(relaxing music) - [Narrator 1] Support for Conversations Live comes from the Gertrude J. Sadat Endowment, the James H. Ola Family Endowment, and the Sydney and Helen S. Friedman Endowment.

And from viewers like you.

Thank you.

- [Narrator 2] From the Keiko Miwa Ross WPSU production studio, this is Conversations Live.

(energizing music) - Hello and welcome to Conversations Live.

I'm Carolyn Donaldson.

We're coming to you live from the Dr. Keiko Miwa Ross, WPSU production studio.

About 5% of the US population experiences what's called seasonal depression.

Now, Pennsylvania in particular tends to have higher rates on average when winter hits.

We're in the thick of it.

But what is the umbrella group called seasonal affective disorder?

How does it differ from depression?

We've got two experts tonight to help us answer these questions, discuss some methods for treating it, and ways to stay healthy and active as part of those treatments during these somewhat long winter months.

And we ask you, and welcome the opportunity for you to ask the questions that you might have about this issue.

So let's meet our guest.

Dr. Madhavi Singh is a medical doctor with Penn State Health.

She works in family and hospital medicine and has been in practice in our region for more than 20 years.

Welcome.

Dr. Sultan Magruder is a psychologist and the assistant director for diversity, equity, and inclusion at Penn State CAPS.

That's the Counseling and Psychological Services program among the Penn State community.

Now, among his specialties are group therapy, anxiety disorders, and eating disorders.

Whether you're watching us on TV, streaming us online right now, or listening on the radio, we want to hear from you.

We urge you to call us with your questions about seasonal affective disorder and your take on that at 1-800-543-8242 or email connect@wpsu.org.

And we do want to just have a little disclaimer that talks about how we're gonna generally discuss this disorder.

We do want to advise those callers and all of our audience tonight that we're here to discuss the topic in general.

But for specifics, I know our experts are gonna encourage you to seek professional help.

So we'll get into all of that.

But let's start the discussion right now.

Thanks so much for joining us tonight.

So let's start from your perspective lenses, psychology and the medical doctor, the physical and medical profession.

What is this term, seasonal affective disorder and how does it fit into our lives and our mental health?

We'll start with you Dr. Magruder.

- Yeah, thanks for that, Carolyn.

So I think it might be helpful to first start with depression in general, right?

And when I'm talking with people I like to talk about depression as having many faces, right?

And so this can be dependent upon the symptoms, the number of symptoms, the onset of these symptoms, the severity of the symptoms, right?

And so any combination of these symptoms can present a different face of depression.

And so when I then think of seasonal affective disorder, you know, were you to look into the DSM, which is our manual for classifying mental health concerns, you're not gonna see seasonal affective of disorder, an actual diagnosis.

What you will find though, is under major depression, right?

You may find that it has seasonal patterns.

And so really understanding that seasonal affective disorder is this subtype or subset of a larger, you know, depressive episode.

And so when we're thinking then about symptoms, what's unique to seasonal affective disorder is you'll definitely have the isolation, right?

The withdrawal, the hibernation that individuals experience.

The loneliness, the sadness, the increase in eating, increase in in sleeping, or what we like to call hypersomnia.

But then thinking uniquely to seasonal affective disorder, you might see increases in the the want or need for carbohydrates, right?

And then most importantly though is seasonal affective disorder is recurrent, right?

And so in general we see this after, you know, two years of these types of symptoms that it's occurring at a certain point throughout the year.

Typically we find during the fall, winter months.

And so that's how I would classify seasonal affective disorder.

- And, and Dr. Singh, in your practice, how does it manifest itself with some of the patients, generally, that you've seen?

- Yeah, so patient would come in with the symptoms that were described with depressive symptoms.

Mostly with a seasonal pattern.

So people coming in the middle of winter, especially around December and February, you would see more of a presentation with these kind of symptoms.

Or people who don't have winter depression, obviously they will be presenting at different time of the year or with other symptoms like mania and hypomania, who would have seasonal affective disorder, nondepressive types.

So basically in general, they would present with a depressive-type symptoms in the seasonal pattern.

- And it's okay to bring this up to your family doctor or your psychologist or talk to your family members about it, who then may refer you on, right?

This is something that I can personally attest to.

I think I've gone through that and we're in the middle of winter and I've gained 10 pounds in the last month.

You know, I mean, I don't know if I'm on the early stages of that, but that's a real thing.

- Yeah, no, I think it's important to shed light on these experiences that, again, as we've seen, many people, particularly in the United States, will have this, right?

And I think there has been a culture historically of minimizing, of looking away from these types of experiences that our people are having.

But I think we've made some progress in our society now that when we think about mental health and these underlying concerns and challenges that individuals are having, we're bringing those more to light and people are being more aware of talking about those things.

And I'm sure we'll talk about what is needed in order for individuals to overcome these barriers.

But one of the most important things is awareness, right?

And so if we're able to gain awareness with ourselves, that's gonna be most important.

