5 Ways to Manage the Symptoms of Seasonal Affective Disorder

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Photo by: Viktoria Hall-Waldhauser

Ah, winter time. The days are darker, the air is colder and a lot of us feel, sort of….”meh”. One potential reason for this change in mood is Seasonal Affective Disorder (or SAD). SAD is defined as “recurrent depressive episodes during autumn and winter alternating with nondepressive episodes during spring and summer”. Symptoms include low energy, irritability, overeating and weight gain. Symptoms generally begin in November and last, on average, for five months. Like with any condition, there are a range of possible causes for SAD.  It can be a mix of climate, psychological and sociocultural factors and genetic vulnerability. It also seems to disproportionately affect more women than men, and is more common among younger people.

Here are five things you can do to help manage SAD symptoms:

  1. Bright Light Therapy: These bright lights can be purchased at a variety of stores and the general recommendation is 10,000 lux (light intensity) for 30 minutes daily in the morning for up to 6 weeks. The light helps to alter circadian rhythms and modulate serotonin and catecholamines. Potential side effects include headache, eye strain, nausea and agitation. UBC has some good information on how to get a light device.
  2. Cognitive Behavioural Therapy (CBT): CBT has been shown to improve SAD symptoms, either on it’s own or alongside light therapy. Many therapists and other health care providers offer CBT services. Alternatively, there are options for working through CBT exercises online, such as with moodgym.
  3. Vitamin D: Many Canadians find themselves deficient in Vitamin D during the winter months. With the sun being further away from the earth and our skin being regularly covered with multiple layers of clothing, it’s hard to get much sun exposure. Improved Vitamin D status has been linked to improvement in depression scale scores.
  4. St. John’s Wort: This herb, also known as Hypericum, has a long history of use when it comes to depression. It can be consumed in a tea, tincture or pill form. Finding the dose that is right for you is important, as well as making sure this herb does not interact with any medications you may be taking.
  5. Melatonin: This hormone is produced by the pineal gland and helps to regulate sleep. It’s synthesis is triggered by darkness. Abnormal melatonin synthesis may be a cause of SAD. Supplementing with melatonin may help to manage SAD symptoms.

This list does not include the basic pillars for health, which are diet, exercise, stress management and sleep. These pillars should always be addressed first before beginning any sort of treatment. Seeing a Naturopathic Doctor can also help you to discover whether there is a dietary or hormonal component to your mood changes. I invite you to book a free 15 minute appointment with me, so that you can begin to feel good this winter and beyond!

Yours in Health,

Dr. Madeleine Elton, ND

 

References:

Ferri, F. Ferri’s Clinical Advisor 2018.

Goth, FM 3rd, Alam, W, Hollis, B. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. J Nutr Health Aging. 1993;3(1):5-7.

Leppamaki S, Partonen T, Vakkuri O, et al. Effect of controlled-release melatonin on sleep quality, mood, and quality of life in subjects with seasonal or weather-associated changes in mood and behaviour. Eur Neuropsychopharmacol 2003;13:137-145.

Martinez B, Kasper S, Ruhrmann S, Moller HJ. Hypericum in the treatment of seasonal affective disorders. J Geriatr Psychiatry Neurol 1994;7:S29- S33.

Ravindran et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder Section 5. Complementary and Alternative Medicine Treatments. Can J Psychiatry. 2016 Sep; 61(9):576-587.

Rohan, K, Meyerhoff, J, Ho, SY, Evans, M, Postolache, TT, Vacek, PM. Outcomes one and two winters following cognitive-behavioral therapy or light therapy for seasonal affective disorder. Am J Psychiatry. 2016 Mar 1;173(3):244-51.

 

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Getting aligned…why I decided to offer a sliding scale

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Photo by Jens Lelie on Unsplash

I feel like this post has, in one way or another, been rumbling around somewhere in my psyche, waiting for me to bring it to the surface, for many years.

