New Hampshire Women Magazine February 2019

COMPLIMENTARY

MONTH YEAR / ISSUE NO

NEW HAMPSHIRE

WO MEN MAGAZINE celebrating the women of New Hampshire

THE HOME

ISSUE

BUILDING HER DREAM

PAMELA HODGKINS INTERIOR DESIGNER - HOUSE FLIPPER - AIRBNB’ER

Inside: Your Cardiovascular Health

pg. 6

nhwomenmagazine.com / VOL 2 ISSUE 2 / 1

NEW HAMPSHIRE WOMEN MAGAZINE

CONTENTS //

IN THIS ISSUE 10 COVER WOMAN: Pamela

Hodgkins: Building Her Dream by Crystal Ward Kent Since launching

her business just a year ago, she and her team have transformed five homes into beautiful, highfunctioning spaces. Along the way, she has earned the respect of builders and craftsmen, proving that a young woman can be successful in the male-dominated building world.

10

06 DARTMOUTH-HITCHCOCK: Women’s Cardiovascular Health

Cardiovascular diseases remain the most common cause of death among women. In the United States, approximately one in four women die each year due to cardiovascular diseases. “Though trends are improving, a majority of women remain unaware of their risk,” says Bina Ahmed, MD, FACC, Interventional Cardiology at Dartmouth-Hitchcock Medical Center. To ensure optimal cardiovascular health, it is important to understand the risk factors and discuss them with your primary care provider.

11

9

12 GYNECOLOGICAL CANCER: WHAT YOU NEED TO KNOWGynecologic cancers start

15 DON’T BE SAD: Addressing Seasonal Affective Disorder Anyone can get the “winter blues,” particularly in northern states where it seems the cold and darkness will never end. However, some individuals are impacted by a more serious condition known as seasonal affective disorder.

in a woman’s reproductive organs.

The most common diagnoses are ovarian, cervical and uterine cancer, but other types include vaginal and vulvar cancer. While they are often discussed as a group, each gynecologic cancer has its own set of distinct symptoms and risk factors. Some possible symptoms include abnormal vaginal bleeding or discharge, feeling full too quickly after eating, pelvic pain or pressure, bloating, and more frequent or urgent need to urinate, among others.

2 / VOL 2 ISSUE 2 / NEW HAMPSHIRE WOMEN MAGAZINE

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9 ASK THE PEDIATRIC SURGEON: Dear Dr. Soukup, My 12-year-old daughter is very overweight and I am worried about her future. What can I do?

-Anonymous

15

32

THE HOME ISSUE

PUBLISHER’S NOTE

H

Home: A place treasured by so many. A place that has so many meanings. A place held in our hearts when thinking of a simpler time, a house where you hang your hat today, or maybe a place we look forward to one day in the future. I’d like to pose a question that may help create a new place to call Home. And, this is for my fellow women who have struggled with anxiety.

What would happen if we started to call Home the place that sits right in the center of ourselves? That part of ourselves that we talk to every day. That little voice inside of us that knows deep down there’s something so meaningful about why we are here and what life all means. What if this place - this tiny, sacred place that only we truly know, can be Home.

I pose this question because, for me, and I believe so many more, the thought of carrying around the comfort of our Home right inside of us may make this intense world a bit more easy to navigate.

Now for the big question: How do we make this happen? Well, I’m still working on that. Currently, it’s a theory, but one that really warrants pursuit. If you’ve meditated, you probably have felt those few glorious minutes within your practice (in between trying not to think about your shopping list or if that email earlier was a hack) when you just were. That quiet place that felt safe, at peace, still. I’m pretty sure that this is the place we can call Home.

I think that this space within us is also recognized during tons of other times in our lives as well.

Maybe while walking on the beach, driving in the car alone on

a beautiful day, walking the dog in the snow, listening to classical music. I think the point of it is this place is recognized when our free styling, constantly-thinking mind is slowed down and we are truly in the present moment. I know this term, present moment, has been overused lately, but I can’t think of a better way to describe it? Present moment awareness? Being in the moment? The point here is that when our minds are slowed and life is contemplated in the current space we are living - there’s a true sense of calm and of peace.

