Wednesday, December 7, 2011

Seasonal Affective Disorder (SAD): What It Is, & What To Do About It

"The Color Of Springtime Is In The Flowers, The Color Of Winter Is In The Imagination." ~Terri Guillemets

SAD. Just reading the word makes you, well, sad. As a health care provider in the state of Oregon, I'm all too familiar with this seasonal disorder. It rivets many of my patients, and can send them reeling backwards in both mood, activity level, anxiety and sleep.

The onset of the dark, winter months in Oregon can be brutal. My father, raised in Alaska, often remarked how the winters in Oregon "are tropical compared to where I grew up." Living on the coast in Oregon (one of the wettest, darkest parts of the Pacific N.W.) is nothing short of relief for him.

I grew up there, in Newport, OR., nestled 1/2 way between San Francisco and Seattle, Newport is a bustling fishing town. Its cold, stormy winter waters have produced some of the most prominent American artists, awe-struck with the powerful coastline and old growth forests that line it.

Newport, OR. Where I Was Born & Raised. Home To Some Of The Most Spectacular Coastal Storms Around.

While the scenery is stunning, the familiar sound of the seagulls soothing, the winters there are made only for the hardy at heart. As I would watch the fishermen navigate their boats during thunderous coastal storms, I could only wonder what type of person could brave that darkness and the roaring, cold seas day after day. The very dampness that hangs in the overcast, foggy air during the winters is enough to chill one to the bone. Your only retreat is a fire, family and the warmth of home.

There are a few that thrive in winters such as Newport's. My grandma, Jo Ellen Barton, gained her greatest inspiration from the harsh environment. She would run 10 miles along "Coos Bay" everyday, come home make thistle soup (My thoughts as a child? Bleh!), and shut off the world during the wet, winter months. After her winter hibernation, she would showcase her most stunning paintings at the top art galleries all over the world. She became one of Oregon's best known coastline landscape painters. She reveled in the darkness the weather provided, and used it to fuel her artistic creativity.

She was accustomed, however, to raising three rambunctious boys and a young daughter in the harsh wilderness of Alaska. She lived on a meager houseboat, with her family, hunting grouse for dinner at night. Her husband, a bush pilot and logger, frequently went missing for days on end in deadly arctic storms. No where to be found until one day, he would stagger in, disheveled and worn, asking for "a beer and a bed." This became Grandma Barton's way of life. "Taking the bull by the horns," (as she often told me to do) she decided that to leave fate up to her husband, and his outdated airplane radio, was to live in a state of constant worry. She promptly went down and got her bush pilot license, so that she could look for her husband amongst the frozen tundra, should the need arise.

Alaska, My Father's Family's Home. Long Nights...Short Days...

Grandma Barton's constitution was one of survival. It was hardy. It was practical. It was no nonsense. It served her well, as she finished out her life along the dark coastline of Oregon, painting and running in the pelting rain.

My Favorite Painting Of Grandma Barton's...Hanging In My Home Office :)

Many of us do not relish the darkness as my family from Alaska does. Oregon can seem almost inhospitable to many in the winter. SAD, or "Seasonal Affective Disorder," can affect people's quality of life here.

Let us take a closer look at SAD. What is it? Who is affected? What can we do about it?

“Seasonal affective disorder (SAD) is a variation of depression that plagues normally healthy people with depressive symptoms during the winter. These symptoms include feelings of hopelessness, anxiety, loss of energy, social withdrawal, oversleeping, loss of interest in hobbies, carbohydrate cravings, weight gain, and difficulty concentrating and processing information. Approximately 6 percent of Americans experience SAD, and another 14 percent experience sub-syndromal Seasonal Affective Disorder, a milder form of SAD.”

The above statement seems a bit dismal. Yet, there are things within our control that we can do to help mitigate the effects of SAD. I do find it interesting to note that 3 out of 4 SAD sufferers are women.

Across the board experts agree that there are fundamental things that should be done to work with a SAD patient. There is now an acronym, widely agreed upon by health care providers, to be shared with their patients: S.E.L.F. (serenity, exercise, love, and food). Let me explain these, as they sound a bit simplistic.

