December 23, 2021

How to Maintain Your Mental Health This Winter

Show Notes

On this episode, Chuck Gaidica is joined by Dr. Amy McKenzie, Associate Chief Medical Officer of Provider Engagement for Blue Cross Blue Shield of Michigan. Together, they discuss how to combat the winter blues and maintain our mental health as the temperature drops.

In this episode of A Healthier Michigan Podcast, we explore:

  • What causes people to be more prone to feeling sad or depressed during the winter months.
  • What are the symptoms of seasonal mood disorder.
  • What we can do to ease the winter blues.
  • Signs that may indicated we’re struggling with our mental health.

Transcript

Chuck Gaidica:
This is A Healthier Michigan Podcast, episode 96. Coming up, we discuss what we can do to maintain our mental health this winter.

Chuck Gaidica:
Welcome to A Healthier Michigan Podcast. The podcast dedicated to navigating how we can all improve our health and wellbeing through small, healthy habits we can start implementing right now. I’m your host, Chuck Gaidica. And every other week, we sit down with a certified expert to discuss topics, covering nutrition, fitness, and a whole lot more. And on this episode, we are diving deeper into the winter clouds. For some, what is turning into winter months that can weigh down on mental health. And oftentimes, it’s because we’re going into winter blues. We’ll tackle what we can do to take care of ourselves mentally and how we can navigate the colder months ahead. With us today is Associate CMO of Provider Engagement for Blue Cross Blue Shield of Michigan, Dr. Amy McKenzie. Doctor, how are you?

Dr. Amy McKenzie:
I’m great. Chuck. How are you?

Chuck Gaidica:
Doing well, thank you. I know that you’re a board certified family medicine physician, and you’ve got lots of years of experience. And this is an issue that comes up in Michigan. We’re not exclusive to this in the United States, but it sure seems like all the clouds in America come here first. And then they don’t go away for a while.

Dr. Amy McKenzie:
Yeah, you’re absolutely right.

Chuck Gaidica:
Yeah.

Dr. Amy McKenzie:
We do have more cloudy weather than many other areas. There are a couple other areas in the country with lots of clouds, but certainly there are, as you move further south towards the equator, they get more sunlight certainly during the winter months than we do.

Chuck Gaidica:
Yeah. And winter for so many people can be challenging. For some, it’s kind of on a scale where it’s just, “Oh, it’s cold and it’s cloudy today. And no big deal, I’m going to work.” And for others, it directly impacts not only their mood for the day, but oftentimes it keeps on going. So this problem can be temporary. It can also be easily managed for some. But it’s something that we need to understand.

Dr. Amy McKenzie:
Yeah, absolutely. The winter blues, it is something that is quite common, particularly when you’re talking about the general feeling of blues. Some estimates up to 10 to 20%-

Chuck Gaidica:
Mm-hmm (affirmative).

Dr. Amy McKenzie:
There’s also something called seasonal affective disorder. When those blues get much more serious and near more depression types of symptoms. And we see that in about 6% of Americans. However, it’s highly variable as you and I were just talking about. The closer to the equator, the less likely you’re going to be suffering from winter blues. And the more Northern regions and more cloudy areas, it’s definitely much more common.

Chuck Gaidica:
So I tend … and maybe this is my thing. I tend to think of it as a cloudy issue. Is it partly due to cold and just how you can’t go out for your walk anymore with the dog, like you used to for 10 miles or something? Is it related to exercise and a whole lot more than just the shade of gray?

Dr. Amy McKenzie:
There are multiple contributing factors. Researchers have looked at this issue in multiple different ways. And we know that the regulation of serotonin, which is that neurochemical that is implicated in contributing to depression, is one of the chemicals that’s involved in this. The other one is melatonin, which is something that helps with the sleep wake cycle. And both of those are dysregulated in that winter blues are more of what we call seasonal affective disorder. And things that contribute to that regulation for both of those are sunlight and vitamin D. But there’s all kinds of things that contribute to people feeling that winter blues, feeling some of which you’ve mentioned. Exercise and ability to get outside and then exposure to sunlight.

