Ask a psychologist | How do you beat the winter blahs?

While Canada is known by the rest of the world as a winter-loving nation, the dark days and persistent time indoors can have a negative impact on some people’s health. For most, the key to combating the winter blahs is to embrace the frigid temperatures with your tribe through outdoor activities, sleeping enough, and eating well.  Or, take a cue from the Danish “hygge” way of life, and make cozy comforts like lounging in your knitwear by candlelight while sipping homemade soup a part of your routine.   These physical and social routines ensure regular exposure to sunlight and activity, which are essential year-round, but perhaps needed to be planned more deliberately in the winter.

For others, winter fatigue is more serious. Around 2 to 3% of Canadians experience a seasonal type of depression that can significantly impact their health and well-being. Another 15% will experience a milder form of the condition, which is also known as Seasonal Affective Disorder (S.A.D.). I sat down with two psychologists to understand more about this condition and when it’s wise to seek help.

Is S.A.D. a real condition or diagnosis?

“The general consensus is that it is indeed a real diagnosis,” says Dr. Ricardo Flamenbaum, a psychologist at Medcan. “Seasonal Affective Disorder, or seasonal depression, is listed in the DSM-5, the official mental health classification system  used by physicians, psychiatrists, and psychologists, as a sub-type of major depressive disorder; what we call depression.  What makes it different from depression is the seasonal qualifier or the seasonal pattern. That means it tends to come on during particular times of year, usually in the fall or winter, when there is a decrease of exposure to sunlight. It can also be associated to the changes our biological clocks undergo during time changes when the days get shorter.”

If someone suspects they have seasonal depression, when is it worth looking into with a professional?

Dr. Aline Rodrigues, also a psychologist at Medcan, says symptoms like low moods and low energy may be something to investigate if you find yourself  unable to function in your daily life.

Other symptoms include feeling down and/or tired most of the time; a general sense of malaise; and a need to sleep more than usual. Some people tend to overeat and have a higher craving of carbohydrates (like sugary treats). Seasonal depression may be the reason you are having difficulty going to work, or being at work and not working (i.e. presenteeism). You may be withdrawing from your circle of friends, or not performing at work or at school as well as usually do.

What are some recommended line of treatments?

Get outside and move more

Both psychologists recommended that we should all, regardless of where you fall on the spectrum, get outdoors as much as we can – which also forces us to be active. So layer up and lug on your boots, it’s time to go into the cold (and maybe even enjoy it). Some options to consider: walk over to the local seniors’ home and volunteer your skills or companionship; leave the car and walk to pick up some groceries; or take a spin on an ice rink you’ve never tried — for Torontonians, have you checked out the new outdoor rink under the Gardiner?

Try light therapy

For more mild levels of seasonal depression, increasing your exposure to sunlight may also be helpful.  Studies have shown an association with light exposure and mood; it’s been found to be just as beneficial as Cognitive Behavioural Therapy (CBT) and, when coupled with exercise, even more helpful.

Talk to an RD about vitamin D

Some practitioners recommend vitamin D to help stabilize mood in the winter months. Victoria Upshaw, a registered dietitian at Medcan, says although there is a strong correlation between vitamin D and S.A.D., there is no concrete cause and effect relationship.

“Researchers suspect that the many vitamin D receptors in the brain play a role in regulating serotonin.  At a minimum, vitamin D is also essential for bone density, immunity, and parathyroid hormone balance,” says Upshaw. “Health Canada recommends adults take 600-800 IU per day but most individuals need 1000 IU or more daily to help achieve healthy levels.  Do not exceed 4000 IU per day unless directed by a clinician as vitamin D is fat soluble and toxicity can lead to calcifications in the body.”

In order to make sure this is the right option for you, speak to a registered dietitian.

I think I may have S.A.D., what should I do?

Dr. Flamenbaum recommends getting a professional assessment before delving into the often risky world of self diagnosis.

