluation for depression is done. If depression is diagnosed, treatment options would be counseling, medication, or a combination of these. A healthy lifestyle is also encouraged as mood can be affected by diet and exercise.
If you think that you are more tired than you should be, or than you used to be, please see your healthcare provider to see if you need to be screened for these common conditions. ¡Salud!
Keep in mind, this is not meant to be a comprehensive list, and each patient’s assessment is based on his/her health history and physical exam.