Stay alert for seasonal affective disorder

Employ these strategies for keeping season affective disorder (SAD) at bay.

Hypothermia-related deaths on the rise in the United States
Hypothermia-related deaths on the rise in the United States

 Every day I drive to work and I pass a billboard. On the billboard is a comparison of the current temperature in the Philadelphia area and the temperature in southern Florida. There is usually at least a 30 degree difference, and the comparison is accompanied by a smiling family splashing playfully in the clear blue ocean water.

I glare at that happy family through my six layers of clothing. They are the bane of my existence. 

It is that time of year when the holidays are over, the groundhog says we have six more weeks of winter, and seasonal depression sets in. For me -- as I'm plucking rock salt out of my socks, wrestling my dog into her sweater, and trying to prevent my eyelids from freezing shut -- it is also the time of year when I start swearing I will be moving south the first chance I get.

In reality, I know I won't be moving away from my family any time soon and instead have to take the necessary steps to make sure I remain unaffected by seasonal affective disorder, appropriately referred to as SAD.

As health-care providers, we are always reminded to screen our patients for SAD. The winter months force everyone inside, the amount of outdoor activities decrease, and people are no longer getting as much vitamin D. 

We are told to look for signs of moodiness and depression in patients that normally have good mental health. We are encouraged to watch for people that want to sleep all day, are gaining weight, and don't want to go about their normal activities. We are told to screen everyone else, but are we screening ourselves? As clinicians, we often make the worst patients. 

We tend to do things such as forego physicals because we spend so much time in healthcare settings, the last thing we want to do in our spare time is spend it at the doctor's office. But it is important to keep these appointments, because we need someone to keep tabs on our wellbeing and hold us accountable for staying healthy. 

For those of us that work in windowless settings such as the emergency department (ED) or operation room (OR), the winter can be especially rough. We often arrive to work when it is dark out and leave work when it is dark out, and we can go for days without seeing a single ray of sunshine. It is extremely important that we are mindful to take care of ourselves. 

I continually remind myself that I have to stay on top of the winter blues before I succumb to them, and I have several rules set in place to ensure that I survive the winter.

Rule 1: Walk my dog

My dog is the very demanding type that will not let you get away with skipping her daily walk. She will cry and stare and bark at you until you are unable to accomplish whatever you are trying to do and are forced to take her for a walk to appease her. As much as I dread going out in the cold, (I absolutely hate the feeling of cold on my teeth) it does get me outside and in the sun for at least 20 minutes.


Rule 2: Go to the gym

Sometimes I am really good at exercising. Sometimes I am really bad at it. Sometimes my workout will consist of walking on the treadmill at two miles per hour while watching a riveting episode of Law & Order. While I debate the cardiovascular effects of this type of workout, there are actually several positives to it:I am keeping my body moving instead of sitting stagnate on my couch, and I am out of my house, appreciating a change of scenery.


Rule 3: Plan a trip

For those that have a family, this can be a little harder to manage. But if possible, I recommend planning a trip, no matter how short. Each year I try and plan a weekend away towards the end of February and in a warmer location. It is also a great time for conferences, as many are held this time of year in warmer climates. 

Knowing that there are flip flops in my future does wonders for my spirit every winter and gives me the extra boost I need to make it to spring. My weekend getaway this year is down in Florida. I have a sneaking suspicion it had something to do with a billboard.

Abiding by these rules helps me avoid the winter blues. I often give this advice to patients as well. SAD can affect both patients and health-care professionals, and many suffer from the condition without even realizing it. As health-care providers, we need to make sure we are taking care of ourselves so that we can take care of others. 

Jillian Knowles, MMS, PA-C, is an emergency medicine physician assistant in the Philadelphia area.

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