I think once you’ve felt it, it becomes easier to recall it. For some it may have a spiritual aspect to it, others may have a feeling of being in tune with nature, others might feel a sense of internal connection.

The practice of recalling that sense of Home for us is important.

Without practice the feeling can be fleeting and leave us pretty quickly when life gets hectic. In the process of our practice, recall becomes easier. The greatest gift of this recall, is that we can pull up the feeling of being Home wherever we are. Crazy traffic jam? Recall Home. Moment of shear panic in a crowded room? Recall Home.

Overwhelmed with juggling the kids and your work? Recall Home.

Breathe. Recall Home.

Having the comforts of Home live inside of us could potentially become the biggest reduction of stress and anxiety in our lives. The most important part is to practice recalling it. The more we do, the more we can harness it in times of great stress. I think this idea truly encompasses the simple phrase: There’s no place like Home.

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THEY’RE TALKING, ARE WE LISTENING? F O R PA R E N T S , E D U CATO R S A N D CO M M U N I T Y

Dartmouth-Hitchcock will host a two-day Summit focused on our youth. On Friday, April 5, invited high-school aged students from across the State of New Hampshire will come together to discuss the challenges they face, celebrate successes and develop solutions. Parents, educators, legislators and anyone interested in the pressures our youth face are invited to attend on Saturday, April 6. Students' voices from Day One will be heard, and observations from the topic experts who attended the previous day's discussion will be shared.

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- Academic Pressures - Addiction - Advocacy - Bullying and Cyberbullying - Community Support - Eating Disorders - Race and Gender Equality - Self Harm - Sexuality, Gender and Sexual Identity - Using Social Media for Good

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Women’s Cardiovascular Health Cardiovascular diseases remain the most common cause of death among women. In the United States, approximately one in four women die each year due to cardiovascular diseases.

“Though trends are improving, a majority of women remain unaware of their risk,” says Bina Ahmed, MD, FACC, Interventional Cardiology at Dartmouth-Hitchcock Medical Center

To ensure optimal cardiovascular health, it

is important to understand the risk factors and discuss them with your primary care provider.

“The priorities remain raising awareness so that women are paying attention to their overall cardiovascular health when it counts the most. In addition, we need to continue efforts toward funding research that helps us understand potential differences between men and women and the various cardiovascular disease like coronary artery disease and stroke,” says Ahmed.

What is heart disease?

Heart disease specifically refers to coronary artery disease, which is due to plaque buildup in the coronary arteries, the primary arteries that supply blood, oxygen and nutrients to the heart. The most common cause of a heart attack usually is a sudden blockage of one or more of the heart arteries.

Though the majority of women present with predictable symptoms such as chest pain, women can present with less typical associated symptoms such as nausea, shoulder/back pain or shortness of breath.

Most heart attacks if diagnosed in a timely manner, can be treated.

There are other cardiovascular diseases like stroke, heart failure and hypertension, which also are a concern for women, especially after menopause.

What are the main risk factors for heart disease?

•

High blood pressure

•

High cholesterol

•

Obesity

•

Inactivity

•

Smoking

•

Diabetes

According to the Centers for Disease Control (CDC) “high blood pressure, high LDL cholesterol and smoking are key risk factors 6 / VOL 2 ISSUE 2 / NEW HAMPSHIRE WOMEN MAGAZINE

for heart disease. About half of Americans (49 percent) have at least one of these three risk factors.”

While the main risks are similar to those for men, women need to be particularly aware of them starting in the perimenopause (roughly between ages 40-60). As women age, the likelihood of developing heart disease associated with one of these factors increases, so preventing, controlling and treating them becomes vital.

One particular risk factor to highlight among women is diabetes. “Diabetes is considered the risk equalizer for heart disease among women; especially among younger women. Younger women with diabetes are at an increased risk of sudden heart attacks and consequently tend to have the worst long-term outcomes,” says Ahmed. Women with diabetes likely have other risk factors such as obesity, high blood pressure and high cholesterol, which compounds their problem. More aggressive therapies, which optimize diabetes and blood pressure control in addition to adopting a healthier lifestyle is very important.

How can you protect your heart health?