But definitely reaching out to community and having those external individuals create that validation as well as awareness to bring us awareness, right?

That's gonna be more important.

So this definitely takes a community in being open and honest about what our experiences are to be able to overcome, you know, these challenges.

- Can we take a look at the rates that we're seeing for seasonal affective disorder?

First, again, I cited that 5% of seasonal depression for Pennsylvania.

But here in central Pennsylvania, again, I love living here in the winter and the snow and snow activities, but it does get long and cold and dark very quickly some days and nights, right?

Do we have a higher influence of this type of disorder in this neck of the woods?

- I don't have specific data for Pennsylvania itself, but in general it can range from .5 to about 3% of the population.

So I would think it would be higher in this part of the country.

- Okay.

Let's talk about, again, more specifically some of the symptoms that folks, and again, we encourage you to call if you've got something that's on your mind about maybe what we're talking about here, or you've got specific questions about some symptoms maybe you've seen or in one of your family members, give us a call.

Again, the number is right there on your screen.

1-800-543-8242.

So let's delve into some of maybe the specific symptoms that are present right now.

Dr. Singh?

- Repeat the question again?

- Oh, the, the symptoms.

If you can just run down some of them and- - Okay, yeah, so I mean, in general, depressive symptoms can be whatever were described earlier, feeling of guilt, feeling depressed, feeling a lack of interest, irritability, sleep disturbances.

But again, when we talk about seasonal depressions, the winter depression, people tend to overeat, gain weight, and tend to sleep a lot.

- [Carolyn] And by a lot, what are we saying Sultan?

What's a normal adult supposed to sleep and what are perhaps some folks that may be experiencing some of these symptoms?

- Yeah, definitely when I throw that back at the medical doctor, Dr. Singh over here.

But you know, generally what I'm telling individuals is it depends on the individual, right?

And so typically, I think they're saying probably between six to eight, seven to eight hours, you know, a day.

But understanding that some individuals, their body is able to respond on just a few hours.

Or some individuals need more.

And so I think it's really, if you're awaking and not feeling rested, then that cues you into something may not be right.

And that may be then your sleep.

And so, Dr. Singh?

- Yeah, certainly.

People can sleep up to 14 hours, (laughs) but again, whatever their pattern is.

If they're sleeping, normal sleep would be considered six to eight hours as described.

So if someone is sleeping about nine, ten hours, that would be concerning.

- I want to typify this and say causes of seasonal affective disorder.

But we were talking before we started the show, and that's probably not the right term, right?

There's no actual causes, it's more what may happen to bring this type of disorder on for some folks?

- Yeah.

So different hypothesis.

So one is circadian rhythm disturbance where our body is set in a certain sleep pattern, which is governed by different parts of our brain.

And because of lack of sunlight or just how our neural transmitting system works, either lack of sunlight could lead to increased melatonin production or lead to shift in the sleep cycle.

Moving the sleep sleep stage to later in the nighttime, or people sleeping in in the morning.

Or sleeping in early and waking up early.

Or the other hypothesis is retinal insensitivity where our retina, the screen part of our eyes is less sensitive to light, which can then lead to decreased light activation.

And those connections are related to our mood part of our brain.

So that can lead to decreased mood effect, depressed mood.

And genetic involvement.

Some people- - Have more of a proclivity to having this.

- Or yeah, the family members with mood disorders are likely to have it more.

- Very interesting.

I think we've got some calls on, I'm afraid, I'm gonna go blindly here and ask the person on the phone to state your name and tell us where you're calling from and your question tonight.

- [Debbie] Debbie.

- Hi Debbie.

Thanks for joining us.

Your question for our experts.

- [Debbie] Yes, I do suffer from depression.

It's not really significant depression, but one of the things I really noticed that think significantly is if it's a sunny day, I'm great and I have a good day.

But then immediately when it's rainy or anything, there's immediately drop in my disposition and the depression seems to increase.

And I wonder if that has anything to do with coinciding with someone who might be significantly depressed or is that some part of being part of the SAD?

Because I notice then if it's like a rainy day in the morning, whatever, and that sun comes up, my mood just seems to like change dramatically even though I'm not out in the sun.

But it's just, if there is a difference, just knowing that sun is out there.

Is there any significance to that that you can put a light on for me?

- Thank you first for sharing that.

I know many, maybe watching, I know I can relate to some of that too.

So who'd like to go first and responding to Debbie's question?

- Yeah, certainly I can go, yeah.

Definitely very typical description.

So again, I think Debbie already knows the answer to her question.

Lack of sunlight, feeling depressed.

Again in Pennsylvania, we are unfortunately blessed with more cloudy days, which means if the whole week is very cloudy, that can really start to affect our daily function.

And when we do feel depressed, our ability to function, not just physical and lacking the desire to get out of bed, our ability to cognitively function get affected as well.

So yeah, definitely.

You're on the right path, Debbie, you should- - It's okay to have the mood swings then, based on the weather.

- Correct.

