Your Checkup: Health Education Podcast
Ever leave the doctor’s office more confused than when you walked in? Your Checkup: Health Conversations for Motivated Patients is your health ally in a world full of fast appointments and even faster Google searches. Each week, a board certified family medicine physician and a pediatric nurse sit down to answer the questions your doctor didn’t have time to.
From understanding diabetes and depression to navigating obesity, high blood pressure, and everyday wellness—we make complex health topics simple, human, and actually useful. Whether you’re managing a condition, supporting a loved one, or just curious about your body, this podcast helps you get smart about your health without needing a medical degree.
Because better understanding leads to better care—and you deserve both.
Your Checkup: Health Education Podcast
83: Seasonal Affective Disorder: How to Recognize and What to Do
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We share a joyful wedding recap and travel bits, then pivot to a clear guide on Seasonal Affective Disorder: what it is, who it affects, why it happens, and the tools that help. Practical and compassionate advice to steady mood, sleep, and energy through winter.
• defining Seasonal Affective Disorder and its seasonal pattern
• key symptoms including oversleeping and carb cravings
• distinguishing normal winter dips from functional impairment
• who is at higher risk and why geography matters
• biology of light, circadian rhythm, melatonin and serotonin
• evidence-based treatments including light therapy, CBT and medication
• practical routines for light exposure, activity and social connection
• when to seek help and how to prepare for a visit
You can email us at your checkuppod@gmail.com
You can look at our website to find all of our old episodes
References
1. Seasonal Affective Disorder: Common Questions and Answers. Galima SV, Vogel SR, Kowalski AW. American Family Physician. 2020;102(11):668-672.
2. Seasonal affective disorder. National Library of Medicine (MedlinePlus).
3. Seasonal Affective Disorder: An Overview. Magnusson A, Boivin D. Chronobiology International. 2003;20(2):189-207. doi:10.1081/cbi-120019310.
4. Seasonal Affective Disorder: A Clinical Update. Westrin A, Lam RW. Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists. 2007 Oct-Dec;19(4):239-46. doi:10.1080/10401230701653476.
5. Seasonal Affective Disorders. Saeed SA, Bruce TJ. American Family Physician. 1998;57(6):1340-6, 1351-2.
6. Seasonal Affective Disorder. Kurlansik SL, Ibay AD. American Family Physician. 2012;86(11):1037-41.
7. Seasonal Sensitivity and Psychiatric Morbidity: Study About Seasonal Affective Disorder. Fonte A, Coutinho B. BMC Psychiatry. 2021;21(1):317. doi:10.1186/s12888-021-03313-z.
8. Melanopsin, Photosensitive Ganglion Cells, and Seasonal Affective Disorder. Roecklein KA, Wong PM, Miller MA, et al. Neuroscience and Biobehavioral Reviews. 2013;37(3):229-39. doi:10.1016/j.neubiorev.2012.12.009.
9. Role of Serotonin in Seasonal Affective Disorder. Gupta A, Sharma PK, Garg VK, Singh AK, Mondal SC. European Review for Medical and Pharmacological Sciences. 2013;17(1):49-55.
Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski
Hi, welcome to your checkup. We are the Patient Education Podcast, where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Delesky, a family medicine doctor in the Philadelphia area. And I'm Nicole Ruffel. I'm a nurse. And we are so excited you were able to join us here again today. Tough to pick from all of the fun things that like we did in Bali to talk about, but timeliness, it's top of mind that huge congratulations to, I mean, if anyone's a longtime listener of the show, they know that one of our most loyal listeners, Mike, who often listens in his basement doing basement things.
SPEAKER_00:Mike doing basement things.
SPEAKER_02:Um, so if anyone knows of this guy, know that he got married this weekend to his wife, Sam. And we are so happy for them. This was like an awesome wedding. They're so easy to celebrate. They're some of the kindest people. They give of themselves so much, and it just they're they're great people, really easy to celebrate.
SPEAKER_00:Yeah, it was really fun. No notes. Food was great, vibes were great. They looked great.
SPEAKER_02:They did.
SPEAKER_00:And I can confidently say it is better, way better of a time to attend a wedding as a guest.
SPEAKER_02:Oh, yeah.
SPEAKER_00:Than to be the couple getting married.
SPEAKER_02:Yeah.
SPEAKER_00:I and I think not that you know we didn't have fun at our wedding.
SPEAKER_02:We had a lot of fun. We had a lot of fun at the wedding. And it's different. Yeah. Yeah. It's like a very intense day. And hold space for both things. Totally. Look at you. All the the the hip lingo. Yeah, it's like yeah, it was the best day of my life, and it was stressful and like intense.
