21 Jul 2021
How (and why) to protect yourself and your family from tick bites

Ah! The joys of summer – sun, vacation, bike riding, swimming, and hiking. All good things for our mental health. Generally. The thing is that lots of animals love this time of year, including ticks.

And where there are ticks, there is Lyme Disease. The black-legged tick is the only organism that can transmit Borrelia burgdorferi between animals or between animals and humans. Carried by a range of hosts, the black-legged tick is about the size of a poppy seed. If it is infected with Borrelia burgdorferi, its bite can have profound health implications.

Covid-19 has dominated our attention for so long that none of us, doctors included, have been thinking all that much about tickborne infections but it’s important to remember that we are now at the height of the 2021 season for tickborne infections. In 2019, Maryland recorded over 1,400 cases of the most frequently diagnosed tickborne infection, Lyme Disease, but other tickborne infections like babesiosis, anaplasmosis, ehrlichiosis and Rocky montan spotted fever (RMSF) are also reported here every year. 

What is Lyme Disease?

With more than 300,000 cases diagnosed each year, Lyme Disease is the most common tick-borne illness in the United States. Caused by the bacteria, Borrelia burgdorferi, the early signs and symptoms of Lyme Disease include fever, chills, headache, fatigue, muscle and joint pain, and swollen lymph nodes. People often think they have the flu. One of the best indicators that the problem is Lyme Disease is the distinctive rash that is caused by the tick bite. Sometimes the rash looks like a “bull’s eye” but most of the time, the rash is simply a red circle. Left untreated, or in its chronic state, Lyme Disease includes symptoms of fatigue, restless sleep, aching joints or muscles, pain or swelling in joints, decreased short-term memory or ability to concentrate, and speech problems.

What does this have to do with mental health?

More than you might think. While the media and the public health community focus on many of the health consequences of Lyme Disease, less attention has been paid to the mental health consequences that can coincide with Lyme Disease. It is also often the case that mental health symptoms are overlooked. Both are true for Lyme Disease, but increasingly significant cognitive and psychological symptoms are being recognized as part of the symptom pattern associated with untreated and/or chronic Lyme Disease.

I’m depressed because a tick bit me?

Depression has been reported in 8-45% of patients with post-treatment Lyme symptoms. But these numbers don’t tell the whole story. Many researchers believe that Lyme disease is vastly underdiagnosed. Diagnostic tests lack sensitivity and the symptoms of Lyme disease often overlap with other disorders. Thus, the true prevalence of depression in those affected by untreated or undiagnosed Lyme disease may be much higher. And although better statistics are needed, Lyme Disease may be so debilitating in some cases that it is associated with increased risk for suicidality. The mental health implications may extend beyond depression and even suicide. Case studies suggest that Lyme Disease can be associated with symptoms common to schizophrenia and bipolar disorder, including paranoia, delusions, olfactory, auditory and visual hallucinations, catatonia, and mania.

Tick Bite Prevention Tips:

Wear insect repellent that contains DEET (≥20%) or another EPA-approved repellent and reapply as directed. Wearing clothing and gear that have been treated with permethrin will also help to repel ticks. 

Walk in the center of trails and stay away from wooded or brushy areas with high grass and leaf litter. 

Tuck pants into socks and shirts into pants. 

Wear light-colored long pants and long sleeves to help keep ticks off of skin.

Conduct a full-body tick check and shower or bathe within two hours of returning indoors. After removal, place clothes in a dryer on high heat for 10 minutes to kill any hidden ticks. • Remove any attached ticks with fine-tipped tweezers. 

Check yourself, your kids, and your pets daily for ticks, especially after spending time outdoors.

And if you do find a tick, consider sending it for diagnostics. Most states have labs where ticks can be tested to find out if they are infected.

19 Jul 2021
How to stay safe while having fun this summer

During this reopening period, many of our patients are enjoying summer, yet still feeling anxious about navigating the specifics. These feelings can be further complicated by the fact that, although many adults are vaccinated, kids under 12 remain ineligible to receive the vaccine and, though case rates are dropping in many areas of the country, other parts of the world continue to struggle with the virus.

“It is possible to balance having a fun and relaxing summer and keeping everyone safe,” says Dr. Valerie Relacion, child, adolescent and adult psychiatrist at the Washington Center for Women and Children’s Wellness. “If you or your kids are feeling anxiety, that’s normal. It will help to identify and even write down the questions you have and do a little extra research and planning, but the good news is so many summer activities take place outdoors and the risk of infection has been minimized greatly since last year.”

Read on for some tips to help you navigate your emotions while planning for fun activities , playdates, and vacations, as well as strategies you can use to help kids who are nervous about their safety or anxious about socializing.