- That's gonna happen.

How about your perspective or ideas to help Debbie, I guess.

- Yeah, I mean the one thing I would say, well, I have a few things I would want to say, but I think it's important to understand that yes, typically us as human beings, we will find that our emotion states will change based on the environmental factors.

And so in this case in point, the weather outside, right?

And so wanting to really normalize that experience, right?

Because that's just a part of the human condition for some individuals.

What seasonal affective of this order, again, what we're really trying to say, if someone was coming and talking with me about some of these symptoms, right?

And if they wanted this diagnosis of seasonal affective disorder, you know, what I would say is, again, has this been recurrent, right?

Has this depressed mood, for example, been occurring more days out of the week than not, right?

And typically for us, you know, we will wanna see this happening for two consecutive years or more, right?

For major depression, with seasonal affective disorder.

And so again, I wanna normalize that, you know, we have these changes in our emotions, in our mood states, and it's definitely, you know, contingent upon the weather.

And I don't want to have people thinking that just because my mood has shifted because of the weather, that means then that there's something, you know, really significant wrong with me.

And the last piece, and I know I'm talking a lot, but I will say is that conditioning too, right?

And this is why it's important to really understand how we think about things.

Because I know for me, if I were to wake up and it was sunny, you know, the past few days, and then I wake up and all's I see is like rain, what's the first thing I'm gonna say?

Ugh, goodness.

Right?

And so I've already conditioned and primed myself to have these thoughts that, oh, this is suck, this horrible, I'm gonna be wet, it's gonna be, you know, more arduous to get to work.

And so I'm already setting myself up to have a more unhelpful sort of like, mood state or emotional state.

- And that's attitude adjustment or however you wanna typify that, right?

- For sure, for sure, for sure.

And so yeah, Debbie, I appreciate the call.

You know what I would say, as Dr. Singh had mentioned, like, great awareness into what's happening for you right now.

And what I would say is, you know, if this is something that you know, continues to be an issue for you, definitely talking with your medical doctor, go and talk to your mental health provider if you have one to get a more accurate assessment of what's going on.

- All good points.

I do wanna get to other ideas to help, you know, with just the disorder.

So I'm gonna throw out the vitamin D supplement, you know, what's our take on that these days?

What's the theory or what are people saying?

Because vitamin D, from what my little knowledge is that sun delivers a lot of vitamin D to me, but when that sun's not there, I need it somewhere else.

Is that the case?

- Yeah, so the research hasn't shown that it really makes a difference.

The big, large randomized control trials have shown no benefit to vitamin D supplementation.

- [Carolyn] Okay.

Okay.

And how about, we have another caller, so I've got some other ideas.

But let's get to Candace in Bellefonte.

Candace, thanks so much for watching and calling in your question tonight to our experts.

- [Candice] Well, actually my question is if they would talk about, if you have been diagnosed with seasonal adjustment disorder, the sunlight simulation that can be used to help, you know, elevate your mood a bit.

When we moved here, of course, immediately I began to suffer from that because of lack of sunlight from coming from a very sunny area and was introduced to the sunlight simulation.

So I think it could be helpful for those suffering to know something about it.

- Great, we were gonna get to that 'cause we had talked about that, and I have a personal story too.

But first who wants to talk a little bit about how that, what that term means, and how that can be helpful.

- Yeah, certainly.

A first line treatment for seasonal affective disorder with depression.

So again, subsyndromal folks can definitely benefit too, but once we talk about severe depression or mild to moderate major depression, light box treatment definitely helps.

- [Carolyn] It's literally there, you see a picture of it.

So it's literally some sort of a light that you purchase that's you can get online, you can buy in the grocery, you know, stores right?

Locally and- - Yeah, so the recommended intensity of light should be 10,000 lux.

Again, I myself have bought multiple different products, but it's hard to get the right one sometimes.

There are apparently apps available that can assess the amount of light on these light boxes.

(laughs) - [Carolyn] There's an app for that.

Oh my goodness.

- Yeah, thankful to one of the medical student who showed me about this app.

So I got it and I tested on my boxes.

- And Sultan, what do you find as far as that light box or whatever you wanna call it.

- Yeah and so I know at work it's provided for staff to utilize and I think it's been helpful for individuals again, to feel like they're getting that natural light.

And as we had, you know, alluded to earlier, you know, that's definitely impacting the circadian rhythm or the sleep wake cycle of the individual and now allowing us to be a little bit more alert.

And so yeah, I would recommend, you know, that light box treatment and in conjunction with, you know, especially for those who are struggling significantly with these concerns in conjunction with medication or psychotherapy as well.

- Okay, we're gonna have lot's more questions, but if you're just joining us, I'm Carolyn Donaldson, and this is Conversations Live, Seasonal Affective Disorder here on WPSU.

And joining us tonight, we have Dr. Madhavi Singh from Penn State Health and Dr. Sultan Magruder from Penn State CAPS program.