Manage high blood pressure - According to the CDC, “about one of three U.S. adults—or about 75 million people—have high blood pressure,” a condition that occurs when the force of blood flowing through your body is too high. High blood pressure hardens the arteries, causing decreased blood flow and can ultimately damage your heart, brain and kidneys.

Control cholesterol - Cholesterol is a substance made and used by your body to create cells and hormones, but producing too much can cause build up in the heart’s arteries, resulting in blockages. While cholesterol is produced by your body, you get a substantial amount of the “unhealthy” cholesterol by consuming foods high in fat.

Eating healthy is the first line of defense against high cholesterol.

Maintain a healthy weight - Being overweight or obese increases the risk of developing heart disease. Ask your doctor to help determine a healthy weight for you.

Stay active - An active lifestyle helps you maintain a healthy weight and it can help to lower blood pressure and cholesterol.

According to the CDC, “the Surgeon General recommends two hours and 30 minutes of moderate-intensity exercise, like brisk walking or bicycling, every week.”

Stop smoking - Smoking damages the lining of blood vessels, thickens the blood, making it more likely to clot, and increases build-up of plaque (fat, cholesterol, calcium and other substances), which can block or restrict lock blood flow.

While risk factors such as inactivity and smoking are personal choices, other conditions such as high blood pressure or high cholesterol could be due to age or genetics. “In these instances, early diagnosis can be lifesaving. Many treatments are available to help effectively lower the risk of cardiovascular diseases such as heart attacks,” says Ahmed. “In addition, lifestyle therapy with diet and exercise can make a significant difference.”

Stay Informed by talking with your doctor Dr. Ahmed emphasizes the importance of being engaged and keeping communications open with your provider. Have a conversation about your cardiovascular health and ask: •

“What is my cardiovascular risk?”

•

“Are my blood pressure, cholesterol and weight within appropriate standards?”

•

“How can I improve my risk of cardiovascular diseases?”

The American Heart Association’s website, heart.org, is a great resource for up to date information on Heart Health. You can even check your heart health score at / MyLifeCheck.

Provided by Dartmouth-Hitchcock

ALLIYAH LIVES WITH SICKLE CELL DISEASE, BUT IT DOESN’T STOP HER FROM LIVING LIFE TO THE FULLEST.

Alliyah S. Manchester, NH

NEW HAMPSHIRE’S ONLY CHILDREN’S HOSPITAL. Born with sickle cell disease, Alliyah has relied on the Children’s Hospital at Dartmouth-Hitchcock (CHaD) her entire life. As the only children’s hospital in New Hampshire that offers advanced pediatric services, CHaD is dedicated to providing every child with outstanding and compassionate primary and specialty care. With a focus on innovative research and education, Dartmouth-Hitchcock is there for Alliyah and her family every step of the way.

go.d-h.org/kids nhwomenmagazine.com / VOL 2 ISSUE 2 / 7

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MAULING

Elliot Hospital: Ask the Pediatric Surgeon

BOULDERS

Q.

Dear Dr. Soukup, My 12-year-old daughter is very overweight and I am worried about her future.

What can I do?

-Anonymous

Dear Anonymous,

Your question is so important and I have invited Dr. Jose Greenspon, a colleague pediatric surgeon from the Children’s Hospital at St. Louis University who specializes in pediatric obesity care, to respond to your question: Obesity amongst kids and teens has been on a steady rise and is now close to 20% of all children under 19 years of age. More and more children are being diagnosed and treated for diabetes, hypertension, sleep apnea, liver failure and other conditions that result from obesity.

Childhood and adolescent obesity is reaching epidemic proportions and as parents we need to consider what preventative strategies can we employ to have an impact on decreasing this problem. Here are the five recommendations I make: 1. Develop a family centered healthy relationship with food A child cannot be expected to control the kinds of foods that are brought into the home. If there are unhealthy foods such as sugary snacks and chips, that is what the children in the home will gravitate towards. To optimize the likelihood of success for these kids we must have family buy-in to change the home-food environment to reflect healthier food choices for everyone.

2. Don’t drink your calories While food companies continue to market fruit juices as “healthy,” it is well known that these drinks contain as much, and sometimes more sugar than soft drinks.

