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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

When I was a young girl I remember reading Little House On The Prairie and imaging what life was like in the winter back in those days. From what I recall, back then winter meant staying indoors for months, knitting, snowing, mending, cooking and basically trying to stay warm and avoid blizzards. Well now we have central heat, indoor plumbing and electricity to help combat the harsh outdoors. But we still have issues with the winter.

For those of us that don’t suffer from actual Seasonal Affective Disorder but are feeling the effects of winter, SparkPeople has some great tips on keeping your mood up this time of year. Nicole Nichols, Fitness Instructor Health Educator wrote a great post, “10 Cool Ways to Beat the Winter Blues.” I’ve provided an excerpt below. Read Nicole’s entire article at Spark People here.

The “winter blues” are characterized by the mild depression, lack of motivation, and low energy that many people experience during this cold season. Luckily, there’s a lot you can do to both prevent the blues from coming on and get yourself back to normal if they’re already here.

1. Exercise: Exercise isn’t only for maintaining your weight and staying healthy. It’s great for relieving the stresses of life. Plus, the effects of a good workout can last for several hours after you hit the showers. You’ll have more energy throughout the day, and your metabolism with stay elevated too

2. Eat a Healthy Diet: Avoid refined and processed foods (like white breads, rice, and sugar). These foods are not only devoid of the nutrients your body craves, but they zap your energy levels and can affect your mood—causing depression, lack of concentration, and mood swings. Try to incorporate more complex carbohydrates (whole wheat breads, brown rice, veggies, fruit) and get your daily 8 cups of water.

3. Get Some Rays: Did you know that sunlight improves your mood? Winter days are shorter and darker than other months, and because of the cold weather, a lot of people spend less and less time outdoors. Similar to exercise, sunlight exposure releases neurotransmitters in the brain that affect mood. Try to spend a little more time outdoors.  Keep your shades up during the day to let more light in. Sit near windows in restaurants and during class. Try changing the light bulbs in your house to “full spectrum” bulbs. These mimic natural light and actually have the same affects on your mind as the real thing.

4. Act on Your Wellness Goals: A recent study from the CDC showed a strong link between healthy behaviors and depression. Women who exhibited healthy behaviors (like exercising, not smoking, etc.) had less sad and depressed days than those whose behaviors were less than healthy.

5. Avoid Binge Drinking: Many people who feel down also tend to turn to alcohol when they’re feeling down. But alcohol is actually a depressant, and rather than improving your mood, it only makes it worse. Avoiding alcohol when you are already depressed is a good idea. Moderate drinking is fine for most people, but binge drinking (defined as having 5 or more drinks in one sitting) is never a healthy choice.

6. Give Yourself Something to Look Forward To: Plan something that’s exciting to you—a weekend trip, a day at the spa, a party (but keep #5 above in mind), or special event like a play, girls (or guys) night out, or sporting event.

7. Make relaxation part of your life: Work, class, family, friends, appointments, meetings—even if you enjoy being busy, everyone needs some time off. Don’t be afraid to say “No” to extra opportunities (covering a shift for a co-worker, bringing food to your son’s class party). Try to spend a few minutes each day doing nothing! Read a book or magazine, sleep in on the weekend, go to bed early, try some meditations, or take a yoga class.

8. Embrace the Season: Instead of always avoiding the cold and the snow—look for the best that it has to offer! Take up a winter sport like ice skating, snowboarding, hockey, or even sledding!

9. Get Social Support: Keep a mental list of these special people and don’t be afraid to ask for help or encouragement when you need it. Something as simple as a phone call, a chat over coffee, or a nice email or letter can brighten your mood.

10. Sleep Well: With a little time management, and some self-discipline, you can meet your shut-eye needs. Aim for 7-8 hours each night, and try to keep your bedtime and waking time consistent. That way, your sleeping patterns can normalize and you’ll have more energy. Try not to oversleep—those 12-hour snoozes on the weekend can actually make you MORE tired. Don’t forget naps! A short (10-30 minute) afternoon nap may be all you need to re-energize midday.

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapists, Certified Wellness Coach, ACSM Personal Trainer

Lately everyone I talk to is feeling the effects of winter. In Chicago we’ve had little to no sunshine, lots of cold weather and snow, snow, snow. Crankiness, irritability, more frequent colds and flues result.  But for some people, the winter blues may be more serious, they may have Seasonal Affective Disorder (also called SAD).

According to the MayoClinic, SAD is a an actual medical disorder: Seasonal affective disorder  is a type of depression that occurs at the same time every year. If you’re like most people with seasonal affective disorder, your symptoms start in the fall and may continue into the winter months, sapping your energy and making you feel moody.

What Are the Symptoms of SAD?