Our toll-free number for you to call your question in for our experts is 1-800-543-8242 and we are ready to take your calls.

You can also send us your questions by email connect@wpsu.org.

So again, thanks for joining us.

And my personal story about the light box is for 25 years I worked in the nighttime profession doing news inside of a non-windowed newsroom, entering that place at about two in the afternoons and not leaving it until about one in the morning.

And I literally bought one of those things on my own without medical help.

So maybe I wasn't doing the right treatment, but I would put it on a lot more than 30 minutes, which is probably not good, but it just simulated for me, I don't know, feeling like I was, you know, getting something good, you know?

And if I couldn't physically get outside, I felt like that was kind of substituting.

But there is no substitute for getting outside, right?

And getting that walk around the block.

That can be that simple to beat some of this, or at least to help hold it at bay?

You're nodding, doctor.

- Yeah, certainly.

I mean, walking outside in general will be helpful for any spectrum of this depressive disorder.

But again, in conjunction with a moderate intensity exercise.

- Okay.

And your thoughts?

- I'm just wondering what moderate intensity exercise means?

(Carolyn and Sultan laugh) - [Madhavi] Where you can't have a conversation with someone.

- Oh, okay.

Good, good.

We're gonna get to lots more, but we have another call.

And that's Dick from Johnstown.

Dick, thank you so much for calling in and joining us tonight.

Your question?

- [Dick] Yes, could you briefly, the doctors explain maybe the biology of how the light boxes or natural light or sunlight helps mitigate SAD?

- Hmm, good point.

Thank you for bringing that up, Dick, I appreciate that.

Who would like to give us a little brief, hopefully not too medically induced-type description of what our bodies are doing with that light source?

- Yeah, like I think I initially I explained the way light works is it activates some of our brain centers which govern circadian rhythm and also keep the melatonin level down during the day, which helps with the depressive symptoms.

Also, like we said earlier, those with decreased retinal sensitivity, that increased lights helps activate the brain, again.

- We hear the terms- - Mood centers, yeah.

- Melatonin and serotonin, so can you weigh in and give us a little primer on the difference there in our bodies and why we need both, I guess for keeping our moods active but yet tempered.

- Yeah.

And so I will say I am not a psychiatrist.

And so this is beyond my level of competence.

You know what I will say, serotonin.

We all know about melatonin, right.

And that really being implicated and helpful for our sleep, right?

And again, it ebbs and flows throughout the day.

And so, you know, it's most prominent, you know, during the nighttime helping us sleep.

And it'll start to decrease during the daytime so that we can feel more awake and have more energy.

As far as serotonin, we know that that is related to not only mood, but also sleep, right?

And so knowing with seasonal affective disorder, there may be limited amounts of serotonin which then we know may be impacting then the sleep.

But definitely mood and depression.

- Okay.

Great.

We've about 30 minutes into the program.

That means we have a good half hour left of this conversation.

We'd love you to join us.

Call us at 1-800-543-8242.

We have experts here from Penn State Health and from the Penn State University CAPS program, which is psychological help for students.

But our psychologist here, Dr. Magruder, has expertise in the anxiety and eating disorders as well.

So thank you so much for being with us, Dr. Singh and Dr. Magruder.

I wanted to get to other contributing factors.

So we know that sun and cloudy days, you know, but do economics, do demographics, do social isolation, does post-COVID play into all this?

Are we seeing any trends now coming out of what we just came through with the pandemic and how it plays into this disorder as part of that umbrella for depression?

Can we attach any similarities to what what you're finding, doctor?

- I mean, in general for seasonal affective disorder, I can't say that I have come across much studies, but yes, social isolation secondary to COVID is definitely contributed to increased incidents of depression and anxiety.

Does that translate into increased incidence of SAD?

I don't know.

- I think the the jury's out.

That's a terrible descriptor, but there's research, I'm sure, that's underway I would assume, on all of this in relation to mental health, and this is being one.

Tell us a little bit about your students.

I think people would be interested in knowing, you know, coming out of COVID and with seasonal affective disorder as that umbrella.

But what are you finding in the student population, Dr. Magruder?

- Yeah, so pre-COVID we definitely saw an increase in you know, anxiety and depression.

I think nationally amongst, you know, all the all demographics, right?

But especially amongst our students.

And in post-COVID, you know, what we have seen is still that trending upward of depression and anxiety, particularly depression.

And so when we experience this type of weather, especially for students who are coming from different places, again, I wouldn't diagnose it as seasonal affective disorder because again, we need that two years plus of these symptoms recurring.

But we definitely see a lot of depression amongst our students, right?

And you know, one might think that'd be due to adjustment related concerns.

So again, they're coming from different places and it's a significant stressor, right?

Adjusting to not only the community, but also within the environment that may be playing a part into the depression.

But also again, social isolation, right?

And so when we talk about seasonal affective disorder, social isolation is very pronounced.

Again, I wanna hibernate, I want to stay in my room, on my couch, watch some Netflix, whatever that may be.