Activities
If you’re anxious about allowing your children to engage in organized activities or summer camp this year (not to mention burned out from this past difficult school year), assuage your concerns by looking into the organization’s or camp’s masking, testing, and infection protocols, as well as staff vaccination requirements. The CDC has issued guidelines around summer camp practices, although each camp’s policies will be determined by the state, locality, and the camp itself. Camps that followed safety protocols last summer had an incredibly low transmission rate even as cases were rising in the country, according to studies from Maine and North Carolina.

Playdates
It has been heartening to see our kids with their friends again. However, it can be stressful planning playdates if you are concerned about the vaccination status of parents and teens in another household but are wary of an uncomfortable conversation.

“The pandemic pushed us to talk more openly about what we’re comfortable with and set boundaries in terms of health and our families, and that’s something we can hang on to,” says Dr. Relacion. She suggests asking about vaccination status in a straight-forward and diplomatic manner, from a place of concern for your children as well as respect for the other parent, who is likely also thinking of their kids’ safety. “In the end, you’ll feel less anxiety if you know you’re doing what you can to protect your children,” says Dr. Relacion.
You can always share your family’s vaccination status first, which often encourages people to say whether they’re vaccinated, too.

Events
Similar to navigating playdates, if you’re hosting a backyard barbecue or picnic this summer, being clear about boundaries upfront can help you feel more at ease, such as setting masking and distancing expectations in your invitation. For example “We’re asking everyone who’s not vaccinated to wear masks indoors, and choose what you’re comfortable with outdoors.” Have extra masks on hand in case anyone forgets to bring one. Check out Johns Hopkins’ guide on what’s safe after the vaccine, if you’re trying to figure out ground rules.
If you’re invited to an event, check with the hosts to see what they’re expecting. It may help you feel safer to stick to outdoor events, like patio dining and outdoor concerts if you have unvaccinated kids at home.

Planning a trip
Taking a vacation is a great idea, for the memories and your mental health, and there are ways to do it safely. Again, planning ahead will ease anxieties and keep everyone safe. This can include checking about the masking practices of your accommodation and mode of travel; researching activities and dining options ahead of time; checking on vaccination and infection rates in your destination; and finding out if adults and teens of families you’re vacationing with are vaccinated. And remember— you don’t need to add the pressure of an overloaded schedule. After the past year, some R&R is definitely in order!

If your child is nervous about re-entry
What if your child is more fearful than you are? Some kids are understandably frustrated that their parents are vaccinated and they’re not. Address their concerns directly. Sit down with your kids and a calendar and discuss what they can expect over the next several months. You could sign them up for fewer activities than they might normally do and build up to more, as they get comfortable. You can also update them about the vaccine timeline. As of now, a vaccine for kids is expected later this year, possibly as early as fall.

If your child is more introverted and feeling anxious about socializing, it’s a good idea to talk to them about it. “Understand who your child is. If they love to read and want to be home all the time, maybe you could sign them up for an activity where they’re getting some exercise but they don’t have to be at camp all day,” says Dr. Alexis Wesley, child, adolescent and adult psychiatrist at the Washington Center for Women and Children’s Wellness. If they’re still experiencing significant anxiety around this, consider having them see a professional.

As we’ve said before, you don’t need to go from zero to 100 overnight. In fact, being patient with yourself and your family will lead to a more successful transition. Says Dr. Wesley: “After this past year, it’s important to take the pressure off yourself, and focus on making this summer one of quality time and creating memories.”

06 Jul 2021
How to Adapt to the “New Normal”

With re-openings and loosened mask restrictions, many patients have told us they have mixed feelings about going back into the world again. There is also some embarrassment about admitting this. Shouldn’t I want to see my friends and extended families, send my kids to school and camp, and get back to “normal,” people have asked? This article will help you understand why you may be feeling ambivalent and even anxious about reopening, and how to navigate this transitional time.

Why you’re feeling ambivalent about reopening

We lived through a collective trauma this past year, having experienced death and illness on a mass scale, economic instability, disruption of our day-to-day lives, deep political divisions, and the important but difficult work of confronting racial injustice in our society. If you’re feeling some level of anxiety, fear or vulnerability, that’s a normal response to trauma.

Additionally, there’s nervousness around navigating social situations, particularly because children under 12 are not yet eligible for a COVID-19 vaccine. Some parents have shared that they feel kids are being forgotten with the loosening of restrictions. Politicization around mask-wearing and vaccination may add a layer of discomfort about socializing with people who have different views than you.

Finally, although the past year was incredibly difficult, there were silver linings for some, such as more time with family, less commuting, and a calmer schedule. Plus, it’s normal for humans to adjust to routines, and to fear change, even good change. “Anytime we go through trauma or transition in our lives, says Dr. Wendy Hookman, founder and medical director of Washington Center for Women & Children’s Wellness we emerge into a ‘new normal’ where life feels somewhat familiar but also very different at the same time. The good news is that going through times like this builds resilience which is one of the most important contributors to lifelong mental health and stability.”