Seasonal affective disorder is a cyclic, seasonal condition. This means that signs and symptoms come back and go away at the same time every year. Usually, seasonal affective disorder symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer. Some people have the opposite pattern and become depressed with the onset of spring or summer. In either case, problems may start out mild and become more severe as the season progresses.

Fall and winter seasonal affective disorder (winter depression)
Winter-onset seasonal affective disorder symptoms include:

  • Depression
  • Hopelessness
  • Anxiety
  • Loss of energy
  • Social withdrawal
  • Oversleeping
  • Loss of interest in activities you once enjoyed
  • Appetite changes, especially a craving for foods high in carbohydrates
  • Weight gain
  • Difficulty concentrating and processing information

What Causes SAD?

The specific cause of seasonal affective disorder remains unknown. It’s likely, as with many mental health conditions, that genetics, age and, perhaps most importantly, your body’s natural chemical makeup all play a role in developing the condition. A few specific factors that may come into play include:

  • Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may disrupt your body’s internal clock, which lets you know when you should sleep or be awake. This disruption of your circadian rhythm may lead to feelings of depression.
  • Melatonin levels. The change in season can disrupt the balance of the natural hormone melatonin, which plays a role in sleep patterns and mood. Talk to your doctor to see whether taking melatonin supplements is a good option.
  • Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in seasonal affective disorder. Reduced sunlight can cause a drop in serotonin, perhaps leading to depression.

How Do I Know if I Have SAD or Just Hate Winter?

To help diagnose seasonal affective disorder, your doctor or mental health provider will do a thorough evaluation, which generally includes:

  • Detailed questions. Your doctor or mental health provider may ask about your mood, seasonal changes in your thoughts and behavior, your lifestyle and social situation, and sleeping and eating patterns, for example. You may also fill out psychological questionnaires.
  • Physical exam. Your doctor or mental health provider may do a physical examination to check for any underlying physical issues that could be linked to your depression.
  • Medical tests. There’s no medical test for seasonal affective disorder, but if your doctor suspects a physical condition may be causing or worsening your depression, you may need blood tests or other tests to rule out an underlying problem.

Seasonal affective disorder is considered a subtype of depression or bipolar disorder. Even with a thorough evaluation, it can sometimes be difficult for your doctor or mental health provider to diagnose seasonal affective disorder because other types of depression or mental health conditions may mimic seasonal affective disorder.

How Can I Treat My SAD?

Treatment for seasonal affective disorder may include light therapy, medications and psychotherapy.

Light therapy
In light therapy, also called phototherapy, you sit a few feet from a specialized light therapy box so that you’re exposed to bright light. Light therapy mimics outdoor light and appears to cause a change in brain chemicals linked to mood. This treatment is easy to use and seems to have few side effects.

Although light therapy is widely used and appears to be helpful, it isn’t clear how light therapy works and how effective it is in treating seasonal affective disorder. Before you purchase a light therapy box or consider light therapy, talk to your doctor or mental health provider to make sure it’s a good idea and to make sure you’re getting a high-quality light therapy box.

Medications
Some people with seasonal affective disorder benefit from treatment with antidepressants, especially if symptoms are severe. Medications commonly used to treat seasonal affective disorder include:
• Bupropion. An extended-release version of the antidepressant bupropion (Wellbutrin XL) may help prevent depressive episodes in people with a history of seasonal affective disorder.
• Other antidepressants. Antidepressants commonly used to treat seasonal affective disorder include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor)

Psychotherapy
Psychotherapy is another option to treat seasonal affective disorder. Although seasonal affective disorder is thought to be related to biochemical processes, your mood and behavior also can add to symptoms. Psychotherapy can help you identify and change negative thoughts and behaviors that may be making you feel worse. You can also learn healthy ways to cope with seasonal affective disorder and manage stress.

Do It Yourself Treatments for SAD

  • Make your environment sunnier and brighter. Open blinds, add skylights and trim tree branches that block sunlight. Sit closer to bright windows while at home or in the office.
  • Get outside. Take a long walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun. Even on cold or cloudy days, outdoor light can help — especially if you spend some time outside within two hours of getting up in the morning.
  • Exercise regularly. Physical exercise helps relieve stress and anxiety, both of which can increase seasonal affective disorder symptoms. Being more fit can make you feel better about yourself, too, which can lift your mood.

Mind-body therapies that may help relieve depression symptoms include:

  • Acupuncture
  • Yoga
  • Meditation
  • Guided imagery
  • Massage therapy

Read the entire article at MayoClinics’ website here.

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By Harvard Health Publications

Since the 1970s, meditation and other stress-reduction techniques have been studied as possible treatments for depression and anxiety. One such practice, yoga, has received less attention in the medical literature, though it has become increasingly popular in recent decades. One national survey estimated, for example, that about 7.5% of U.S. adults had tried yoga at least once, and that nearly 4% practiced yoga in the previous year.

