3 minute read
Wellness Winter Well-Being: Combating Seasonal Affective Disorder
By Wendy W. Sun, MD; Amanda J. Deutsch, MD; and Vytas P. Karalius, MD, MPH; Michelle D. Lall MD, MHS; Mia L. Karamatsu, MD; and Amanda M. Ritchie, MD on behalf of the SAEM Wellness Committee
Seasonal Affective Disorder (SAD) was first described by Dr. Norman Rosenthal in 1984 as changes in mood that occur in a predictable pattern with the changes of the seasons, most frequently during the fall and winter months when the days get shorter. Epidemiology studies suggest that SAD affects approximately 6% of the U.S. population and correlates with latitude (e.g. 9.7% in New Hampshire and 1.4% in Florida). SAD could include symptoms of major depressive disorder as well as additional symptoms such as oversleeping, craving carbohydrates, weight gain, and desire to withdraw socially/ “hibernate”. The “winter blues” are a less severe form of SAD. The current mainstays of treatment for SAD include light therapy (LT), psychotherapy (Cognitive Behavioral Therapy), and medications, with 60-80% of folks affected by SAD benefiting from LT (guidelines in table). However, physical exercise and other activities that decrease stress and increase well-being could be helpful as well. Here is what some of our SAEM Wellness Committee Members do for their well-being in the winter to fend off SAD:
Exercise and Movement
• Participate in shared fitness activities for something to look forward to (e.g., volleyball league, Peloton with friends, running group) • Download and use yoga apps like 26 & 2, Bikram, hot yoga and other fun fitness activity apps • Strategically schedule breaks between Zoom meetings to take advantage of the outdoors (e.g., skiing a run between meetings) • Go outside, especially during warmer days
Connectedness
• Build buddy and accountability systems • Pause to reach out to friends not seen in a while • Volunteer and give back to the community • Visit family/friends who live in warmer places with longer daylight
Food
• Gather over food • Make and enjoy warm soups and stews
Light
• Place a light box in work areas (helpful when wrapping up notes) • Optimize light by moving a desk closer to a window • Take a 5–10-minute break during work to step outside and enjoy the sunshine • Put bedroom lights on a timer to simulate dawn when waking up (several smart lamps, smart light bulbs, and alarm clocks provide these features and can easily be paired with a phone via Bluetooth)
Other
• Partake in plant retail therapy
If you find yourself with SAD or the winter blues, know that you are not alone. As emergency physicians, it is important to remember that, like anyone else, we are human and vulnerable to mental illness. These seasonal mood changes are not a reflection of our character or ability, so let’s remember to normalize these harder and sometimes literally darker moments in the fall and winter seasons. Please find available mental health resources here. Let’s continue to #StoptheStigmaEM. ABOUT THE AUTHORS
Dr. Sun is a chief resident at YaleNew Haven Health, Immediatepast president of SAEM RAMS, resident member on the SAEM Board of Directors, and AWAEM Wellness Committee cochair.
Dr. Deutsch is a clinical instructor and physician wellness fellow at Stanford Emergency Medicine.
Dr. Karalius is a clinical instructor and medical education scholarship fellow at Stanford University.
Dr. Lall is an associate professor at Emory University, an AWAEM past president, and is currently serving a second term as a member-at-large on the SAEM Board of Directors.
Dr. Karamatsu is an assistant professor and pediatric emergency medicine well-being champion at Stanford University. She is also AWAEM’s Wellness Committee cochair.
Dr. Ritchie is a second-year emergency medicine/internal medicine resident at Louisiana State University.