SPEAKER_01:Yeah.
SPEAKER_02:But this, like, you know, there were no like wedding parties per se. They had a best man and a maid of honor, but like no wedding parties. So you just show up as a guest and you just have a grand old time. It was close to home, which is good. Some of our friends really had to travel. Um, no, probably no more than two hours. But we had an electric legendary table. That was awesome.
SPEAKER_00:Table nine was great.
SPEAKER_02:Table nine was awesome. And look, I've gotten, I mean, if you guys listened last week, you know, I was like dipping my toe in like expressing myself by making videos. Now I'm like expressing myself all over the place. And I might have to reel it in a little bit. That was no pun intended.
SPEAKER_00:Never reel it in.
SPEAKER_02:You like them?
SPEAKER_00:I do. They're so funny. I look forward to them. I mean, we got up this morning and I was like, oh my God, I can't wait for your reel from Mike and Sam's wedding.
SPEAKER_02:I hope it met expectations. I hope I'm not making expectations for myself. You know, when I have free time, I'll do it because it's fun. And like, I feel like you know, posting pictures with captions is fun and nice, and you can do it that way, but I don't shut up. That's why we have this podcast. That's why I make a video to do voiceovers of the photos and videos that we have. So yeah, that one was a fun one to make. Um, poor Austin tore his hamstring, I think, while he was busting a dance.
SPEAKER_00:He the two of them together, he and Addie are like so funny.
SPEAKER_02:Oh, they they really are. Yeah, they have such like a an energy to them when they were on the dance floor.
SPEAKER_00:They Addy's hilarious. I think like honestly, if she wasn't like invited, like she obviously was invited to our wedding, but like she's one of those people where like you would like hire her to be a guest just to like get the party going and like oh yeah, be like electric on the dance floor.
SPEAKER_02:Her walk down the runway.
SPEAKER_00:Oh my god, it's so funny. Yeah, it was not like it was just like so great.
SPEAKER_02:I'm so glad I got it on video. It was like just her her posture, her pizzazz, just everything.
SPEAKER_00:Yeah, the she's got the pizzazz.
SPEAKER_02:It was the pizzazz. Austin is the pizzazz too, and a dump truck. But um, like the way he was able to just like get on the ground, he would like crouch down and bounce up and crouch down and bounce up. And you know, like he's a little meatier than that other guy who was doing it, the other Mike at the park. Oh, yeah. Um, he was doing it, but he was like a like a pencil, he was just like bouncing up and down like a pencil on the ground. But like Austin's more on like a marker, like one of those like thick dry erase markers. Thick, yeah, but handsome, but thick but handsome, yeah.
SPEAKER_00:Not I think write it on his tombstone. Thick but handsome.
SPEAKER_02:I might send this to him and let him know, like, hey, we talked about you. He's like been at the forefront of my mind for the last like three weeks. Like, I don't see the guy all that often, but now like I saw him like a couple weeks before the wedding, saw him at the wedding, see him a couple weeks after the wedding. Like, lots of Austin in my life recently, and I'm not upset about it. Um yeah, oh um braised brisket, like they let you know, eight hours braised brisket at the the event. Um, it was kind of like a go up and get your food buffet style. That was delicious. I loved that.
SPEAKER_00:I thought they were short, it was short ribs. Is that the same thing? Is it? I don't know.
SPEAKER_02:We're not like meat and names really always kind of get me. Like we just figured out last year that like sirloin is the name of a meat that we like.
SPEAKER_00:Well, I knew that.
SPEAKER_02:Well, yeah, there's a special school for people like me. Yeah. Um no, well, I'm just figuring it out. And short rib or what did I call it?
SPEAKER_00:Brisket.
SPEAKER_02:Brisket. Like I'm not sure which one it was. It was delicious. Maybe Mike can chime in here.
SPEAKER_00:Yeah, the food was great.
SPEAKER_02:I loved it. And then like all of the people working were great. Uh, let's see. The DJ was funny. He had like three songs when he was transitioning from dinner to the um like the dance portion, and it was like the bride and groom and their their best people out there, or maybe her sister and her boyfriend, and like they were dancing out there, and like I know Mike got worried. He was like, I really like I thought he wasn't gonna pull through. No, it was so fun, but it was so fun, yeah. And like there was plenty of dancing time. I think it was like two and a half hours of dancing time. Like by the end, I was tuckered out. I was like a little like I was like Ollie. Your feet were really hurting. When you say your feet are hurting, that probably meant that like they were on fire because you're tough.
SPEAKER_00:Yeah.