And while that can be helpful in the short term, right?

In the long term, that can be detrimental.

Because I always tell people that I work with, you know, we are social beings and we need connection, right?

And again, I can't talk about the biology too much, but we know that there's neurochemicals that are happening in our body when we touch someone, when we have a conversation with someone, right?

And so when you're isolated, you're unable to have those experiences that is very nurturing and reparative for the human body.

And so we know that then that can contribute then these types of depression, and potentially the seasonal affective disorder as well amongst our students.

- Cool, I would argue too, that coming out of COVID, there's many of us that, perhaps, were in need of that social interaction and are working towards coming back to some sense of normalcy or trying to get back into those rhythms and those regular social interactions and things.

But it's a different world, you know, beyond seasonal affective disorder, right?

We're dealing with all sorts of different things.

We'll continue that, but right now we actually have an email questions that I do want to get to.

So let's put that up on the screen.

Larry writes, "Are there any foods in particular that can help mitigate SAD and depression?"

Thank you, Larry.

That is good.

I wanna know this.

Help us out, doctor, or doctors.

Is there any magic food that we can eat that'll help us feel better?

- Yeah, so in general, eating healthy is good.

I mean, I think the vote that, the diet that got the maximum vote for the best diet for in general for overall health is the Mediterranean diet.

Does that mitigate depression?

I don't think there are any studies out there to prove that.

There was a recent study from a journal of affective disorder, which points out some of the nutritional, nutrients that may help with depression.

And I think magnesium was one of them.

But again, I don't think we have enough specific research to say, okay, this kind of diet will be helpful.

Overall, the recommendation would be to eating a balanced, healthier meal with more raw fruits, vegetables, whole grains- - less process, less carbs.

- Yep.

- Agh, all the stuff I love.

Less sugars, all that stuff, right?

- Yes.

- And I'm no nutritionist nor dietician, so I can't speak specifically to this.

What I will say in working and in relationship with those types of providers, what they're really recommending is, as Dr. Singh said, a well-balanced diet that consists of nutrient rich or dense, you know, foods.

But also I like to tell people no food's a bad food, right, in moderation.

And I think that's important to recognize because again, there may be some individuals who are experiencing seasonal affective disorder and you may want, you know, those sugars, you may want those processed foods.

And I don't want you to be discouraged necessarily from eating that if that's what your body is needing in the moment, right?

And because then that can bring about feelings of shame, helplessness, whatever that may be.

And again, those are some of the symptoms- - That feed into the depression.

- That feed into the depression and can just worsen it, right?

And so yeah, I would just say, eat what you need to.

Make sure it's well-rounded and balanced and just don't judge yourself.

But definitely consult with, you know, again, a medical provider, a dietician, a nutritionist, especially if you believe that, you know, what's happening, what you're eating, what you're consuming may not be as helpful in getting you through.

- And as the doctors expressed earlier, again, that daily exercise regimen, combined with the healthy eating, of course, is a tandem, right?

My motto has always been eat less, exercise more.

It doesn't always work most days.

But you know, you just, in my simplistic mind, I think that way.

Hey, we've got another caller, Priscilla from St. Marys, thank you so much for holding on and waiting for us to get to you.

We appreciate your call tonight.

Your question for our experts?

- [Priscilla] My question is, is seasonal affective disorder the same as bipolar?

- Ah, bipolar, we hadn't talked about that yet.

Thank you for bringing that up Priscilla.

So your relationship, how that works with bipolar disorder?

- Yeah, thank you Priscilla.

That's a very thoughtful question.

So actually bipolar disorder, there are two types, type one, type two.

And the main feature there is fluctuation of mood to the extremes.

And mania patients can be very disorganized and not able to function.

So when we talk about people feeling happier on sunny days, they're functional, they are not disruptive, they're able to accomplish their task without making impulsive decisions.

Versus, in bipolar disorder, you would have extremely disruptive life- - Behaviors.

- Behaviors, yeah.

And so yes, depression will be part of bipolar depressive phase, but this would not be the same as seasonal affective disorder.

So yes, you're feeling happy on a happy day in seasonal affective disorder.

But you're depressed.

Versus in bipolar disorder there are extremes of both sides.

- Okay.

And again, a true professional.

And we always wanna caution that our talk tonight and our conversation is very general.

But if you are having these feelings, we're also gonna have a resource page at the end of the show that we'll make sure to have up and you can reference that later if you're watching this on our website or in later, we'll have lots of follow up.

So be sure if you do have those things to ask those questions, right?

'Cause no question is a bad question.

And healthcare providers need intel to be able to make the diagnosis.

Is that- - The more we can, and I'm sure we'll talk about, you know, treatment for seasonal affective disorder, but I think the more that you can be open and honest about what your actual experiences are, the better you'll be served, right?

And so I always think about this as painting a picture.

When I paint a portrait of you, of the individual, right?

And the more paint, the more nuanced, the more strokes that we have of that paintbrush, it's gonna allow us to see the picture a little bit more clearly, better, right?