Soda consumption by children has increased by 300 percent in the past 20 years and studies have shown that the risk of obesity increases significantly for every regular soda consumed per day. The World Health Organization released a powerful statement in 2015 recommending that juices and sugar sweetened drinks should be avoided altogether. Replacing juice and soda with water may have a major impact on our kids’ risk of obesity.

3. Eat Your Meals Together as a Family Aside from the added benefit of family time, eating together, at a table, without the distraction of screens or other technology presents an opportunity to eat more mindfully. It provides a healthy expression of the social aspect of eating and kids and parents can work together to learn what it feels like to “eat until you’re full” rather than eating past that point.

4. Get Outside The US Department of Health and Human Services recommends at least 60 minutes per day of vigorous exercise for children and 150 minutes per week for adults. Not surprisingly, the group least compliant with these recommendations are adolescents.

Spending time outside engaging in team sports or individual activity is an important way that we could impact their risk of obesity.

5. Get More Sleep, and Less Screen time Prolonged cell phone and tablet screen exposure is linked to depressed mood and sleep deprivation-both of which are directly linked to increased risk of obesity.

Making sure that our kids and adolescents are getting eight or more hours of sleep is another potentially important way we could help affect the risk of our children developing obesity.

-Dr. Soukup askthepediatricsurgeon@elliot-hs.org #askthepediatricsurgeon #cdcheadsup

Elizabeth S. Soukup, M.D., M.M.Sc. Pediatric Surgeon

Dr. Soukup is a Pediatric Surgeon at the Elliot Hospital and has an interest in educating families about pediatric health and wellness. Her mission is to provide expert specialty care for children of all ages in New Hampshire – newborns through teenagers – striving to keep them close to their families and communities. If you would like more information, call 603-663-8393 for an appointment, or visit our website at http://elliothospital.org/website/pediatric-surgery.php. Check out her previous articles at #askthepediatricsurgeon.

Dr. Soukup earned her Bachelor of Science from the Massachusetts Institute of Technology and her Doctor of Medicine from the University of Chicago Pritzker School of Medicine, where she received the Outstanding Achievement Award in Medicine, graduating first in her class. She completed her General Surgery training at the Massachusetts General Hospital and her fellowship in Pediatric Surgery at Children’s Hospital Boston. During her time in Boston, she also completed a Masters of Medical Sciences degree in clinical investigation

from Harvard Medical School. She was awarded Elliot Hospital’s “Physician of the year” for 2018. She is board-certified in both Pediatric Surgery and General Surgery. She has specialized training and experience in minimally invasive surgical treatment for babies, children and teenagers. Her practice includes all areas of general pediatric surgery, including common pediatric surgical problems as well as neonatal surgery, congenital anomalies, minimally invasive surgery, and complex thoracic surgical problems.

Please send your questions to: askthepediatricsurgeon@elliot-hs.org

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NHWM COVER WOMAN | HOME ISSUE

PAMELA HODKINS:

BUILDING HER DREAM

For years, women have pushed through glass ceilings to further their careers; Pamela Hodgkins has literally broken down walls to launch hers. Hodgkins is the owner of Brass & Pine of Portsmouth, New Hampshire, a home renovation and design firm.

Written by Crystal Ward Kent & Photograpy by Lindsay Leigh Photograpy Since launching her business just a year ago, she and her team have transformed five homes into beautiful, high-functioning spaces.

Along the way, she has earned the respect of builders and craftsmen, proving that a young woman can be successful in the maledominated building world.

“One thing that has helped me succeed is that my guys know I’m not afraid to do anything that they do,” says Hodgkins. “I’ve been in there with them knocking down walls, putting up tile, painting, and wielding a hammer. If we are on a tight deadline and I need to get hands-on to get the job done, I’m there. I also treat everyone very fairly and respectfully. I have a great relationship with my team— they know I have their backs and they have mine.”

PHOTOGRAPHY BY: LINDSAY LEIGH PHOTOGRAPHY

With her petite frame and stylish looks, Hodgkins doesn’t seem like a likely candidate for a job site, but her enthusiasm for renovating quickly comes across.

“I am passionate about what I do,” she smiles. “I love design; I love creating. When I’m in project mode, my brain just goes crazy! I love seeing spaces transformed and the reaction from my clients when they walk in.”