SPEAKER_02:Like I got one little blister at our wedding, and I was like, Oh, I'm I'm out for a month. I'm out.
SPEAKER_00:I'm still taking you up on your foot rub offer that you oh yeah.
SPEAKER_02:So much around here, like so many wifely things. Like clean the entire fridge, put our groceries away. Yeah, you're getting a foot rub.
SPEAKER_00:I love cleaning the fridge. I gotta do the freezer next. Yeah, you know, and then everything's like clean. Like I cleaned the fridge. Like cleaned the actual fridge, you know. And then everything's like nice and clean and fresh. Put the groceries away. Really turning into my mother.
SPEAKER_02:Not a bad thing. Not a bad thing. Let's see. Um great to see Dylan and Maria sat right next to them at the table, got to catch up. Don't see them a whole lot.
SPEAKER_00:So Dylan's really funny too.
SPEAKER_02:He's hilarious. He like, I felt like I was like dancing in a mirror of my energy on there.
SPEAKER_00:Yeah, he's really funny.
SPEAKER_02:Yeah. Like I took it to a new level and he went right there. Or he took it to a level and I went right there. And I reflected on my behavior of like, you know, the style of dancing I was doing. And it was a personal thing, you know, it wasn't like a work event, but like I was getting in there. I was burning a hole in the dance floor. But enough about me. Yeah, Dylan, like Dylan also happens to know every lyric to every wedding.
SPEAKER_00:He really does.
SPEAKER_02:Yeah. Confidently, too. Like, I'll say, like, oh, I know like a bunch of words, and then like, you know, the part that I don't know comes on. I like turn my head to the side and I try to hide, or like you start mumbling a little bit. No, this guy has studied. He knows. It's impressive. It's impressive. He really knows like every lyric. What else happened? Um, oh, poor Karthik. He was like he was so jet-lagged. Yeah, he should have listened to last week's episode.
SPEAKER_00:Do you think he did?
SPEAKER_02:Um, you know, I think he he is one of the biggest supporters. You know, he was always posting this on his Instagram stories, and he's always listening. Like, real shout out to the people who come back every week truly and like actually demonstrate their support by listening. We are honored, he's one of them. Um but I mean, the man like just think about how we were. Like we were jet lad coming back from Bali ourselves. You probably still are. And this guy showed up and he he was in there. He didn't just he was present. He was present, he was doing his best he could, and then he had to take her to the the airport at 4 a.m.
SPEAKER_00:Yeah, she had an early flight.
SPEAKER_02:Yeah. Busy, busy. Um, so we went to Trader Joe's today, and we haven't been there in a long time.
SPEAKER_00:I was hoping um that some of the Christmas stuff would be out. But it's too early. It's also only like two days into November.
SPEAKER_02:Well, that's not like totally you got the um the advent calendar for Ollie.
SPEAKER_00:Oh yeah, we did. Yeah. They had I'm so upset we couldn't get one last year because they sold out.
SPEAKER_02:Not this year. First in line.
SPEAKER_00:Yeah. He's gonna love it.
SPEAKER_02:It was busy, but they were like all hands on deck. Like they had every cash register was like had a person there, and they're wildly efficient.
SPEAKER_00:They are just like China Airlines.
SPEAKER_02:Gosh, wildly efficient, wildly efficient, and like I knew exactly what was going on.
SPEAKER_00:Like, can we fly China Airlines like domestically?
SPEAKER_02:I wish in the US, honestly, because like that was so cool.
SPEAKER_00:There's like can't like American Airlines and like United anymore, you know?
SPEAKER_02:Yeah, I look, I it was company.
SPEAKER_00:We were taking off at the minute, down to the minute that it said like our flight was scheduled for.
SPEAKER_02:Yeah, none of this, like, oh, there is a tractor on the runway, we're gonna build things in the way 20-minute delay, which stinks, and like we yeah you build it in. We built in like a four-hour timeline before our flight and in between to like make sure that no hiccups happen because we expect so many delays. And it happened, yeah, but no, not China Airlines. Wow, have you seen Taiwan?
SPEAKER_00:Some people most people think it's small.
SPEAKER_02:But I ask you, have you really seen all of Taiwan? Go ahead and tell. Tell them, tell the good people.
SPEAKER_00:Okay, on China Airlines, China Airlines is owned by Taiwan, but China Air is owned by China, I found out.
SPEAKER_02:Oh, did you? I did not know that.