And that's gonna then guide our interventions, what we can do to help, you know, support you.

- Okay.

If you are just joining us, I'm Carolyn Donaldson and this is Conversations Live Seasonal Affective Disorder here on WPSU.

And joining us tonight we have Dr. Madhavi Singh from Penn State Health and Dr. Sultan Magruder from Penn State CAPS program.

That's the program that helps the students on campus.

But his psychology, or excuse me, yes, he's a psychologist working also on many different disciplines and research.

So thank you both for joining us.

You're much more of an expert than I am on this subject.

I wanna bring up of any other treatments for the seasonal affective disorder that we wanted to just put out there in a general sense.

We've talked about the vitamin D or getting out for walks in the sun, health, exercise, food, the light therapy, any other general things that we want to just make sure that folks are aware of if they come across some of the symptoms?

- I think sleep hygiene we haven't...

I know we brought that up, but I think it's like, that requires extra emphasis.

So making sure if there is a ability to maintain a steady schedule, that's very important.

- Set your, I read this right?

It's good even on the weekends, keep a solid sleep pattern, schedule.

- [Madhavi] Yeah, yeah, yeah.

- And don't set too many alarms or it's okay to set alarms?

(Madhavi and Sultan laugh) We were talking about that 'cause I hit snooze a lot these days.

Good?

Bad?

(Madhavi laughs) - What I will say is every, we want to have deep sleep.

We wanna cycle through the different stages of our sleep, right?

Get to that rhythm cycle.

And the more we sort of like interrupt that process and if we may get stuck in one stage versus the other, you know, when we awake that can inform then our energy levels and stuff like that.

And so definitely I would probably recommend sticking with one alarm and waking up at that point in time.

- And the ever non-ending screen debate, you know.

Don't have those screens on.

Don't go to bed with your phone.

Don't have a TV left on.

Oh boy I'm seeing some truth serum here 'cause I'm guilty of sleeping on my phone.

That's not a good thing, right doctors?

- Correct.

But again, the student I mentioned earlier, he also educated me, apparently there are blue light apps for the phones.

- [Carolyn] Oh, there's an app for everything.

- Yes.

- That's good to know.

- So, I mean I myself use my phone before I go to bed.

So again, I think if someone cannot let go of their phone and they have to use it, just using it in a way that it doesn't interrupt their sleep pattern or the circadian rhythm because of the excess light from the blue light.

- And what I would say is, if some people are capable of utilizing their phones and I know I'm one of those people, I can be looking at the phone, put it down and be able to fall asleep within a few minutes, right.

I have that privilege and being able to do that.

I think for individuals who can't though, and who have really significant problems, you know, with their sleep or experiencing mental health concerns, you know what I would say is, if you're starting with that, we know that you can associate things, you can pair things together, right?

And they can influence one another, right?

And so when we're talking about sleep hygiene, for example.

And you can look that up literally just Google "sleep hygiene" and it'll give you a list of recommendations for that.

We know that one of the first things is like, only use your bed for sleeping, or sexual activity if that's something you're into, right?

Because I know particularly working with students, you know, they're in bed, they're using it for more than that.

They're using it for eating, they're using it for studying, right?

And we know then that we're tricking our brain and associating then the bed with being alert, being awake similar to our phones, right?

We're typically alert and awake when we have our phones.

And so if I have my phone and I'm using that, it's telling my brain, "Oh, be alert."

So when I'm then able to disregard that phone, put it away, then I'm creating a new normal, right.

A new association with my bed that, you know, this is just for sleeping and over time then, my body's gonna naturally be able to respond to that being, it's gonna shut down a little faster.

- Very interesting.

We've got about 15 minutes left.

We're getting in some neat things.

I have to bring up in light of the hybrid work situation that many of us are in now and that's a newer norm post-COVID.

You know, work offices are often in the bedroom or you can work from home.

Has that changed seasonal affective disorder numbers or do you think that will impact the fact that, you know, our work patterns are different.

Therefore, you know, getting outside or, you know, taking those breaks between Zoom calls, you know, is an important part of maybe being proactive in fighting these kind of things?

- I would think that kind of lifestyle definitely affects our mood.

But again, I mean I'm not necessarily sure that it would have impact on specifically a seasonal pattern depression.

But yeah, separating like, okay, I use my phone for this, I use my work computer for my work.

I don't go on YouTube on my work computer.

And then separating my work in a different room.

I do think that helps people separate their boundary of work and home and have a better home lifestyle, yeah.

- And I think employers are becoming more aware of that, you know, in light of how we're all working from different modalities now and doing things in whatever industry that happens to be.

But I do sense that, you know, we're having to pay attention to how those different pockets of our life need to work together but not override each other.

- Yeah.

You know, I think what I would say is, I hope more employers can continue to be aware of the impact of like hybrid work on the actual wellbeing, health and wellbeing of the employee, right?

And you know, I will say that's why it's even more important.