While Hodgkins always had a creative bent, she did not start her professional life in the renovation field. “I’ve lived in a lot of different places—Boston, New York and other parts of the country,” she says. “I worked in fashion and then the technology field. In technology, the money was good, but there was no chance to be creative. I didn’t realize how much I missed that until I bought my first home.”

Hands-on Inspiration Hodgkins bought a two-family home in Kittery, Maine with the idea that she could live in one half, and rent the other half for extra income. Her parents were realtors, and also die-hard do-it-yourselfers with a strong work ethic. This foundation inspired Hodgkins to undertake the home’s renovation herself. “My dad helped a lot and showed me how to do things,” she says. “As I tackled different projects, I’d post pictures on Instagram. I was very honest in my approach, literally showing the good, the bad, and the ugly of renovation. I also told other women how they could do some of these things themselves. It was all just for fun—I had no idea it would change my life!”

Before too long, Hodgkins had

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people reaching out to her asking questions about where she got her design ideas or for other how-to tips. A colleague was impressed with what she’d done and suggested that they partner and start flipping houses. Six months later, Hodgkins found a good investment opportunity, and an investor who would back the renovation and resell the property.

She jumped in, even though she was still working full-time at her other job. “It was crazy!” she says, looking back.

“The client wanted it in 90 days, so I was working seven days a week to get the work done. I could see the renovation budget starting to go up, so I wound up doing the tile work myself to keep us on budget. I finished the project in 75 days. It’s a good thing I work well

under pressure!”

That successful flip led to her first client renovation project. The house needed significant work and Hodgkins recognized a number of red flags that would most likely impact time and budget. Her bid was higher than the others, but because she had meticulously pointed out possible problems, the client selected her firm.

“I think they respected my thoroughness and honesty,” she says. “I may overthink the process, but I’d rather quote higher and come in under than the other way around. I also tell my clients that I may quote a number of extras in terms of design, so that if we find problems, we can cut those extras and have the money to deal with any issues. That approach can help people stay within their budget.

Extras can often be added back in down the road.” Getting the job proved to be a mixed blessing, as the homeowners found out that they were pregnant and needed to accelerate the turn-around time. Once again, Hodgkins rose to the occasion, turning the house around in 70 days—one month ahead of schedule.

A Passionate Approach Despite the often intense schedule, Hodgkins says that there is nothing she would rather be doing. “I’m super motivated, like my parents,” she says. “I’m so grateful to them for all of the things that they have taught me, and for the ethics that they have instilled in me. I’ve learned to work hard, to help others, to be a good businessperson, all from them. They are my biggest support system and I admire them very much.

“Because of them, I was able to push myself and be stronger than I thought I was, which I had to be this insane first year.

There were times when I thought I was going to have a breakdown, but I pushed

“I know now that I can push through anything.” through and just kept focusing on the job at hand. I know now that I can push through anything.”

Hodgkins admits that the road to respect in this business can be difficult. “I’ve had situations where I put my expectations out there and people acted like I was crazy, but I stuck by what I believed was doable, and ultimately, we succeeded. Failure isn’t in my vocabulary. If I feel like I’m failing, I find a way through or around. I guess you could say I’m very stubborn!” she laughs. “I like to feel that I can make the impossible possible. However, over time, I’ve found a team that believes in me and respects me. They know that I’d bend over backwards for them, and that I’m always looking for work for all of us. I know they’d do anything for me.”

Hodgkins has come to enjoy the flexibility that being self-employed can provide, although her attempt to take the holidays off backfired. “We’d had a good year and I planned to take a month to relax, and be with family—that lasted about three days. I wound up leasing a retail space and renovating it for myself as an office and showroom. I spent the whole month up to my eyes in renovation work!”

One of her goals was to move her office

out of her home and create a showroom.

Her new location at 695 Islington Street in Portsmouth, New Hampshire provides a unique opportunity not only for clients to enjoy a comfortable meeting space, but also to see some of the cool furniture, lamps, paintings and fixtures that Hodgkins has used to help transform other spaces. “People ask me all the time, where did you get this or that item,” she explains. “I always refer people to my sources, as I like to help other businesses.