SPEAKER_00:So the whole like on like the screens on the back of the seat, they have this whole like um, I don't know, video, like marketing video, I guess, but it's like for I guess like tourism in Taiwan, and it starts out and it's like, what does it say? Have you ever seen Taiwan? And then it's like most people think it's small, but then it goes on to say, you know, all the things that Taiwan has to offer you. And it just like kept keeps playing on a loop with this very specific music in the background. And so it was on, like, and it like does it on for like takeoff and then landing, then it like starts playing again, and we had two of those flights, so we were watching it on a loop four times. And um, should we tell them about Jade?
SPEAKER_02:I think it would be so funny, yeah.
SPEAKER_00:So there's one part in it, and they talk about Mount Jade, that I guess is like the highest point in Taiwan. Yeah, I think is that what it was?
SPEAKER_02:I think that's what it was.
SPEAKER_00:And so then Eddie is like, if we have a girl, like if we have kids and we have a girl, we should name her Jade. And then when she asks, when she asks, like, how we came up with her name, we can say that it was what are we saying? Like, oh, we named her from like our honeymoon, and then when she asks, like, oh, like where did you go? We can say, I don't know, whatever. And then we'll basically be talking about how we were in Taiwan for four hours on a lie over.
SPEAKER_01:Yeah.
SPEAKER_00:And her name was like from Mount Jade, which is the t the tallest point in Taiwan. But we had never actually been there, and it would all have just like been for the bit.
SPEAKER_02:Yeah, and our only Taiwan experience on the plane lounge.
SPEAKER_00:Yeah.
SPEAKER_02:And uh, yeah, that would say so.
SPEAKER_00:If we ever have a daughter named Jade, it's all for the bit.
SPEAKER_02:Let this be a marker that this is why this happened. And maybe if it does a pretty name, it is a pretty name, though. It is, but Jade, why am I named Jade? Well, we went to Taiwan.
SPEAKER_00:One time your father and I were in Taiwan on our honeymoon. Like, I thought you were in Bali.
SPEAKER_02:We did, we did, but we also went to Taiwan. Well, how long were you in Taiwan? Well, only for a few short hours. Well, what do you mean? How did you see the mountain? Well, we didn't actually. On a video, we saw it on a video. Have you seen Taiwan? Many people think it's small. But I asked them, have you really seen all of Taiwan?
SPEAKER_00:And then that's when she's going to Google, how do I put myself up for adoption?
SPEAKER_02:Oh, it's such a funny bit. I really like now I've made this and I'm it's vexing. I'm fixated on it. Might need to happen. Who knows?
SPEAKER_00:Jade duh. See, I feel like because the name would end in a duh, and then he can't go like duh to duh, like jade de lesky. Like you know.
SPEAKER_02:Duh to duh. It's tough to say.
SPEAKER_00:Yeah.
SPEAKER_02:Yeah. Duh to duck.
SPEAKER_00:Jade Rufal.
SPEAKER_02:Right. That rolls. Could do that. Yeah, that rolls. Um let's see. Maybe we'll have to save our um our food antics and some other Bali stories for another time. Um, oh, wait. What? So Halloween obviously happened recently. And for anyone who's seen Hocus Pocus, we went as um, there's a very small scene, but it's an important scene where the Sandison sisters go in and they meet the devil, and they think it's the devil and his wife, Medusa. Um, you you mentioned sister, but I think wife.
SPEAKER_00:And no, I think in real life, those actors are brother and sister.
SPEAKER_02:Oh, the actors are an actress. Um, oh, well, it seemed like they were playing a married couple, and they were that scene, like the the devil and Medusa is what we went as. And I think it was very well received. You put it together. I had the idea, you made the vision happen. So credit to you, um, Amazon Fairy. Um, that was a fun one. I was really happy about that.
SPEAKER_00:And it was nice because I got to wear pajamas.
SPEAKER_02:You certainly did. So we were actually stepped outside, and some guy was like, Hello, good evening, my lord. But I was dressed as the devil.
SPEAKER_00:He had like a witch hat on.
SPEAKER_02:He oh oh, did he? Yeah. I thought he was just an average person dressed on the street.
SPEAKER_00:Yeah, he had the hat on. Oh, we've got a lot of satanic.
SPEAKER_02:Worshippers around here. Yeah. And then down the street there was someone screaming at the top of their lungs, and the police showed up.
SPEAKER_00:Yeah. We're getting all the gosp from our one neighbor earlier today.
SPEAKER_02:Yeah, apparently a lot of stuff happens around here. But we um it was funny because he was like, Oh, like we don't want people to change their behavior or like stow themselves away inside. And I was like, Oh, that's funny. That's exactly what we do.
SPEAKER_00:That's actually what we do. Yeah, yeah.
SPEAKER_02:I think now's as good a time as any. Um, do you have any more thoughts for the the banter?