Yoga classes can vary from gentle and accommodating to strenuous and challenging; the choice of style tends to be based on physical ability and personal preference. Hatha yoga, the most common type of yoga practiced in the United States, combines three elements: physical poses, called asanas; controlled breathing practiced in conjunction with asanas; and a short period of deep relaxation or meditation.

Many of the studies evaluating yoga’s therapeutic benefits have been small and poorly designed. However, a 2004 analysis found that, in recent decades, an increasing number have been randomized controlled trials — the most rigorous standard for proving efficacy.

Available reviews of a wide range of yoga practices suggest they can reduce the impact of exaggerated stress responses and may be helpful for both anxiety and depression. In this respect, yoga functions like other self-soothing techniques, such as meditation, relaxation, exercise, or even socializing with friends.

Taming the stress response

By reducing perceived stress and anxiety, yoga appears to modulate stress response systems. This, in turn, decreases physiological arousal — for example, reducing the heart rate, lowering blood pressure, and easing respiration. There is also evidence that yoga practices help increase heart rate variability, an indicator of the body’s ability to respond to stress more flexibly.

A small but intriguing study further characterizes the effect of yoga on the stress response. In 2008, researchers at the University of Utah presented preliminary results from a study of varied participants’ responses to pain. They note that people who have a poorly regulated response to stress are also more sensitive to pain. Their subjects were 12 experienced yoga practitioners, 14 people with fibromyalgia (a condition many researchers consider a stress-related illness that is characterized by hypersensitivity to pain), and 16 healthy volunteers.

When the three groups were subjected to more or less painful thumbnail pressure, the participants with fibromyalgia — as expected — perceived pain at lower pressure levels compared with the other subjects. Functional MRIs showed they also had the greatest activity in areas of the brain associated with the pain response. In contrast, the yoga practitioners had the highest pain tolerance and lowest pain-related brain activity during the MRI. The study underscores the value of techniques, such as yoga, that can help a person regulate their stress and, therefore, pain responses.

Improved mood and functioning

Questions remain about exactly how yoga works to improve mood, but preliminary evidence suggests its benefit is similar to that of exercise and relaxation techniques.

In a German study published in 2005, 24 women who described themselves as “emotionally distressed” took two 90-minute yoga classes a week for three months. Women in a control group maintained their normal activities and were asked not to begin an exercise or stress-reduction program during the study period.

Though not formally diagnosed with depression, all participants had experienced emotional distress for at least half of the previous 90 days. They were also one standard deviation above the population norm in scores for perceived stress (measured by the Cohen Perceived Stress Scale), anxiety (measured using the Spielberger State-Trait Anxiety Inventory), and depression (scored with the Profile of Mood States and the Center for Epidemiological Studies Depression Scale, or CES-D).

At the end of three months, women in the yoga group reported improvements in perceived stress, depression, anxiety, energy, fatigue, and well-being. Depression scores improved by 50%, anxiety scores by 30%, and overall well-being scores by 65%. Initial complaints of headaches, back pain, and poor sleep quality also resolved much more often in the yoga group than in the control group.

One uncontrolled, descriptive 2005 study examined the effects of a single yoga class for inpatients at a New Hampshire psychiatric hospital. The 113 participants included patients with bipolar disorder, major depression, and schizophrenia. After the class, average levels of tension, anxiety, depression, anger, hostility, and fatigue dropped significantly, as measured by the Profile of Mood States, a standard 65-item questionnaire that participants answered on their own before and after the class. Patients who chose to participate in additional classes experienced similar short-term positive effects.

Further controlled trials of yoga practice have demonstrated improvements in mood and quality of life for the elderly, people caring for patients with dementia, breast cancer survivors, and patients with epilepsy.

Benefits of controlled breathing

A type of controlled breathing with roots in traditional yoga shows promise in providing relief for depression. The program, called Sudarshan Kriya yoga (SKY), involves several types of cyclical breathing patterns, ranging from slow and calming to rapid and stimulating, and is taught by the nonprofit Art of Living Foundation.

One study compared 30 minutes of SKY breathing, done six days a week, to bilateral electroconvulsive therapy and the tricyclic antidepressant imipramine in 45 people hospitalized for depression. After four weeks of treatment, 93% of those receiving electroconvulsive therapy, 73% of those taking imipramine, and 67% of those using the breathing technique had achieved remission.