This way, they can see various pieces and do a little browsing if they like. I sold a sofa two days after my soft opening.”

Hodgkins has been involved in every aspect of the business her first year, but hopes to add a full-time team member before too long so that she can effectively manage multiple projects at once. She has also shifted her business model to not just flipping houses, but doing client renovations. “The flipping model is not sustainable in this market,” she says. “In this business, you need to be smart and reshape your goals based on what your research indicates. Changing direction and doing more direct work with clients is where the work is, and I enjoy working with people and hearing their hopes and dreams.”

As she looks toward the New Year and beyond, she offers this advice, “Believe in yourself like you have never believed in anything, Make short- and long-term goals and make a step by step plan to achieve them. Be determined and tenacious. These things will get you to where you want to go. I believe that if you have a passion for something, you can’t fail. People love seeing others pursue their passions—it inspires them. Next thing you know, people are rooting for you, supporting you, endorsing you, and dreams catch fire.

Life is short—go for it! You have nothing to lose!”

The Brass & Pine Showroom is open Wednesday through Saturday 10:00 a.m. to 6:00 p.m., or by appointment.

2018 was a banner year for Hodgkins, with achievements beyond her wildest dreams.

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CANCER CARE | WOMEN’S HEALTH

GYNECOLOGICAL CANCER: WHAT YOU NEED TO KNOW

Massachusetts General Hospital Gynecologic Oncologist Amy Bregar, MD, has joined Wentworth-Douglass Hospital’s Seacoast Cancer Center. In coordination with Mass General’s Center for Gynecologic Oncology, WDH’s Gynecology Oncology Program offers women on the Seacoast local access to expert specialized care for gynecologic cancers, including cervical, endometrial, ovarian and uterine cancer.

E

ach year in the United States, more than 100,000 women are diagnosed with gynecologic cancers. Here, Dr. Bregar discusses some the main warning signs and newest treatments available to women.

What are the signs and symptoms of gynecologic cancer?

Gynecologic cancers start in a woman’s reproductive organs.

The most common diagnoses are ovarian, cervical and uterine cancer, but other types include vaginal and vulvar cancer. While they are often discussed as a group, each gynecologic cancer has its own set of distinct symptoms and risk factors. Some possible symptoms include abnormal vaginal bleeding or discharge, feeling full too quickly after eating, pelvic pain or pressure, bloating, and more frequent or urgent need to urinate, among others.

What I like to stress is the importance of recognizing what is normal for your body and paying attention when something is different. For instance, almost all women experience occasional bloating, but if you are suddenly experiencing persistent bloating, you should tell your doctor about it.

A fact worth noting is that cervical cancer is the only gynecologic cancer that can be detected through routine screening – so schedule a Pap test if you are due for one. This easy screening can

detect abnormalities before they become cancer. Cervical cancer is unique among the gynecologic cancers in that it is most often caused by a virus.

Human Papillomavirus (HPV) causes 70% of cervical cancers.

Accordingly, the Centers for Disease Control and Prevention recommend the HPV vaccine for girls and boys starting at age 11 or 12, and the vaccination has been recently approved by the Food and Drug Administration for men and women up to 45 years old. .

If you are diagnosed with gynecologic cancer, what treatment options are available?

As a gynecologic oncologist, I am specially trained to treat women’s reproductive cancers.

Treatment depends on the type of cancer and how far it has spread, but they are usually treated through a combination of surgery, chemotherapy and radiation therapy. I can perform some surgeries here at Wentworth-Douglass, but more complex cases may need to be done at Mass General. The Seacoast Cancer Center also has a vibrant clinical trials program, so patients can benefit from access to trials investigating potentially new or more effective treatment options.

Research has shown that women who have access to gynecologic oncology specialists have better outcomes than women who do not, so we are very pleased to offer this level of care to women right here on the Seacoast.

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What can a patient expect when receiving care at WDH’s Gynecology Oncology Program?

Offering women the option to receive their care close to home is critical to their overall health and well-being. The Seacoast Cancer Center’s expertise and technology, and full array of supportive services, is especially equipped to offer women the most comprehensive, personalized and compassionate care in the region.