So again, the literature is still out.

There needs to be more research conducted on hybrid model and what impact that may have on different mental health concerns, particularly seasonal affective disorder.

But I liked your word, being proactive, right?

And so we know then that if you have your home office in your bedroom, for example, right?

Again, there's that association, my bedroom is associated with sleep or whatever that may be.

And now I'm changing that.

And so it's hard then to take that hat off when you're outside of work and have your body respond naturally, you know, to the bedroom.

And so that's why it's even more important that we are making sure that we're taking breaks, that we're getting outside.

Even if it's, and I know myself, I would go on the front of my porch and look out and say, "World, ooh.

Okay, thank you."

Right?

And so creating a new normal in that way of how you engage and interact just with your home is gonna be important proactively to mitigate potential mental health concerns.

Particularly, you know, depression.

- Very good.

I want to talk about the seasonal affective disorder and the seasons.

We're in the middle of winter, but is this the only time of year we have it?

I understand that there's also a summer affective disorder or, you know, the seasons can ebb and flow?

- Yeah, certainly people can get depression during summer as well.

And that's from excessive light.

That is more associated with agitation and lack of sleep and decrease appetite.

So it would be the- - [Carolyn] There we see some ones, I guess, for the summer pattern SAD that we've kind of showcased here.

So yeah, why sleep?

The sun's out till 9:30 at night.

Let's make the most of it, right?

And that's not a good thing either, I guess.

- [Madhavi] Correct, correct.

Yeah.

I mean not necessarily.

Again, these people are prone to these presentation, not necessarily that it's bad to be outside when the day is long.

- Okay.

Okay.

Yeah.

A little more substantive.

I have a friend, I'm not sure he's watching at the moment, a meteorologist in this area who brought up on a recent social media post about the change that maybe is happening with daylight savings time to standard time and how, if they permanently make it one way or the other, that that could change, you know, people's behaviors and the amount of light that you get and does it come in the morning or in the evening?

Do you have any thoughts about that?

I know it's kind of like I'm hitting you with this, but his theory is that, you know, maybe we shouldn't, we should have one area and if we change it, it should be the standard so that there's more light in the morning versus in the evening and that might be a better balance for our health and conditioning.

- Yeah, I mean I think waking up in the morning with light definitely keeps us more alert.

So I would think going out to work with the lights out would make anybody feel better versus if it was dark.

So I would kind of concur (laughs) from my standpoint.

- On a very super, yeah, I'm throwing this out 'cause he had that theory in saying that, you know, that could be discussed from many different vantage points.

Climatology, farming, I know there's all sorts of theories out there with the difference of the timeframe.

Dr. Magruder?

- I just want them to figure it out.

(Carolyn and Madhavi laugh) Get something and stick to it, please.

But yeah, you know, as Dr. Singh had mentioned, you know, having light in the morning is very important.

That's gonna be helpful for alertness, right.

And I know there's research out there that talks about different areas of our functioning and so we have our cognitive functioning and we have our physical functioning among other things, right?

And we know that cognitive functioning, that's gonna be highest in the morning.

So that's why it's important that we have light to be able to wake up.

We have food that we're consuming that's gonna be fuel for our bodies, for our mind to be able to function at an optimal level.

Because then you start to see as the day progresses, and this is probably happening right now, at least with me, right?

The more we talk, you know, cognitively it's taken a lot more energy now to stay alert and engaged.

- [Carolyn] We've got good lights right here.

- Great lights, right?

But we know that over the day that part of our functioning starts to decline and we're not our best selves, but what happens, we also see that the physical functioning starts to become more pronounced and capable as the day progresses, right?

And so there's this sort of flip.

And so again, I think that's why it's just very important that, you know, I hope they figure something out that's pretty standardized so that we can become acclimated to it.

But definitely more light in the morning is gonna be helpful for all people, probably.

- Thank you, that goes to my friend Joe Mergo, our meteorologist where I used to work.

So I'll make sure to pass that on if he's busy working at this hour.

We've got about 10 minutes left and we do have an email question that came in.

and this is from Carl who writes, "I'm a big fan of wine and beer, but should I stop drinking alcohol if I think I have SAD?"

Wow, that's an interesting connection.

Thoughts?

- Yeah, so alcohol can certainly make depression worse.

But again, there is something alcohol, the extent of alcohol that is alcohol use disorder versus just drinking regular wine and beer, that should not be necessarily affecting someone's day-to-day function.

But yes, if someone has seasonal affective disorder and if they notice that drinking wine and beer affects their mood, then certainly stepping back would be helpful.

- Yeah, Carl, I would say that, you know, we know that alcohol is a depressant, right?

And depressant connected with, you know, depression, right?

And so, as Dr. Singh had mentioned, you know, we don't want to tell you to necessarily stop doing something, you know, right now without understanding the full complexity of what's going on.

And so I think if you have awareness into the impact that it's actually having on you, right?

I think that's the first step.