SPEAKER_00:No.
SPEAKER_02:You did make a treat today.
SPEAKER_00:I did make a treat. I made some Christmas crack.
SPEAKER_02:Can you tell us a little bit more?
SPEAKER_00:Oh, yeah. Christmas crack. You probably need it.
SPEAKER_02:It's like a professional medical podcast. It's like Christmas crack.
SPEAKER_00:It's like saltines or ritz crackers, and then you pour over, you melt like brown sugar and butter, pour that over it, bake it for a couple minutes, and then put chocolate chips, spread it. So then it's this like caramely, chocolatey, salty, crunchy, sweet, yummy dessert.
SPEAKER_02:Sounds super.
SPEAKER_00:I made some last year for Thanksgiving, and people seem to really like it. And then my friend Lauren and I were talking about it at work the other day because she's having a Christmas party that we're going to, so she was like telling me things she wanted to make. We were talking about Christmas crack and how much we both love it. This was actually on Wednesday when you were working late, and I was like, oh, I might make some Christmas crack for like a little girl dessert to go with my girl. I usually have girl dinner when you work late on Wednesdays.
SPEAKER_02:Oh.
SPEAKER_00:Uh, but we didn't have enough chocolate chips, so I decided to make it this weekend. Okay. Because we were talking about it and I've been wanting it.
SPEAKER_02:Are we gonna enjoy that tonight? Yeah. Is that a thing? Oh, sweet. Wow. All right. Well, now that we're a healthy amount into the show, giving them a lot of stuff to think about. What are we gonna talk about today, Nick?
SPEAKER_00:Well, today to keeping topical with daylight savings time, we are talking about seasonal affective disorder.
SPEAKER_02:Yeah, this is, I feel like it's one that might be under-recognized and underappreciated. Um, but it is that time of year again, uh, you know, where people wake up and it might be dark or a little less dark in the morning, but you probably get back from work and it is dark if you didn't step outside before 5 p.m., um, everyone feels a little off because the clocks moved back an hour. You may feel like you were getting up a little earlier than normal, or maybe a little tired earlier in the night. And just overall, a little less sunlight, I think. Um, the struggle is real. And when this time of year comes around, um, as the days get shorter, this fogginess or that heavy feeling that creeps in may not be just like winter blues or just something you feel like. It could be something more significant. And that's why we want to spend time talking about this today. It's called seasonal affective disorder, um, aptly shortened to sad. SAD. We're hoping to tell you what it is, why it happens, and what you can actually do that's simple and not medicine to try to feel better. So uh Nikki, can you tell us a little bit more about what seasonal affective disorder is?
SPEAKER_00:Seasonal affective disorder is a type of depression that follows a seasonal pattern. So basically what it sounds like. And it usually starts in the fall or the winter when daylight savings time happens, there's less daylight, and then it kind of lifts in the spring, also kind of coinciding with daylight savings when the time changes and we have more daylight.
SPEAKER_02:Yeah. So the for the symptoms to count as seasonal affective disorder, they need to actually show up for at least two winters in a row and clear up when the seasons change. Um, so keep an eye on that if you're curious about this, and that would be an important thing to tell whoever you're working with on this. Um, but it is really more than just like a bad week or feeling bummed out for like a day or two. It is a real pattern. So that's something to keep in mind. Um, for some people, this is very real. Um, it can interfere with their function, with their daily life, work, relationships, motivation, and even appetite and sleep. So this can be a really significant thing that is probably underrecognized in in truth.
SPEAKER_00:I feel like, well, yeah. But then I also feel like everyone just like says they have it.
SPEAKER_02:You think?
SPEAKER_00:You know, like, oh my seasonal affective disorder. Like, no, it's just dark out.
unknown:True.
SPEAKER_00:So it does like otherwise like functioning normally. Yeah, that's like I don't like that it's dark at 4 30 either, but like I'm fine.
SPEAKER_02:Yeah. The what I usually like to do, um, a little like a side here is when people are talking about a symptom, they may be experiencing that symptom. So like in this instance, it would be like sadness or decreased mood and disinterest in doing things, concerning for like things that look like or masquerade around is depression. But then how does that stuff, how do those symptoms affect the functioning and like what you're actually able to do? And that's a big bridge. Um, usually people are pretty surprised. Like sometimes if I ask them and they're like, oh no, I feel this way, but I'm functioning fine. It's important that you feel that way. But if you're able to function, it's at a different level. Sometimes people take it for matter of a fact, though, and they're like, Oh, yeah, I feel this way, and I haven't been able to do X, Y, and Z. And I'm like, Oh, so like in that way, you I draw that line for them. And I'm like, oh, you really have not been able to function and like physically do things that you need to do.