As the GYN Oncology Program Manager, Kathy Quinn, RN, OCN, plays a vital role in helping to coordinate seamless care for patients between our program, the radiation and

Amy Bregar, MD medical oncology teams and the many other integrated services available at the Seacoast Cancer Center, such as social work, rehabilitation services, and palliative care.

It’s a truly multidisciplinary approach to care bringing all these specialties together to create a personalized approach to each woman’s needs.

For more information about the Gynecologic Oncology program at WentworthDouglass Hospital, contact Kathleen Quinn, BSN, RN, OCN, Gynecology Oncology Program Manager, at (603) 609-6024.

* Special Section: Content provided by Wentworth-Douglass Hospital

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DON’T BE

SAD

Addressing Seasonal Affective Disorder Written by: Dr. Kevin DiCesare and Kara Morse, MSW, LICSW from Southern New Hampshire Health

A

nyone can get the “winter blues,” particularly in northern states where it seems the cold and darkness will never end. However, some individuals are impacted by a more serious condition known as seasonal affective disorder. Its acronym, SAD, is just an inkling of what people experience when suffering from this form of depression.

Dr. Kevin DiCesare of Southern New Hampshire Health affirms it is, in fact, a type of depression and presents symptoms similar to clinical depression. These symptoms include feeling sad or down most of the time, lack of energy, changes in sleep or appetite, concentration lapses, or feeling hopeless or helpless. “Sometimes, if depression symptoms are severe, it can even cause folks to have thoughts of ‘maybe I’d be better off not being around’ or wanting to harm themselves,” says Dr. DiCesare.

What Causes SAD to Occur?

While varying factors contribute to both SAD and clinical depression, one of the main causes is a drop in certain neurotransmitters that play a role in mood; particularly serotonin. Another culprit is changes in melatonin levels in the brain, which can spark disruptions in mood or sleep patterns.

And, lack of sunlight means less vitamin D production, which can also impact mood.

“All of these potential factors can play a role as to why some people might be susceptible to experiencing seasonal affective disorder,” notes Dr. DiCesare.

Diagnosis & Treatment Options Diagnosis typically starts with an individual’s primary care physician, who upon evaluation of the symptoms may either initiate treatment themselves or refer to a mental health provider to perform more extensive evaluation and treatment.

Light therapy is an effective approach to treating symptoms of seasonal depression, and it’s something that can be obtained fairly easily. This therapy involves daily exposure of 20-30 minutes in front of a light box which emits “full spectrum” light—the kind of light you would normally get from the sun. Therapy continues daily until symptoms begin to improve.

Other treatments that may be helpful include medications like antidepressants, which Dr. DiCesare says would be standard treatment for patients who struggle with clinical depression. “People who only get depressed during the winter months may want to talk to their physician about being on an antidepressant, possibly even proactively if they tend to have seasonal depression on an annual basis,” he adds.

Vitamin D supplements can also be beneficial, particularly if an individual has documented low vitamin D blood levels.

Behavioral Therapy While medication, vitamin supplementation, and light therapy are all viable treatments,

Kara Morse, MSW, LICSW, of Southern New Hampshire Health advises patients look into behavioral therapy as well.

Common techniques used by therapists include helping the patient identify any negative thinking and learning how to reframe or challenge those negative thoughts that accompany depression symptoms. Therapists also introduce strategies to improve patients’ ability to manage stress that might be occurring, especially around the holidays.

“Helping people get through those stressful holiday times can be highly beneficial,” informs Morse.

Mindfulness is an additional tactic that helps patients connect their minds and bodies, all in an effort to reduce depressive symptoms.

Morse also recommends lifestyle adjustments, including more time in the sun and physical activity.

“There’s absolutely a correlation between darker days and seasonal affective disorder,” affirms Morse. “So, one way to combat that is to get outside, get sunlight, hopefully improve your vitamin D levels, and exercise— whether you are hiking, snow shoeing, skiing, or maybe you simply improve your gym attendance and get more exercise, more frequently.”

Morse also encourages people to reach out for help, which isn’t always easy given the stigma that still plagues a depression diagnosis. “Please know you are not alone; there are services and professionals ready to assist you.”

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