And if it's having you feel like a detrimental impact, that it's not really helpful that, you know, I'm awakening after drinking and just not feeling well physically, and that's sort of like impacting my mood, then that's probably a key indicator that you might want to change up, you know, what you're doing.

But again, alcohol, we know that that can impact, you know, mood related concerns, particularly depression.

We know that it's also gonna disrupt sleep, right?

And so I talked earlier about the sleep wake cycle, the REM cycle, and we shift through various stages of our sleep and we know that alcohol then can actually significantly impair our ability to move through those stages and stick into our deep sleep.

That's gonna be really important, so.

- Okay, very, very critical.

Thank you.

And thanks for the question.

We've got a caller right now from, I think it's Alise, I hope I'm pronouncing that correctly from McKean County.

Good evening, Alise.

And your question tonight?

- [Alise] My question is how long does it take for someone to pretty much get a diagnosis of seasonal affective disorder?

Because it could be associated, let's go, when I go back to school or whatever.

But then does it happen more than one time a year?

Because mine happens twice a year and it's like late August and mid-March or so.

It's a time change I think.

- Okay Alise, thank you for sharing your story.

So if we understand that correctly, you wanted to know how long before a diagnosis.

- [Alise] About what age?

- Go ahead.

- About what age.

- About, yeah, there you go.

- Yeah, so I think in looking at the research, you know, onset or individuals typically likely to experience seasonal affective disorder, I think they say around age 20, 21 and up, right?

That they'll start to experience seasonal affective disorder if they are going to, right?

As far as how long it takes to actually get a diagnosis, as I said, if you, you know, go in and talk with a mental health provider, I'll just stay in that lens, again based on our manual, which we utilize to be able to diagnose different, you know, concerns, you know, what we're really going to wanna see is a type of depression.

So for example, major depression and then that subset would be, is there a seasonal pattern to this, right?

And so if it's occurring in at the same time every year in August for example, right?

That may be some indication that this could be, you know, a concern.

But again, we wanna see if this is consecutive years, right?

That's before, that's when we would actually diagnose it.

And so that's not to say that, you know, if you went and talked with your provider and, you know, this was the first year for example, that you noticed these symptoms, that you may not get a diagnosis.

It could be preventional for example, right?

And it doesn't mean then that you won't get treatment, you know, so we can definitely proactively, you know, do some things to help potentially mitigate that.

But yeah, to get an accurate diagnosis, what we're really wanting to see is someone who's had something ongoing for quite some time and it poses a significant sort of like, disruption in their daily life.

But again, it spans on all ages of who can get this.

But typically we're seeing starting around age 20, 21 and up is when you might find it.

- We've got just a couple of minutes left, So, I just want generally to say that help is available, right, for this disorder.

We didn't even get into the specifics of medication 'cause that is very individualized, right, based on the diagnosis and the collaboration between the medical health professionals and the mental health professionals and how that comes to be.

So I guess again, my precursor is to, for those folks watching, if you find similarities in what our discussion has been and you want to talk to someone, best reference would be contact, first your primary care provider or if you have a mental health provider that's already seeking, you know, give them some feedback on this program and maybe there'll be some discussion points that you can take away.

But with the remaining time, I always like to give each of our experts just that kind of closing summary to give us just a one minute synopsis of what takeaway there could be and what we can come out of this discussion for those of you watching for next steps.

And I'll begin with you Dr. Singh.

- Yeah, I think, I think the call is making noise.

- [Carolyn] Sure.

I'm sorry.

Yeah, just take that out.

That's fine.

We've got about one minute left, so we'll have to be brief, thanks.

- Yeah, so I think just the awareness that there is a seasonal pattern to a depressive mood or other mood symptoms and then reaching out for help and then if there are mild symptoms, getting the routine exercise, sleep hygiene, and walking outside and just a light box, dawn simulator, whatever helps out.

And reaching out to the primary care provider and going on from there.

- [Carolyn] Great.

- Yeah, and what I would add to that is, you know, this is a problem that affects a lot of people and it's normal thing that happens, right?

And so, you know, for individuals who may feel, like guilty or feel bad about themselves for experiencing this, I just want to like destigmatize that and reduce some of the shame, right?

But I definitely think being able to be aware of how you're functioning in general, you know, throughout these seasons, taking note of that, right?

So I can have a journal and jot those things down, but making sure that I'm also connected with other individuals who can be that external source of support or validation and telling me and confirming that, you know, what's happening with me is not right and I may need something else.

And so I think that awareness is gonna be important.

- Great, great ideas, great thoughts, great conversation.

Thank you so much.

We've been talking with Dr. Madhavi Singh from Penn State Health and Dr. Sultan Magruder from Penn State CAPS.

I'm Carolyn Donaldson.

Our next episode of Conversations Live will be February 16th, where we're gonna talk about I guess a very serious issue here, Making Sense, what we can, of the Economy.

We need your input.

And from all of us here at WPSU we thank you very much for joining us tonight.

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