SPEAKER_00:Yeah. I feel like it's one. There are like a I feel like there are a handful of things people like softly like quote unquote self-diagnose themselves with, and I feel like this can be one of those. This might be sometimes, yeah.
SPEAKER_02:Popped in there, yeah.
SPEAKER_00:Like when people are like, I have OCD, like no, you're normal and you're like your house to be clean, like stop. Yeah, no, that you ate too much bread, I'm bloated. Oh my god, I can't have gluten.
SPEAKER_02:I have celiac.
SPEAKER_00:I have celiac, like you don't that does happen.
SPEAKER_02:People do jump to conclusions a lot of times, and that you know, this they're valid questions and thoughts like you should bring up to your clinician, but like don't do it yourself. Like if your car's rattling, unless you're Fran, you're probably gonna take a look at it yourself, like your brother. But like if your car's rattling or shaking, like mine was. Oh my god, I don't like take it myself, and I'm like, there was nothing wrong. Uh they told me there was nothing wrong, but like I brought it to the mechanic and had them tell me that. So that's just kind of the thought here.
SPEAKER_00:Yeah, anyway, I digress.
SPEAKER_02:That was um, so Nikki, can you tell us how you know what do people normally notice when they have seasonal affective disorder?
SPEAKER_00:So it can look a lot like depression. So having low energy, low mood, general kind of just like loss of interest in things maybe that you used to do. Um, but seasonal affective disorder has a few unique features where people tend to sleep a lot more and then crave carbs and as a result of that might gain a little bit of weight in the winter.
SPEAKER_02:Yeah, and some of this, like we I mean, we're gonna share all of our resources that we looked into these two, but like I feel like when people there's less light outside, people are also moving less. And so that may also contribute to a little bit of weight gain. Um, but this does sound like me every February. Um, you know, I so we'll take that as it is. Um so sometimes it seems like there's even a group that gets a reverse pattern. Um, it tends to be more rare, but like in the summertime they may feel more anxious um and they might end up sleeping less or eating less. So it's a little bit of mix and match here, but the far more common one is the one that Nikki described right there.
SPEAKER_00:Okay, Eddie. Who will tend to get seasonal affective disorder the most?
SPEAKER_02:So it's more common in women and younger adults. It's more likely if you live farther from the equator. Um, and that technically means that like places where the winters are darker and longer. For example, like when we went to Bali, we were talking with them and they were like, What do you mean the sun goes down at 4 30?
SPEAKER_01:They were shocked.
SPEAKER_02:And they're like, You mean it gets cold and there's snow? Whereas there, like, I think it all just kind of hovers between like 75 and 88 degrees, and it's like sunny from 6 a.m. to 7 p.m. pretty much all the time.
SPEAKER_00:So summer all the time.
SPEAKER_02:Yeah. So they're close to the equator, and that's what that means. Um in the US, around one to five percent of adults experience seasonal affective disorder. But like you mentioned earlier, many more people claim to have milder seasonal dips in mood that may not reach the threshold of like a formal diagnosis of SAD.
SPEAKER_00:So basically, if you're living in the Northeast, you know someone with this.
SPEAKER_02:Probably. And I've seen a bunch of patients, like I would get people who were really like it really bothers them. And those in residency, they would come in and they would like be really down. And then the month would go by and I'd be like, all right, well, I want to see you in a month, why don't I see you in three months, and then the season would change, they'd come back and like they'd pop right up. And so it can be a little confusing because like we started medicine at the same time too, so it was tough. Like, you need to do all of the things, and we're gonna talk about what that looks like, but it can be confusing. Like, is the medicine working? Is it the season changing? Sometimes tough to say, and I think that's probably why you need two seasons. So then talking about why it happens, um it in large part comes down to the way light affects our brain. When we get less sunlight, our internal clock or the otherwise the circadian rhythm, like we talked about last week, it gets out of sync. And so that messes up with hormones like serotonin and melatonin. And then these already at baseline help regulate mood and sleep. And if they are out of whack, it's probably not too far out of the stretch to imagine that this will cause problems. And so there's some evidence out there showing that some people's eyes detect light differently because of their genes related to pigment called melanopsin. So some people are literally wired to feel light changes more intensely than others at their baseline. So, Nikki, why don't we talk about um treatments that work? Because this not, I mean, sometimes you can just get these things. No, we're telling people like don't self-diagnose yourself. But if you're looking for some extra stuff to do to be more proactive, here's where the list starts. Um, so what are some things that people, the good folks who listen to us, can think about?