I recently made the decision to officially offer a sliding scale for my naturopathic services. I’m not the first ND to offer this, and I won’t be the last, but I wanted to take a minute (or 5) and I explain why came to this decision.

I’ve always been a highly empathetic person. I knew I had this trait as an adult, but it wasn’t until I came across one of my report cards from kindergarten that confirmed that this has always been one of my stronger traits. I realized this is just me. When I was studying nursing, I really resonated with our lessons on the social determinants of health. One of the strongest social determinants of health is income and social status. In general, those who have more money are healthier. Learning about these types of concepts are what inspired me to become a public health nurse. I wanted work with marginalized populations, offering education, tools and resources to prevent and manage disease. As a public health nurse I was so blessed to work with amazing clients. I worked with different populations. Some with addiction challenges, some who were underhoused, many who barely had enough money to keep themselves and their families fed.

As much as I loved my job, I had always had an equally strong desire to study naturopathic medicine. To dive much more deeply into the body and all the natural ways to support health and healing. I wanted a career where I had more creativity and autonomy, and where I could use some of the modalities that naturopathic medicine offers. I knew, however, that I was getting into private health care, and this was something that I struggled with regularly. I remember when I toured CCNM (the school I attended) I asked my tour guide how she felt about the fact that our services aren’t accessible to the general population. She said that we work hard for 8 years (true! we have to do a 4 year undergraduate degree and then CCNM for 4 more years) and that we invest a lot of money into our education (very, very true), and so we deserve to charge those rates for our services. The truth is, I don’t disagree with this. I don’t think naturopathic doctors overcharge for their services. In fact, based on all of the research and effort that is put into our work behind the scenes, we are realistically probably under charging a lot of the time. Most people who become NDs don’t do it for the money. They do it because they are passionate about the career. You see the power of the medicine and you want to share it with others. But then you graduate and you realize that now you need to be a doctor, a business person, an accountant, a social marketing expert, a top notch researcher, oh and maybe also live your everyday life. It’s not easy.

But the reality is, many people can’t afford our services. There are more and more private health insurance companies that are covering naturopathy, and yes there are people who can afford the services no problem, but many can’t. I will argue that some people could choose to prioritize their health care more, financially, and maybe spend less in other domains. But there are also many people who, no matter how they prioritize their money, wouldn’t be able to afford it. Most of my best friends are artists: singers, dancers, actors, etc. They are my favourite people in the entire world. They feed my soul and make my heart sing. Most of them will never see an ND. They don’t have private health insurance, they probably never will, and their financial stability is up and down.

So, I had to ask myself. Where do I stand? What feels right for me? A sliding scale feels right for me. I want to be able to service artists. I want to be able to service single Moms. I believe that alternative health care should be accessible to everyone. One of my favourite teachers from CCNM, Dr. Chris Pickrell, ND, has been offering a sliding scale for years and it has been very successful for him. I recall him telling me that some of his patients who couldn’t afford the full rate finally got a job where they were making more, and they felt proud and excited to be able to offer the full price for their visits. I believe people don’t take advantage of these options, they use them because they need to.

When I finally came to this decision I immediately felt lighter and more like myself. When you are trying to do what you think you are supposed to do, and it doesn’t align with your deepest ethics, it weighs you down. I encourage my patients to listen to their deepest and truest self, so if I’m not doing the same, how can I ever expect anyone to heed my advice?

Is my decision the smartest business decision I could make? Maybe it is, maybe it isn’t. Maybe I will be wildly successful. Maybe I will fail miserably. But I’d rather listen to my heart, try and fail then to have never tried at all.

I have a fixed rate for all of my standard appointments, however, if the rates do not match your current financial situation, please speak with me and we will work together to find an appropriate rate.

When I registered my business with CRA I called it Metta Health Services. I learned the word Metta when I did a ten-day silent meditation retreat. It means “loving kindness”. It’s a meditation practice where you send yourself loving kindness, and then you extend the circle and send it out to your friends and family, and then finally to all sentient beings. This is my way of practising Metta.

