The winter blues. When the season cools and the daylight lessens, sometimes we find that we don’t have our usual energy, agitated and depressed. Seasonal Affective Disorder (SAD) is a form of depression that is set off by seasons. It typically appears in the fall and winter and goes away in the spring or summer. Diagnosis may take up to 2 years to see a pattern. So how can you remedy or at least get through the seasons?
Therapies for Seasonal Affective Disorder
There are some therapies that have been effective in treating SAD. I will mention just a few here.
This therapy has been used for a few decades. It involves sitting in front of a light box, which filter out the ultraviolet rays and require 20-60 minutes of exposure to 10,000 lux of cool-white fluorescent light. This level of energy emulates a bright sunny day. Who doesn’t feel good on a sunny day. Treatment is once a day for 20-60 minutes in the morning until spring comes around. Price can start at $25 to $600. This is a great therapy that is easily accessible.
Finding a professional therapist to talk through the season to help you build an actionable plan to help cope with the season. Traditional cognitive behavioral therapy has been adapted for use with SAD (CBT-SAD). CBT-SAD relies on basic techniques of CBT such as identifying negative thoughts and replacing them with more positive thoughts along with a technique called behavioral activation. You can find what activities best engage you and give you pleasure. Working with a therapist proficient in understanding SAD you may find that you need medication and they can help you find the best option for you such as Selective Serotonin Reuptake Inhibitors (SSRIs), bupropion, another type of antidepressant, for treating SAD.
There are mixed reviews on vitamin D being useful for treating SAD. I for one find it effective, but perhaps in combination with these therapies above you can get good results. It never hurts to up your vitamin D whether in supplement form or upping you intake in vitamin D rich foods, and or getting plenty of outdoor time (yes even in winter) for some sunshine and exercise.
I think you knew this was coming. Massage has a rich evidence in helping alleviate depressive symptoms. How it works? It decreases the cortisol in the body that cause stress. It increases a person’s ability to get some good sleep which further reduces stress and anxiety. It has been shown in studies to be effective in alleviating Seasonal Affective disorder.
Find Your Joy Again
So now you have a battle plan. Eat well, exercise, have a person to talk to, get sunshine real or the electrical kind, take the medicine if you need it, and get regular massages through out the season. Do the things that bring you joy. Experiment in what activities you find refresh and de stress you and keep on doing it.
Congratulations! You’re pregnant. There are so many things to plan and look forward to. Besides the name of baby, the room colors, etc., the one thing that may be tough to decide on is who should be your care provider. Depending on where you live, your options may include, a family doctor, an OB/GYN, or a midwife. How do you choose? What are some things you can ask your potential candidates? I hope by the end of the article you’ll know what to ask and start thinking about what is important to you for your birth experience.
Where were you trained? What school did you attend for your training?
How long ago were you trained?
Please tell me a little bit about your practice?
How many births have you attended?
What are the kinds of births you have attended?
How many of those births were you there from start to finish?
Will you be available for my birth and is there any chance that someone else will attend?
If someone else will be attending my birth, who are they and can I meet with them?
When is it decided that a Cesarean is necessary?
What are your conditions that a Cesarean will be necessary?
Will you allow a VBAC (Vaginal Birth after Cesarean)?
Can I work with a doula?
Can I move around in labor?
If you’re speaking with an MD ask if they work with a nurse-midwife?
Questions specific to a midwife
Is there a backup midwife and if so, can I meet them?
What are the conditions that would require a physician’s referral of my care?
Will you allow an HBAC (Home Birth after Cesarean)?
You want to know the stats of the provider you are choosing. This can tell you what kind of care you will likely receive. If it is an OB/GYN or family doctor, they are most likely associated with a hospital and those statistics are a matter of public record. Here in NYS, you can go to http://profiles.health.ny.gov/
Things you will be looking for is what are the percentage of Cesarean sections, what are the percentage of vaginal birth Cesarean, What is the percentage of drug use in labor, the percentage of Epidurals, the percentage of vaginal births, and more. It is nice to be able to compare and contrast the hospitals you are looking at in comparison to each other and the national average.
Though it’s a big decision to decide on a care provider for you and your baby, just know that if you feel you are not getting the care you need with the provider you have chosen, no matter how far into the pregnancy you are, you can switch your care to another provider. Whoever your final candidates may be, ask family and friends for their recommendations or if they have had experiences with those particular care providers. The first thing we do in making a choice a household service or before hiring a mechanic, is ask friends who they recommend. How much more so care should be given in choosing a provider to attend on us as we bring our child into this? I wish you the best in choosing your provider as you build your birth team. Happy birthing!