Chuck Gaidica:
So does lifestyle in general, including diet affect us? Because if we’re going for the comfort foods of Mac and cheese and all the sweet stuff around the holidays. That’s got to be part of it too potentially, right?

Dr. Amy McKenzie:
Yeah, things that can be triggers around this is more alcohol, things that can be depressants in your life. And that’s all more common around the holidays, as well. Less exercise, more sugar and more diet. And those are also things that when you are working toward improving those things, that can actually help combat some of these feelings.

Chuck Gaidica:
If you’re getting through even the beginning to mid part of this winter feeling this way, does this mean that you have to have it the entire season? In other words, can it be temporary for some people?

Dr. Amy McKenzie:
So generally with winter blues, it is very seasonally associated. Usually lasts about four to five months, especially when we get into that more diagnosis of seasonal affective disorder. And what we see with that is that that can happen recurrently, but not everybody has symptoms every season. And those symptoms that people feel around this oftentimes are similar to what we see with depression. So feeling depressed every day, loss of interest and things that you enjoy, trouble sleeping, trouble concentrating. Specifically with like winter blues, the things that we see are like over sleeping, overeating, craving for carbohydrates. You’ll hear people talk about, “I feel like I need to hibernate during the winter.” So they tend to withdraw from activities that they enjoy.

Dr. Amy McKenzie:
But in terms of like, does it have to last all season? There are things that you can do and I think that’s the hopeful side of this is, is there are things you can do to combat it. We can’t like wipe away the clouds, we know that they’re going to be here for a couple months. But there are things you can do to take care of yourself and help combat that.

Chuck Gaidica:
And where do we start on that checklist of things we should do? Should we be taking vitamin D supplements, as we hit the winter months?

Dr. Amy McKenzie:
Yeah, it’s a great question. So vitamin D levels are definitely another contributor. We know that with that sunlight that we get vitamin D. And vitamin D’s been one of the things that’s been implicated in this and that can impact those neurochemicals that we talked about. So generally, I recommend that you talk to your doctor about vitamin D because they can check your levels on that.

Dr. Amy McKenzie:
But for many of us in Michigan, we have found that vitamin D is something that can be helpful to take, particularly during the winter months. There are other things that can be done as well, some we’ve talked about. Maintaining your exercise, staying away from things that we know are depressants, alcohol or cannabis, taking care of yourself, ensuring that you’re getting enough sleep every night, doing things that are meaningful and that you enjoy. And then staying with a healthy, balanced diet, avoiding sugars and things like that. There’s some very simple things you can do, too. Taking a walk outside, moving your desk if you’re sitting and many of us are still working virtually, moving your desk in front of a window so that you’re getting light and you’re seeing light during the day.

Dr. Amy McKenzie:
And then there are specific treatments that if you truly have like seasonal affective disorder that can work as well. One of which is, vitamin D, there are medications that can help to improve your serotonin imbalance, similar to what we use with depression. We also use things like talk therapy, trying to replace negative feelings and behaviors that come during the winter months. And then finally, there’s also light therapy that can be utilized. Many people have heard about light boxes and that can be a very simple therapy that is used 30 to 40 minutes a day, generally in the mornings, that can help if you have seasonal affective disorder.

Chuck Gaidica:
If you don’t mind sharing, do you have any issues with the clouds when we head into the winter months? Do you tend to find yourself having any winter blues at all?

Dr. Amy McKenzie:
I absolutely feel it. And I notice a difference and I have done some of those things, moved my desk in front of the window. I use a light in the morning as I’m getting ready in the morning. I take vitamin D because my vitamin D levels were tested and shown to be low. Particularly during the winter, they tend to take a nose dive. So I ensure that I’m taking my vitamin D and trying to get in enough exercise. So have all been things that really help me.

Chuck Gaidica:
Yeah. So if you’re not going to stay away from the holiday cookies and spirits, just stuff that are part of normal parties, and we’re getting back closer to normal, anyway. What if this becomes an issue where you’re struggling? And you realize it’s not just temporary because you had too many cookies. What are your suggestions then if this seems to be leading toward depression?