SPEAKER_00:Well, the good folks can think about. Um main ones are light therapy, cognitive behavioral therapy, or CBT, or in some cases you might need some antidepressants.
SPEAKER_02:Yeah, and it's reasonable to try. Like, I mean, I think hopefully as we like move farther and farther along in life, like there's less stigma associated with like using a medicine like this. Like you get a cold, like you get a bacterial infection, you take an antibiotic, you have depression, you take a medicine for it, you know. But to each their own. Um, light therapy. That's the one that I found really interesting. This is something that you can just easily buy. Um, it's kind of with a special lamp. The idea is that you sit near a 10,000 luxe light box for about 30 minutes each morning, and it essentially tells your brain, like, hey, it's morning, wake up. And it helps reset your rhythm. And many people know.
SPEAKER_00:I've thought about getting one of them before.
SPEAKER_02:Yeah, I I mean it's an easy thing. I was kind of when we were preparing this, I was like, I mean, we get up really early at five, yeah, and it's always dark, and part of me is like, do we put it in the Pelly room?
SPEAKER_00:Like maybe, maybe. I had thought about getting one when I was working on the floor because like, well, you know, like you leave for work, it's dark out, and then you leave work and it's still dark out. And then I was like, when I was reading like what to do and stuff, I was like, I'm not waking up another 30 minutes when I already have to leave for work so early to sit in front of this light.
SPEAKER_02:Right. Here I am in this light, trying to enjoy my coffee, getting blinded by it. But most people notice an improvement within a week or two. So honestly, it's something that I mean. Should we get one? Can we let's see if we can think you can get them on Amazon. Hmm. I'm seeing different things. I'm seeing one. Um, I mean, like Oh yeah, Happy Light.
SPEAKER_00:That's like the the big one that's like marketed a lot.
SPEAKER_02:That one looks like it's$40. Is that I'm seeing that right? That's the uh overall pick on Amazon. Happy Light. Yeah, you just like clip that onto the treadmill in the morning. Or the bike and then let it ride. Might not be a bad idea. We're not divulging ourselves to you guys saying that we have seasonal effects. Oh, that's small. You can put it on a nightstand. Could probably like hook it up to turn on at a certain time too. It's an interesting concept. So we're looking at like$40 here is what I'm seeing. Um, which you're there are also more expensive ones. Um, maybe they have more perks or things, but like the$40 one has like eight and a half thousand reviews compared to more expensive ones, which are like 600, 100. So it's just something to think about. Um, that's an easy one to get started with. Um, there are medications, I'll save the name just because I don't want people running out there, like running to their doctors to be like, I need this medicine. But there are medicines that you can give um that might help, and you can start in the early fall. And if this is like a well-known thing that you have, you know, maybe in that third season you figure it out and you're like, oh, maybe I need to start this medicine preemptively to make sure I can take care of this. And sometimes people pick up their therapy sessions at a higher rate when the sun goes down, and I mean people can identify the negative thought patterns and plan ahead for these hard months. But like nothing's one size fits all. Um, Nikki, are there lifestyle tips that we can just remind folks of uh that will certainly help them, but like maybe harder to do when it's darker outside?
SPEAKER_00:Yeah, there are pretty simple changes you can make. Um, the first one, if it's possible to get outside early in the day, even if it's like cloudy, just you know, when the sun is up to get some light, or maybe even if it's not early in the day, like if you can like go for a walk during lunch or something to you know.
SPEAKER_02:I might start doing that.
SPEAKER_00:Get outside. I go for we go for walks all the time at work. It's a mental health walk. Yeah, it's like splits your day up.
SPEAKER_02:I yeah. My like lunches, so people usually show up like so I have like every 20 minute visits. Um, you know that, but they might not. And that there's like an 1140 slot, and my lunch is like technically supposed to start at 12, but it like never does unless that person doesn't come or that that slot isn't scheduled, and then I'm probably wrapping up and trying to catch up on my morning. So, like in a perfect world, it would be really cool if I could do that. Um it might not happen, but like there's there's times I'm gonna be like leaving, even this job, like leaving in darkness, coming home in darkness. So I probably want to get outside a little bit. So I I get it for all the folks out there who are like, I'm using the word folks a lot. I don't I don't love the word folks.
SPEAKER_00:Yeah, when did that start?
SPEAKER_02:Um today. I don't love the word folks, but here we are. Here we are, folks. Um, what else can we do?
SPEAKER_00:Let's see. You can try to keep your regular schedule, stay active, and staying social is really important so you're not in an isolation of darkness and depressingness.