May you be happy. May you be well. May you be safe. May you be peaceful and at ease.

Sincerely and from my heart,

Dr. Madeleine Elton, ND

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Tapping: Emotional Freedom Technique

You might be reading the title Emotional Freedom Technique (or EFT) and thinking “what is this energetic hippie non-sense that this Naturopath is making me read?”. Well, believe it or not, this is a technique that actually has a great deal of evidence behind it, including an array of Randomized-Control Trials!

This technique has been shown to decrease anxiety, depression, stress, pain, anger and tension headaches, just to name a few of it’s benefits! I kind of like to think of this technique as a good substitution for those who tell me “I can’t meditate” or “I hate meditating!”. Some people find sitting in silence a painful experience, and although I still highly recommend meditation to anyone (trust me, it can be enjoyable), EFT it a nice way to experience a lot of the same benefits without motionlessness and silence.

So, I guess the next logical question you are asking is, what the heck is EFT?? Well, I’m here to tell you! It involves tapping on specific acupuncture points (with your fingers) while focusing on an upsetting memory, issue, or emotion. As mentioned above, it can help you to lighten or release emotional distress, become more present in your body and shift your perception.

Here is how to practice EFT:

1. Choose a specific memory or experience.

2. Rate the emotional intensity from 0-10

3. Set-up: Tap the Karate Chop point on the side of the hands while saying aloud three times, ‘Even though I have this…., I deeply and completely accept myself’.

4. Tap the sequence of points, with a reminder phrase. If your phrase was “Even though I felt embarrassed when I had to speak in front of the class, I deeply and completely accept myself”, the reminder phrase would be “embarrassed when I spoke in class”.

5. Tapping the points: tap each point 7-10 times while repeating your phrase, with 2-4 fingers. The points are top of head, eyebrow, side of eye, under eye, under nose, chin, collarbone, under arm (see image below).

6. Rate your emotional intensity again from 0-10.

EFT image copy

If the emotional intensity hasn’t lessened after your tapping sequence, try to become more specific with your phrase to get at the core of the emotion you are feeling.

I love this technique because it is a reminder that no matter what happens in life, we must always return to the love that we have for ourselves. This should be our landing strip, our comfort zone, our default setting. In the words of Brené Brown (the queen of quotes that hit us in those deep feeling spaces!):

When you get to a place where you understand that love and belonging, your worthiness, is a birthright and not something you have to earn, anything is possible“.

If you’d like to learn more about EFT or other ways to help manage stress, anxiety, depression, chronic pain and more, I would love to chat! Until then, happy tapping!

Dr. Madeleine Elton, ND

 

References:

Benor, D, Rossiter-Thornton, J, Toussaint, L. A randomized, controlled trial of wholistic hybrid derived from eye movement desensitization and reprocessing and emotional freedom technique (whee) for self-treatment of pain, depression, and anxiety in chronic pain patients. J Evid Based Complementary Altern Med. 2016 Jul 18.

Bougea, AM, Spandideas, N, Alexopoulos, EC, Thomaides, T, Chrousos, GP, Darviri, C. Effects of the emotional freedom tehcnique on perceived stress, quality of life, and cortisol salivary levels in tension-type headache sufferers: a randomized controlled trial.

Church, Dawson & Marohn, Stephanie. Clinical EFT Handbook. Fulton, CA: Energy Psychology Press; 2013.

Freedom, John. Heal Yourself With Emotional Freedom Technique. Great Britain: The McGraw-Hill Companies Inc; 2013.

Gaesser, AH, Karan, OC. A randomized controlled comparison of emotional freedom technique and cognitive-behavioral therapy to reduce adolescent anxiety: a pilot study. J Altern Complement Med. 2017 Feb;23(2):102-108.

Pagett, Lawrence. Principles of EFT. London, UK: Singing Dragon; 2014.

