The Dose24:45How can I take care of my mental health through the dark months?
As winter sets in and daylight fades earlier, you may be starting to notice some familiar patterns.
Perhaps you’re having a hard time getting out of bed in the morning, even if you slept a solid eight hours. Maybe your appetite has increased, or you don’t feel like leaving the house.
It could be that you just feel sad.
“People have heard the term SAD, or seasonal affective disorder — and affective is just a psychiatric term for mood,” said Dr. Raymond Lam, a professor of psychiatry at UBC who has spent decades researching seasonal depression.
“These are people who have clinical depressions but only during the wintertime,” Lam told Dr. Brian Goldman, host of CBC’s The Dose.
“By spring and summer they are actually feeling better — and in the summertime they’re feeling well.”
Roughly 15 per cent of Canadians will have at least one mild episode of SAD in their lifetime, while two to three per cent will have more severe episodes, according to the Canadian Psychological Association. In order to be diagnosed, symptoms need to significantly undermine daily functioning, experts say.
But even if that’s not the case, you may still not feel your best at this time of year, said Lam.
“We also think about seasonality as a dimension, or a spectrum,” he said.
Some people may experience the “winter blues,” he said.
“They have a lot of the same symptoms of winter depression — but not to the point where it’s really interfering significantly with their functioning.”
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What causes winter depression?
While it’s difficult to establish the exact biological cause of most mood disorders, research has shown the connection between winter depression and the reduced amount of daylight caused by shorter days, Lam said.
“SAD may be like a form of jet lag, where there’s a disconnect between the internal clock and the external environment,” said Lam. “Light is the strongest synchronizer of that biological clock.”
Other research connects seasonal depression and serotonin, one of the neurotransmitters in our brains that helps regulate our moods.
Because of changes in daylight, we have higher levels of serotonin in summer and fall and the lowest levels in winter and early spring, he said.
What are the symptoms?
Common symptoms for winter depression include low mood, reduced energy, fatigue, increased appetite, craving carbohydrates, weight gain, withdrawing from activities and problems with concentration and memory.
More serious cases could include thoughts of hopelessness and suicide.
“When you’re in that state of mind, the journey from the bed to the couch is a long journey,” said Marian Goldstone, an educator and mental health worker in Manitoba.
Goldstone speaks from experience, both professionally as a consultant for the non-profit Mood Disorders Association of Manitoba, and personally through her lived experience with depression.
“One of the things that I want to do in the winter more than anything else is socially isolate. And I have to keep pushing myself to keep connected with people,” she said.
Shine a light on it
There are many options for treating winter depression or preventing symptoms from worsening.
During light therapy, people sit in front of a light device or lamp for about 30 minutes each morning.
“It isn’t a one-off treatment. You have to continue using it on a daily basis,” said Lam.
Light therapy is a common and effective treatment for winter depression, experts say. (Halifax Public Libraries)
About 60 to 70 per cent of people using light therapy get relief from their depression symptoms, with most noticing within a week or two, he said.
Lam said it’s important to choose a light device that is bright enough to be effective.
“The key ingredient is really the intensity of light,” said Lam.
That intensity is determined with a light measurement called lux, defined as the amount of illumination when one lumen is evenly distributed over a square metre. Experts recommend using a light device that has a 10,000-lux intensity.
Put in context, direct sunlight can be from 50,000 to 100,000 lux, while typical lighting in a home’s living room would be less than 100 lux, Lam said.
For the 30-minute light therapy sessions, the device needs to provide the 10,000 lux of intensity to someone who is sitting a reasonable distance away from it — not just a few inches, he added.
“You can be reading or eating breakfast or looking at your screens during that time,” said Lam.
What else can ease symptoms?
Seeing a therapist can help, with experts pointing to cognitive behavioural therapy (CBT) as being particularly effective in reducing symptoms of winter depression.
“People say, ‘Oh, I always get depressed in the winter. I’m never gonna be able to do anything,'” said Lam. But CBT, he said, can help change a person’s negative thought patterns about winter.
“It’s this extremely powerful tool to gain control of emotions through understanding the way we think,” added Natasha Sharma, a therapist and owner of NKS Therapy in Toronto.
Exercizing outside during the winter can help with symptoms of depression, experts say. (CBC/Radio-Canada)
Getting regular exercise, particularly outdoors, can make a difference all though the winter.
“We have to continue to get outside even when it’s cold,” said Sharma. “That fresh air, that exposure to daylight plays a big role.”
Some people may benefit from taking antidepressant medication, said experts.
How to prepare
People who know they are prone to seasonal depression symptoms can take steps to be better prepared, said Sharma.
She recommends creating a mid-summer calendar reminder to start monitoring your mood and self-care efforts. Steps could include journaling, eating healthier and sleeping well.
Goldstone advises having a support team in place before the worst of the symptoms hit.
“What do I have to watch for? Who do I need around me to help get me through this?” Goldstone said.
“It’s pretty hard to do that kind of work when you’re down in the tank in the middle of January.”
Other factors
Be mindful of other things happening in our environment at this time of year that may be affecting our mood, said Sharma.
That could be holiday stress or even current events that we find disturbing.
“It’s hard to tease out how much of this is seasonal affective disorder and how much of this is our environment that kind of goes a little crazy towards the end of the year,” Sharma said.
“The environment plays a huge role in our mental health … we are living in a very difficult time.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