SPEAKER_02:Yeah. We were we were talking about this today, like having a sense of I mean, like uh we are obsessed with each other, so like we're never alone.
SPEAKER_00:Yeah, it's sick.
SPEAKER_02:Um but having a sense of community in some way, shape, or form is nice. Like you like see friends that you haven't seen in a while. Like you saw like all your friends at the wedding, and you're probably like, I mean, I saw them yesterday and I was like, wow, like I love these guys and I miss them. And so like having some sort of like I don't know, Meg has a book club, and that was really cool. They like all meet once a month and they like talk about the book or the audio book, and I think that that's great. So, like you could do something like that, or if you have like a club that you go to or the gym, sometimes people like go to classes at the gym, two birds, one stone, or two birds, one scone for the people who are bird enthusiasts.
SPEAKER_00:What a scone?
SPEAKER_02:Yeah, you know, um, there's a school of people out there who don't like saying like killing two birds with one stone because it's like harmful to animals.
SPEAKER_00:PETA is gonna come for you.
SPEAKER_02:Yeah, no, they're coming after me. So then the alternative statement, which I hope that nothing gets clipped and is only me saying two birds, one stone, because they think I'm gonna murder murder birds. It's funny, like murder of crows. Um murder, murder. Why am I saying murder so much?
SPEAKER_00:Just keep yeah, keep keep going.
SPEAKER_02:Crime. Um feed two birds with one scone.
SPEAKER_00:Oh, feed two birds.
SPEAKER_02:Yeah, but I just truncated it in the front, so like I normally do and like tried to communicate something that just didn't work out. Yeah, typical me.
SPEAKER_00:Well, now I understand.
SPEAKER_02:Thank you.
SPEAKER_00:You're welcome.
SPEAKER_02:Um, yes, even this could be even as simple as like meeting a friend for coffee or someone regularly. Um a quick highlight on like when to get help. If you notice that the same pattern is happening every year, your mood dips, you're more tired, you're not yourself, it's probably worth bringing up to your doctor. I would I wouldn't say like go to your physical or just like show up and meet a new doctor and say, like, hey, I'm here. And like you should bring it up, but like maybe expect a follow-up appointment, I would say.
SPEAKER_00:Yeah. Because you can't Well, it's also hard to meet like, even if you're already established with your doctor, to go to them one time and say, I guess unless it's like very, very severe. But to, you know, go to them one time and be like, hey, X, Y, and Z, I don't know.
SPEAKER_02:Oh, it's tough. Yeah, right. Like, I and like for someone to listen to you, because you have to be like, I'm worried I have this, and then not feel like you're getting blown off and be like, I've noticed for the last two years, like that I have felt this way. And then they're gonna have to jump in and be like, oh, maybe it's this thing. And I don't know, there's like opportunities for misdiagnosis or like trying to cover so much in one visit. So, you know, do the best you can. That's why we do this kind of thing, so you can prepare for your visits better. So the long and short of it is that seasonal effective disorder is real, it responds to treatment. It might be just a little more than just like feeling down or tired when the sun goes down earlier. But you also don't have to just wait for the spring to feel better. We gave you a couple things that you can work on and see if they help you. And you're not gonna get a medal for toughing it out and not feeling good. Like you're the only one who's gonna not feel good. So might as well look into it and try to make it a little better. Any last thoughts?
SPEAKER_00:Nope.
SPEAKER_02:Great. So thank you for coming back to another episode of Your Checkup. Hopefully, you were able to learn something for yourself, a loved one, or a seasonally affected neighbor. You can check out our Instagram. Check out my personal Instagram if you want. Um Yeah, you've been on fire lately. I yeah, I'm just like pumping them out. Um, but check out our Instagram. You can email us at your checkup pod at gmail.com. You can look at our website to find all of our old episodes, of which there's a ton. And the my next thoughts for a few episodes are gonna be like about osteoporosis. I think we're gonna dip our toe into menopause soon. And the conversation about hormone therapies for menopause, which are often very confusing, and we're gonna try to take some time to break them down in the coming weeks. So if you're interested in that, send us to a friend, a loved one, or a neighbor. And until then, we will see you next time. Until but most importantly, stay healthy, my friends. Until next time, I'm Ed Doleski.
SPEAKER_00:I'm Nicole Ruffo.
SPEAKER_02:Thank you and goodbye.
SPEAKER_00:Bye.
SPEAKER_02:This information may provide a brief overview of diagnosis, treatment, and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments, or medications for a specific person. This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly disclaim any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for a complete information tailored to you. In short, I'm not your doctor. I am not your nurse. And make sure you go get your own checkup with your own personal doctor.