Suh, JW, Chung, SY, Kim, SY, Lee, JH, Kim, JW. Anxiety and anger symptoms in hwabyung patients improved more following 4 weeks of the emotional freedom technique program compared to the progressive muscle relaxation program: a randomized controlled trial. Evid Based Complement Alternat Med. 2015 Oct 11.

 

 

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Starting Life as a Naturopathic Doctor

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Sometimes you wait so long for something to happen that it’s hard to believe the time has actually come….I am so happy to announce that I am officially a Naturopathic Doctor in the province of Ontario! I began my journey into this career back in January 2014 after working as a Registered Nurse for a few years. The photo above is of me and my best friend from CCNM named Andy. Graduation day was certainly a day filled of pride for us!

Once CCNM (the most intense schooling I have ever experienced) was done, the journey was not over. Oh no, no, no. This past summer consisted of me spending most of my days studying for NPLEX II (a three day core clinical science examination) which you have to pass before you can apply for registration as a Naturopathic Doctor with the College of Naturopaths of Ontario.

The entire process is complicated and sometimes frustrating and sometimes terrifying, but one day you wake up and BAM, it’s all done! And now the time has come to start my ND practice – what joy! I will be working at Elevated Health Associates Inc. on Danforth Ave. The clinic owner, Toni Sharman, is an amazing Osteopath who serendipitously was brought into my life, and I am so grateful! The clinic is about halfway between Coxwell and Woodbine station and has a really wonderful, welcoming energy. I can’t wait to see who I get to treat in the future and the wonderful results that occur.

Hope to see you soon!

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Canadian Infertility Awareness Week: May 7-13, 2017

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As we approach the end of Canadian Infertility Awareness Week I wanted to write a blog post on this topic, as I am very passionate about this area of health. Over the last year, I had the privilege to be on the Fertility and Reproductive Health Shift at the Robert Schad Naturopathic Clinic with the wonderful Dr. Zeynep Uraz. Now that my Naturopathic Medical schooling is complete, I am gearing up to write the Naturopathic Physicians Licensing Exam in August 2017. After passing this exam I will begin to see patients in private practice, and I intend to focus a lot of my energy in the area of infertility.

From all that I have learned so far, it has become clear to me that, by and large, infertility is a poorly understood topic among the general population. I don’t just mean this in the sense that people often don’t understand it medically, but also, and perhaps even more so, emotionally.

When we see our friends on social media, it isn’t uncommon to see a pregnancy or birth announcement. What is much less common is to see a post from an individual or couple saying, “it’s been 14 months of trying to conceive and my period came again”, or “another failed IVF, I feel so hopeless”, or “I just got diagnosed with infertility, I never thought this would happen to me”. The shame and sadness is often kept hidden, tucked away, into living rooms filled with tears or cold medical offices. Infertility can be a reality for a person of any age or gender.

Sometimes people who are facing infertility get asked questions like, “why don’t you just adopt”, or they receive the common advice of “just relax and it will happen”. While these statements may be well meaning, they are rarely helpful.

Fertility Matters Canada is an excellent resource for anyone wanting to learn more about this topic. I especially love the #1in6 section of the website, where couples share their personal experiences with infertility. The name of this is based on the fact that 1 in 6 couples are diagnosed with infertility. So whether you have been diagnosed with infertility, have a friend who is on this journey, or would like to learn more, I highly recommend checking out their website.

I will end on this quote:

There isn’t a person you wouldn’t love if you could read their story

– Marjorie P. Hinckley

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Province Apothecary meditation blog magic!

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I am a big fan of Province Apothecary: a Toronto based company that makes all natural skin care products. I met the founder, Julie Clark, at a friend’s house a few months ago. She is a genuinely kind person who is passionate about her work! After chatting with Julie, I offered to write a guest blog post on their website. I decided to write about my top three favourite apps/websites for guided meditations. The post was published on Thursday, and you can read it on their website here.

Happy meditating!

Madeleine

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