Tag Archives: winter

What’s Behind Those Winter Blues

'Winter Fishing on Lake McDonald' photo (c) 2011, glaciernps - license: http://creativecommons.org/licenses/by/2.0/
The season got you down? Struggling with the motivation to get moving, even though you know it will help? Do you find the color red mildly depressing?

You may have a serious case of righteous indignation with the superficiality of life, or perhaps just the winter blues. While we don’t specialize in existential funks, we know something about depression and its cousin, colorfully named Seasonal Affective Disorder (SAD).

Our brains are immersed in a neurochemical and hormonal stew that is dauntingly complex, but a lot of work in the last decade has given us understanding of at least the broad strokes. It’s pretty complicated up in the head.

It is completely normal to slow down some in the fall; your body is conserving energy to get you through the cold winter.

For up to 10% of people, this is much more than simply banking the fires; it is a life changing and unwelcome annual ordeal. An affective disorder is a fancy way of saying a mood problem. The namesake symptom of SAD is depression.

Depression is usually associated with varying degrees of fatigue, increased need for food and sleep, weight gain and difficulty concentrating.
This occurring during the holidays is particularly irksome – when the need for energy is greater than normal. The increased appetite when the house is full of Christmas cookies is torture to anyone trying to maintain an ideal body weight.

An additional 10% of people have a milder form of the condition that may only have fatigue as a symptom.

The scientists tell us that the decrease in daylight triggers a decrease in brain serotonin and increase in daytime melatonin levels. You probably remember serotonin; that is the brain chemical that Prozac increases. Serotonin is good.

You would be right in deciding that medications like Prozac would be helpful in Seasonal Affective Disorder.

For those inclined toward more natural cures, we just need to trick your body into thinking it’s summer.

Your body mostly wants a sunbeam, like a cat. That is something we know how to do. Light therapy is essentially a portable sunbeam. The UV light is filtered out so you won’t get skin cancer, or unfortunately, a suntan. Light therapy with the intensity of 10,000 Lux seems to work the best, with 30 minutes every morning commonly recommended. Sitting in your sunbeam after work can also help, but occasionally causes insomnia. This treatment actually can work in as little as a week. That is three times faster than is usually seen with medical pill treatment.

Melatonin is also commonly used to treat Seasonal Affective Disorder. Melatonin is a hormone that is produced by your body in dim light. Taking supplemental melatonin in the afternoon can reset the hormonal clock.

Light therapy isn’t the only unusual treatment for SAD. Use of a negative ion generator in the bedroom at night shows a 50% response in patients with SAD.

Medications of the SSRI class work well but take a few weeks to become effective. Prozac is the best known SSRI, but any of them are effective.

The seasonal nature of Seasonal Affective Disorder favors the non-drug approach to the disorder. In people with SAD it usually returns each winter. Light therapy can be started in the fall before symptoms occur and can be useful in preventing the onset of SAD. Many find this more palatable than starting and stopping medications every year.

Seasonal affective disorder is often the cause of winter blues. A variety of treatments are usually well tolerated and effective. In the meantime, have a Christmas Cookie, can’t hurt.

Take care,

Dr. B


Best of Our Blog: Winter Weather and Flu Shot Myths

Periodically, we re-post some of your favorite blog posts. We’re offering two that are timely today: precautions to take for winter weather and flu shot myths.

Baby, It’s Cold Outside: Winter Weather Precautions to Take
Winter is here! Anyone out and about in the cold, wet weather is at risk for some temperature-related injury if they do not follow some basic common sense precautions. Understanding what things make you at risk can help prevent mild and severe cold-related problems.

Read More

Top Ten Flu Shot Myths: Don’t Fall for Them

It seems most people won’t get a flu shot this year – many turning to what can only be called the Top Ten Flu Myths. Here goes:

Read More

5 Steps to Survive Winter Allergies

Most of us associate allergies with spring and summer when things are in bloom. Even some of us who don’t have allergies seem affected by a vigorous bloom; however, folks who have spring allergies are also more prone to winter allergies. The human immune system’s sensitivity to different allergens is very individualized. But if one is prone to spring allergies then there is a greater chance that you may have problems in the winter even though the triggers are entirely different.

When the weather gets cooler, we close up the house and turn on the heat, making the perfect storm for allergy sufferers. Dust, mold, mildew and pet dander are the big winter culprits. The secret is these things are actually around all year long. In sensitive individuals, these factors may intensify allergies any time of year but really come into play in the cooler weather. Trying to minimize the amount of these allergens in your environment is helpful.

Even though you cannot truly be the master of your domain, you can improve the condition of your habitat by following these tips:

“Cats are magical. . .the more you pet them the longer you both live” ~photo © 2010 Nancy ~ | more info (via: Wylio)

1. Avoid known allergens: This means some regular house cleaning, probably weekly with a more vigorous attention to problem areas once per month. Keep pets out of the bedroom – this will make your sleeping area as a safe zone to keep down the amount of pet dander, dust and molds that animals also carry on them wherever they go. You spend a lot hours in your bedroom, so keep it as allergen-free as possible. Really sensitive individuals may consider showering more often to remove potential allergens from hair, skin and clothing.

2. Change your bedding weekly. Washing sheets, linens and towels helps keep the amount of dust, dust mites and mildew down to a minimum. Dust mites are microscopic organisms that exist everywhere. They thrive on dry skin cells that naturally slough off our bodies. Special bedding or mattress covers can be purchased that help contain this situation for individuals who need additional help. Allergy bedding and special mattress covers can be purchased at many department stores that handle regular bed linens.