SERENITY: Admit you have a problem. That tends to be the biggest hurdle, yet the most important one to confront. Many of my patients have stated that "I couldn't figure out what was wrong with me for years. I just kept trying to pretend I was happy, when I wasn't. It always came on with the onset of shorter days." I hear this a lot. As soon as a label or diagnosis was given, there was a sense of relief for them. The old black-and-white Dracula flicks admonish "If you can name the demon, you can get rid of it." That's really how it is with depression, addiction or dis-ease. First, we need to acknowledge there is something to treat and be pro-active about. With this step comes a deep sense of serenity. A peace in confirming that there is something "off" we need to come to grips with. Once we come to that realization, we can move forward with treatment and lifestyle changes.

EXERCISE: As a certified fitness trainer, I can't give enough reasons why regular exercise is of benefit. From sleep, to mood, to overall body strength and wellness, it can't be beat. Exercise has been termed "Nature's Great Anti-Depressant." I would venture to say that's accurate. It gives a person a deep sense of satisfaction and accomplishment, particularly when the dark winter months tell you to do anything but go outside. When one uses will-power to push through the lethargy of winter's short days to go for a run (yes, even in -12 degrees for me last year), whether the foe is ice, rain, sleet or snow, the reward is a cascade of "feel good" endorphins that permeate your body and psyche all day long. Is this important year round? Absolutely. Is this particularly important for people experiencing the depression of SAD? Its more crucial during winter for these folks than any other time of the year. In addition, exercise can off-set any winter-holiday eating choices that are outside of our norm.

My father used to tell me stories as a child of the dog-sled mushers who would run the "Iditarod" race, braving the coldest Alaskan storms over a distance of 1,150 miles. For the top mushers that takes almost 24 hrs. a day over 9 days. For the "average" musher, it takes approximately 12 days. Can you imagine? The mushers that train for that race train in the darkest of night, under the coldest conditions. It takes some "hutzpah!" to do that. If they can do that, you CAN get to a heated gym, with jacuzzi and sauna available for you after your workout. Those mushers don't have any special advantage over you. Its pure will power and determination to not let the elements get to them, and affect their spirit. Just remember: there is ALWAYS someone training in more challenging conditions than you. This helps me put things into perspective when I have 2 Malamutes pawing the front door to go outside, when the day is dark, the ice is thick and the snow is knee-deep.

My Sweet Girl, Sierra (R.I.P.), After We Dog-Sledded In Snoqualmie, WA., 2002

I moved to Bend 3 years ago. I'm not a skier or snowboarder. I've been on skis one time, when I was in high school, for about 1/2 hr. (so I don't really count it). Snowboarding? I never say never, but I do have a weird "thing" about being strapped into a contraption (bizarre, I know...I guess everyone has their "thing"). I like board sports, but I don't like being strapped to one. Is it time to conquer my dislike of this? Perhaps. I wouldn't mind trying snowboarding.

What I'm getting at is that I live about 25 mins. from "Mt. Bachelor," and yes, I admittedly don't ski or snowboard. This is completely weird for a "Bend-ite" to say. Most of my friends here don't just snowboard, they X-C ski, skate ski, tele-ski, you name it.

Last year, I thought "I better make friends with this snow thing. After all, I moved to Bend to get away from the rain." I do tend to "up" my "CrossFit" in the winter, and head to the rock gym more in the winter also, but mind you, I have 2 VERY "chatty" dogs, who don't care if I just went to the gym or not. They want out, and I'm not talking about a mere walk around the block. They want to run, pull and drag things in the snow, and they don't care at all if I would rather be in my slippers or in a hot bath.

Last year I was already on a roll with trail-running, so sought out an easy way to continue my running, with minimal equipment, and not a lot of hassle. Voila! Snowshoe-running! Thanks to my pal, ultra-runner, Laura Kantor, I got hooked. I found a way to exercise in the dead of winter, outside in the elements, that was a win-win for both me and the pups. I even ended up liking it so much that I placed 2nd in my age division for the 10k "Mt. Hood Snowshoe Scramble" (thanks for encouraging me to do that, Laura :)

"Mt. Hood 10k Snowshoe Scramble," 2nd Place In Age Division, Jan. 2010

Point? There is ALWAYS a way to exercise, even in the winter outside. Believe me, once you get on a roll with snowshoe-running, X-C skiing, etc. you'll be warm in no time...and its fun! :)