Another study examined the effects of SKY on depressive symptoms in 60 alcohol-dependent men. After a week of a standard detoxification program at a mental health center in Bangalore, India, participants were randomly assigned to two weeks of SKY or a standard alcoholism treatment control. After the full three weeks, scores on a standard depression inventory dropped 75% in the SKY group, as compared with 60% in the standard treatment group. Levels of two stress hormones, cortisol and corticotropin, also dropped in the SKY group, but not in the control group. The authors suggest that SKY might be a beneficial treatment for depression in the early stages of recovery from alcoholism.

Potential help for PTSD

Since evidence suggests that yoga can tone down maladaptive nervous system arousal, researchers are exploring whether or not yoga can be a helpful practice for patients with post-traumatic stress disorder (PTSD).

One randomized controlled study examined the effects of yoga and a breathing program in disabled Australian Vietnam veterans diagnosed with severe PTSD. The veterans were heavy daily drinkers, and all were taking at least one antidepressant. The five-day course included breathing techniques (see above), yoga asanas, education about stress reduction, and guided meditation. Participants were evaluated at the beginning of the study using the Clinician Administered PTSD Scale (CAPS), which ranks symptom severity on an 80-point scale.

Six weeks after the study began, the yoga and breathing group had dropped their CAPS scores from averages of 57 (moderate to severe symptoms) to 42 (mild to moderate). These improvements persisted at a six-month follow-up. The control group, consisting of veterans on a waiting list, showed no improvement.

About 20% of war veterans who served in Afghanistan or Iraq suffer from PTSD, according to one estimate. Experts treating this population suggest that yoga can be a useful addition to the treatment program.

Researchers at the Walter Reed Army Medical Center in Washington, D.C., are offering a yogic method of deep relaxation to veterans returning from combat in Iraq and Afghanistan. Dr. Kristie Gore, a psychologist at Walter Reed, says the military hopes that yoga-based treatments will be more acceptable to the soldiers and less stigmatizing than traditional psychotherapy. The center now uses yoga and yogic relaxation in post-deployment PTSD awareness courses, and plans to conduct a controlled trial of their effectiveness in the future.

Cautions and encouragement

Although many forms of yoga practice are safe, some are strenuous and may not be appropriate for everyone. In particular, elderly patients or those with mobility problems may want to check first with a clinician before choosing yoga as a treatment option.

But for many patients dealing with depression, anxiety, or stress, yoga may be a very appealing way to better manage symptoms. Indeed, the scientific study of yoga demonstrates that mental and physical health are not just closely allied, but are essentially equivalent. The evidence is growing that yoga practice is a relatively low-risk, high-yield approach to improving overall health.

Where To Find Yoga Classes

Yoga Chicago magazine is a free publication distributed around the Chicagoland area. It contains a directory of all yhe known yoga classes in the city and suburbs of Chicago. Other cities may have similar publications or online services. For the Yoga Chicago main class directory go to this link here.

There are also a number of great yoga DVD’s available from Amazon, or you may find them at Target, Best Buy or Whole Foods Markets:

Yoga for Beginners from Amazon here.

Yoga for Stress Relief from Amazon here.

Yoga for Every Body from Amazon here.

and Yoga for Inflexible People from Amazon here.

Working Well Massage also provides certified yoga instructors for your home or office.

Sources:

Brown RP, et al. “Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part I — Neurophysiologic Model,” Journal of Alternative and Complementary Medicine (Feb. 2005): Vol. 11, No. 1, pp. 189–201.

Brown RP, et al. “Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part II — Clinical Applications and Guidelines,” Journal of Alternative and Complementary Medicine (Aug. 2005): Vol. 11, No. 4, pp. 711–17.

Janakiramaiah N, et al. “Antidepressant Efficacy of Sudarshan Kriya Yoga (SKY) in Melancholia: A Randomized Comparison with Electroconvulsive Therapy (ECT) and Imipramine,” Journal of Affective Disorders (Jan.–March 2000): Vol. 57, No. 1–3, pp. 255–59.

Khalsa SB. “Yoga as a Therapeutic Intervention: A Bibliometric Analysis of Published Research Studies,” Indian Journal of Physiology and Pharmacology (July 2004): Vol. 48, No. 3, pp. 269–85.

Kirkwood G, et al. “Yoga for Anxiety: A Systematic Review of the Research,” British Journal of Sports Medicine (Dec. 2005): Vol. 39, No. 12, pp. 884–91.

Pilkington K, et al. “Yoga for Depression: The Research Evidence,” Journal of Affective Disorders (Dec. 2005): Vol. 89, No. 1–3, pp. 13–24.

Saper RB, et al. “Prevalence and Patterns of Adult Yoga Use in the United States: Results of a National Survey,” Alternative Therapies in Health and Medicine (March–April 2004): Vol. 10, No. 2, pp. 44–49.

For more references, please see www.health.harvard.edu/mentalextra.

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