Dr. Amy McKenzie:
Yeah. So when it seems to cross that line are things where certainly if you’re noticing depressed mood or feeling every single day for several weeks, two weeks is generally a good cutoff time. That you know that you need to then get in and get some help. When it starts to impede your quality of life. You’re having trouble getting out of bed, that persistent depressed feelings, feeling sluggish or trouble concentrating at work. Then I would encourage you to have a conversation. Your primary care doctor is very skilled at being able to have a conversation around this and identify if you’re in need of additional help. As we mentioned some of those things that can help. And they’re best position to be able to walk you through if you’ve already done some of the other things, staying away from the cookies, doing the exercise and incorporating all those things and still not getting better. You really need to reach out and get some help.

Chuck Gaidica:
Yeah. Now those are important tips. And I don’t know this to be a fact, it’s kind of funny, I’m sitting here in front of two computers and one of them has a screen that’s alternating with beach scenes, which is kind of interesting. Is that alone for someone who’s okay with flying in this time in the world, can that really be one of the prescriptions? Just head to a low cost destination south and get yourself a week of sunshine.

Dr. Amy McKenzie:
Oh, for winter blues, you talk to people and it definitely can pick up their mood. There’s no question. So, I think many of us enjoy being on the beach and that sunlight can be really helpful. Obviously we want you to protect your skin, put on your sunscreen. But certainly that sunshine can be helpful. But there are other things that you’re going to have to incorporate as well, because we do live in an area that is prone to this condition. And so incorporating some of those other good health things in your daily activities can be helpful too.

Chuck Gaidica:
Yeah. So as we start to wrap up here in a little bit, give us, again, a recap from the beginning of just this being a temporary situation to something you’re struggling with. What are the tips of things we can do as we head through the holiday season and beyond now into the new year?

Dr. Amy McKenzie:
Yeah. So there are, in terms of being a temporary situation, we describe this winter blues. And that’s what we would say is a more mild, just feeling it when the weather changes and when the clouds come in. Versus when it actually has crossed that line of being what we would call seasonal affective disorder. And that’s a true diagnosis where you are having persistent symptoms, four to five months out of every year, during the winter months. And generally they like to see it two consecutive years in a row. That can indicate that you have something a little more going on and may need more medical treatment or light therapy or routine vitamin D supplementation or combination of those things.

Dr. Amy McKenzie:
So in terms of differentiating the treatments. With winter blues, there are definitely things that you can incorporate into your daily life to be able to help with that. I certainly know that we’re headed into the holidays, we’re all going to be exposed to the sugar and the cookies and the wine. Moderation is what is key, I would say. It’s okay to have a little. But if you’re indulging excessively in those things, it can contribute to a depressed mood. So incorporating exercise, trying to get a little bit of light, especially on those days where it is sunny. Get outside, get a little bit of light, bundle up, go for that walk, can all be helpful.

Chuck Gaidica:
Well, that’s some great stuff and I’m glad we were able to talk about it because we’ve got, what, three, four months ahead of us. We think of it as a holiday season in the end of the year. But, until we get to springtime, sometimes we don’t step out of the clouds until the ground hog calls the shots. So, it could be a minute. It could be a little while.

Dr. Amy McKenzie:
Absolutely.

Chuck Gaidica:
Yeah.

Dr. Amy McKenzie:
Absolutely.

Chuck Gaidica:
Well, listen, we really appreciate your time and thank you for all the help and happy new year to you and your family.

Dr. Amy McKenzie:
Well, thank you. You too, Chuck. Appreciate it.

Chuck Gaidica:
Thanking Dr. Amy McKenzie, who with us today. She’s an Associate CMO of Provider Engagement for Blue Cross Blue Shield of Michigan. With important information about winter blues and even a little more, just in case this is something you’re having to deal with. We’re glad that you’re with us and listening to A Healthier Michigan Podcast. It’s brought to you by Blue Cross Blue Shield of Michigan.

Chuck Gaidica:
If you like our show and you want to know more, you can check us out. You can go online at ahealthiermichigan.org/podcast, or leave us a review or rating on Apple podcast or Stitcher. To get new episodes on your smartphone or tablet, be sure to subscribe to us on Apple Podcast, Spotify, or your favorite podcast app. I’m Chuck Gaidica. Be well.