I Also Discovered This Past Year That I *LOVE* Climbing Waterfall Ice, Ouray, CO. (a.k.a. "Little Switzerland," or "The Ice Climbing Capitol Of The U.S."), Jan. 2010

Building Ice Anchors With My Girlfriends At The "Ouray Ice Park," Ouray, CO., Jan. 2010

I had a girlfriend say to me, "I just need something to motivate me to get outside when its cold." My suggestion? Get a cold-hardy pup! She took my advice, and is now logging more miles than me with her pup in the winter. She is a single woman who lives and runs alone, and is now relishing having a companion who not only gives her a sense of security, but motivates her to make that first step out the door when the snow is blowing sideways. A win-win. She rescued her dog from the same Malamute rescue I did mine (www.wamal.com) She's so happy to have a winter-loving friend now. :)

My Winter "Motivators," (R to L) Tallon (a.k.a. "Fatty Pajamas) & Anok. The coldest recorded temperature an Alaskan Malamute has spent over 1 month in? -80 F in Antarctica. Watch the movie "Eight Below" for the story :)

LOVE: Who doesn't need love? We all need to give it, and receive it. Its important that folks who suffer with SAD communicate to their friends and family that they're experiencing SAD, and could use some extra support during the winter months. This may cross-over with the "exercise" category, and create opportunities for a "buddy system," so that they go and workout with friends and family. Maybe it means taking more time for self-love and doing some counseling, therapy work, journaling or other nurturing activities. Receiving acupuncture and/or massage is a very nourishing, nurturing way to treat oneself in the winter. There are specific acupuncture protocols and needling-depth techniques that are more employed in the winter. Write down some words (don't judge them, just write) that come to your mind when you hear the word "Love." Pursue those. Maybe it means taking yourself out on a date (yes, it IS *fun*). Or perhaps treating yourself to a vacation, a play, concert, or a poetry reading. Whatever it is, make sure it nourishes you from the inside out.

The holidays can be rough for some people. Christmas, Hanukkah, Solstice, Kwanzaa...whatever you celebrate, if you suffer from SAD, don't celebrate alone. Surround yourself with community, friends and family that you experience joy with. Being afflicted with SAD can be hard enough. Doing it alone makes it more difficult.

Take The Time To Have A Sit-Down Dinner With Friends & Loved Ones Over The Holidays

FOOD: We all eat. Hopefully, three times a day at least. Food is a big topic. One I'm constantly addressing via social media, through public speaking venues, magazine articles, my blog and with my patients. It can feed our souls, or feed our fears and darkest emotions. It is very important, particularly in the darkest of winter to determine your motivation for eating. Cravings don't always mean your hungry. They can mean you're tired, thirsty, depressed, etc. Be a "food detective," if you're experiencing SAD and having ongoing cravings. Journal where you think they're REALLY coming from. Are there un-dealt with emotions that need to be processed and let go of? If so, I promise a bowl of macaroni and cheese, will not help you. The feeling will just come back. With that being said, food can also be a delicious, decadent part of life. I truly learned to enjoy food in Paris. The French and Italians relish every last bit of their food. It is edible art to them, as it should be. Take time to eat communal meals, meals in silence, meals with laughter, and meals by candlelight. Experience every nuance of delicacy and nutrition your food offers you. There is an old saying "Let thy food by thy medicine, and medicine thy food." (Paracelsus) It is true. Your food can be your medicine. Take time to lovingly prepare it, or take yourself out to a beautiful meal prepared with attention by top chefs. It is a real treat when viewed this way.

I think its also very powerful to turn one's grief or SADness into joy for others. It takes us out of ourselves and our own anguish. Consider offering food to those less fortunate than you around the holidays. Volunteer at a soup kitchen. Donate food to a local shelter. Bake something nourishing for an elderly neighbor. In this way too, we are nourished by food. It is as much joy to share it as to
receive it.

Ammachi, Recipient of The United Nations "Gandhi Peace King Award," Humanitarian From Kerala, India. Feeding The Poor In The Slums Of Bangalore, India

"Let Us Love Winter, For It Is The Spring Of Genius." ~Pietro Aretino