3. Add moisture. The dry indoor air exacerbated by heating systems of any kind is irritating to airways and tends to make people with allergies even more vulnerable. Room humidifiers, liberal use of saline nasal spray, nasal irrigation systems, and simply staying well hydrated by drinking plenty of fluids can be very helpful.

4. Take allergy medicine regularly. If you suffer with allergies, you need to be proactive and take a preventive stance against your symptoms. Waiting until you feel bad is too late. It is much harder to gain control by that time. There are good non-sedating antihistamines that are available without prescription, very effective and still form the foundation of allergy control.

No273 13 Oct 2009 Sneezephoto © 2009 mcfarlandmo | more info (via: Wylio)

5. Consult your healthcare provider. If you still can’t gain control and a functional level of comfort with the above mentioned measures, there are additional prescription medications that can be effective. Discussing which choices are right for you and the severity of allergies would be time well spent.

Whatever you do, don’t give up. There is help. It is just a matter of identifying what your triggers are and how best to avoid them.

– Dr. Bruce Kaler

Baby, It’s Cold Outside: Winter Weather Precautions to Take

Winter is here! Anyone out and about in the cold, wet weather is at risk for some temperature-related injury if they do not follow some basic common sense precautions. Understanding what things make you at risk can help prevent mild and severe cold-related problems.

Barry’s Cabinphoto © 2009 Richard Faulder | more info (via: Wylio)

Body Temperature
The biggest danger in winter weather is the actual temperature and the length of time of exposure to the cold. Wet clothing and wind can greatly enhance the dangerous effects of the cold temperatures – even 50 degree weather can be problematic with some wet clothes and wind.

The metabolism of your own body is your only source of heat. Fortunately it is very good at producing heat and regulating body temperature with an elegant thermostat mechanism. The brain initiates sweating to cool your body, and induces shivering and increased hormone production to maintain adequate heat in response to external cold temperatures.

This can be very mild or very severe. In the mildest form, the heart rate increases and breathing gets faster. When you are too cold, shivering and other involuntary movements to stay warm start happening without even thinking about it. Poor coordination and not thinking clearly are common, which can impact your immediate safety and outcome. If the hypothermia progresses, the senses and mental status are even more dulled, and even the shivering or willingness to move diminish.

Serious heart, lung and other vital organ complications ensue due to decreased blood flow. Children are more prone to hypothermia due to their small size and smaller reserves for heat production and energy storage compared to adults. Young infants do not have the ability to shiver, and being unable to express themselves are more vulnerable to prolonged cold temperatures without any obvious warning signs. Elderly adults may also have less capacity or resistance to cold temperatures being unable to respond quickly to environmental changes, decreased metabolic reserves, chronic illness, or some medications. It is well known that certain medications such as antidepressants, narcotics, general anesthesia, some blood pressure meds, and alcohol consumption all impair the ability of the body to regulate temperature.

True frostbite is when exposed tissues actually freeze and form ice crystals in the cells of the respective tissue. This leads to severe tissue damage and even death; however, most of us will only encounter mild forms of this process, which starts with swelling, turning pale, and numbness of the skin. Hands, feet and face are the most common areas involved because of their exposure and because they are farthest from the heart and warmer core temperatures.

Blisters that are clear or blood-filled, discoloration of the skin, swelling and redness indicate more advanced problems. Getting to medical care is paramount if clues suggest serious complications.

Frostbite occurs in the workplace in industries using cold storage of common refrigerated and frozen food products. Overzealous use of an ice pack on an injured knee or sprained ankle can cause accidental frostbite, especially when in direct contact with the skin without some dry cloth to mediate the effect on bare skin. Ice packs should be applied intermittently for only a few minutes at a time.

Re-warming the body part or individual is the most important treatment for the consequences of cold exposure. It is important to avoid re-freezing if this is a risk. In fact, re-warming a truly frozen part should be delayed until you reach some place where re-freezing is no longer a risk. Warm, dry clothes and blankets do wonders to eliminate the continued loss of heat.

If possible, get to a warm, dry location. Any external heat source could be beneficial. Placing cold hands or feet in warm, not very hot, water is helpful. In extreme situations, body-to-body contact with warm dry blankets can help the person suffering from hypothermia in a remote location.

It’s crucial to be prepared, which doesn’t need to be expensive.

Proper clothing and supplies are important whether it is a trip downtown, day hike, or wilderness trip. Plan for the unexpected. Weather conditions in remote areas can change abruptly in the fall or winter. Bring some options with you. The best way to avoid cold related injury is to dress in layers that can be removed as conditions dictate.
Limit the time in the cold as much as possible.
Stay dry. Waterproof footwear and suitable covering for head and hands is a must.
Stay well hydrated. Drugs, alcohol and tobacco can seriously impair your judgment and the ability to tolerate prolonged exposure to the cold.

A small amount of planning can help avoid problems and keep you a lot more comfortable – and healthy – when out in the cold weather.

– Dr. Bruce Kaler

Is it a Cold or the Flu? Dr. Baxter Debunks the Myths on FOX Dallas

When winter rolls around, so do the germs. But does that cough and fever mean you have the flu or just the common cold?

Dr. Shiu-Yueh Baxter, Center Medical Diretor of our Carrollton clinic, spoke with KDFW-TV FOX Dallas this morning to discuss the difference between the two and to explain the truth behind common winter flu myths. The segment is available here.