“If someone came to me and told me they think they had seasonal depression, I would first do an assessment to determine the extent of their symptoms and the impact on their level of functioning. I would also get a detailed history to determine how recurrent it is; i.e. does it happen every winter?” says Dr. Flamenbaum.  “It’s also important to differentiate it from other forms of depression, including depressive reactions related to other factors (e.g., loss of job, relationship stress), as this would inform the focus of treatment and types of interventions that I would use. That’s why a full assessment would be important.”

When do you recommend booking a check-in with a physician or a psychologist?

“It’s always worth talking with a family doctor or psychologist, even if you are experiencing a milder version of seasonal depression,” says Dr. Rodrigues. “And it is definitely time to see someone if your symptoms or mindset are interfering with your daily life and affecting impact. A psychologist or other mental health professional will do a proper assessment and determine the best next steps for both immediate treatment and prevention in the future.”

Ask a Medcan psychologist | 4 back-to-school stress busters

Many people — some kids, most parents — are thrilled when school resumes. But along with the excitement of new beginnings comes back-to-school stress, which can affect both students and their parents.

“Stress is one of those things that doesn’t care if it is a positive or a negative,” says Dr. Mark Rothman, a psychologist at Medcan who works with children, youth, couples and families. “It is cumulative. So when your little stresses add up, they become big stresses. Then our body and our mind is fighting that stress; and that’s what depletes us.”

The best way to offset the negative stress at this time of the year, is to be proactive and prepared — with an emphasis on the ‘pre’. Anything you can do in advance, get done as fast as possible says Dr. Rothman.  Here are four back-to-school stress busters from Dr. Rothman.

Carve out regular time for ‘school-related material’

Ensure that the routine after school includes regular time for “school-related material time”.

“Calling it ‘school-related material time’ makes it a regular occurrence, even when kids say they have no homework,” says Dr. Rothman. “Even without homework, there’s a designated daily time when school-related material is reviewed, addressed or organized.”

This creates a regular schedule for at-home review and study sessions.

Parents must practice their routines, too

Just like students must return to a routine, parents should adopt their school routine: making lunches, managing clothes or uniforms, getting the car ready and ensuring the fridge is stocked with healthy back-to-school foods for lunches, snacks and dinners.

“Doing this type of preparation now minimizes the stress that we experience at the time that the transition takes place,” says Rothman.

At university: Make time management a priority

One of the biggest stresses that university-aged people have is time management. If possible, find a mentor or role model at school — maybe an older student or floor don — who can help suggest a reasonable schedule that includes both recreational and study time.

“It’s important to add routine where it doesn’t exist because in university you aren’t in school 8 a.m. to 4 p.m. Many schedules are very irregular,” says Dr. Rothman. “I recommend students approach school like a full-time job, and put 10 hours a day into school, every day.

“Maybe one day, a majority of that time is in class. Other days, that means you are doing self-directed or group study. Even if you don’t have class, dedicate a set amount of time to study every day. The other hours are designated for socializing, exercise, relaxation and rest.”

Dorm room check-in: Set weekly communication times

As for parents and university-aged kids: there’s a transition period when kids leave the nest for school.

“Some parents can feel very very taken for granted when their child doesn’t keep in touch, while university students could feel smothered if their parents are trying to get in touch regularly,” says Rothman, who recommends a dialogue to set up expectations of communication.  “This is really helpful to avoid parents waiting around and their kids not understanding why there’s anger or sadness when they do make contact.”

The solution? Create “contact times”, which are regularly established times for communication.

“Rather than waiting it out and seeing what it is like; create a plan, and then you can always change the plan. So if it is understood that we will talk on Thursdays or Sundays around 8 p.m. for 10-15 minutes and if those days/times don’t work — you just adjust. No problem! But at least it is a start.”

To learn more about Medcan’s Child & Youth services, please contact (416) 350-3621 or email childandyouth@medcan.com