How to make the “New Normal” easier on yourself

• Practice self-compassion. First, take time to check in with yourself about your concerns and know that whatever they are, they are valid. This is a great opportunity to practice self-compassion and to recognize and accept, rather than judge, the feelings you’re having, and to be as understanding of yourself as you would of a friend.

• Reframe your thoughts. In our practice, we use cognitive behavioral therapy techniques in which we help patients recognize and then reframe distressing thoughts. “One way to reframe the thought that there’s something wrong with you for not being more energized about the new normal is to appreciate that you and your family got through what was an incredibly difficult year. This is a major achievement!” Dr. Wendy Hookman says.

• Communicate about vaccination and masks. Be polite but straightforward about what you’re comfortable with. A diplomatic way to find out someone’s vaccine status is to disclose your own status ahead of seeing them. This invites them to say whether they’re vaccinated. If you go over to someone’s home, bring a mask along and ask whether your hosts would like you to put it on. If they have kids under 12, err on the side of wearing a mask.

• Stay informed. What we know about COVID-19 has changed over the last year. Keeping up-to-date with science can help you manage your comfort level. For example, we now know the virus is rarely transmitted outdoors and that mask wearing significantly limits transmission.

• Don’t feel pressure to over-schedule. If the speed at which you were operating pre-pandemic seems unsustainable, don’t feel like you have to go back to 100 percent. If you enjoyed the slower pace of the past year, try to retain some of that in your life going forward. “Even if it looks like others are going full speed ahead, remember that you are not required to over-schedule yourself or your family,” says Dr. Hookman.

• Make time for self-care. To avoid burn-out, make time for self-care, such as meditation, exercise, taking breaks from your computer and phone, and getting rest.

• Remember that you’re not alone. It’s easy to feel like you’re struggling more than those around you, particularly on social media. While it may look like everyone is thriving, what you see online is a highlight reel, not reality. Many, if not most people are finding this period challenging. Transitions always are, and people handle them in different ways. What we can do is be patient with ourselves and where we’re at.

Seek help if you need it

If you’re feeling overwhelmed by the prospect of the “new normal” and it’s affecting your ability to function in your day-to-day life, consider seeking professional help. Learn more about our team and our services here at Washington Center for Women’s and Children’s Wellness.

05 Jul 2021
Telehealth: Online video sessions

Updated July 5, 2021

 

Telehealth: Online video sessions continue to be the most convenient method of meeting for our patients so we are seeing patients in person upon request only. While Montgomery County has lifted the mandate on wearing masks indoors, we care for many children, who are not yet eligible for the vaccine, in-person. For this reason, we’ll continue with the precautions instituted during the COVID-19 pandemic. If you are coming to the office for an appointment, please expect to wear a mask, fill out a questionnaire, have a temperature, and maintain social distance in the waiting room and public areas of the office. We will continue to post updates here with future plans.

01 Jul 2021
Collective Trauma: What is it and what can I do about it?

As we start to emerge from the isolation of the pandemic, the term collective trauma is being used quite a bit to describe what we’ve all been going through. The is the first time in my memory that the term is being used so widely outside of psychotherapeutic circles and we’re being asked what it means and what it can tell us.

Collective trauma refers to the psychological reactions to a traumatic event that affect an entire society; it does not merely reflect an historical fact, the recollection of a terrible event that happened to a group of people. It suggests that the tragedy is represented in the collective memory of the group, and like all forms of memory it comprises not only a reproduction of the events, but also an ongoing reconstruction of the trauma in an attempt to make sense of it.

Collective trauma differs from individual trauma as it is recollected in the memory of the group and creates a process of on-going reconstruction and reproduction of the memory in order to make sense of it.

Well known collective traumas include: The HolocaustSlavery in the United States, the Atomic bombings of Hiroshima and Nagasaki, Genocide of Indigenous Communities, the Attack on Pearl Harbor, the September 11, 2001 attacks in the United States, and too many others.

The COVID-19 global pandemic is not the first event to be shared by the entire world, but in this age of technology and social connection when information travels the earth at lightning speed, we are all living the full impact of this collective experience, in real time. The daily “losses” we’ve all experienced and the countless individual tragedies of the virus come together in a cumulative and mutual loss to which few of us are immune.

The whole truth is that some of us will be more affected than others by the stressors covid-19 has placed on our daily lives and that of our communities. We won’t really know for years to come the totality of the physical and psychological effects we’ve endured. That said, we can take notes from survivors of previous events to get a sense of what we can do to mitigate any negative effects. 

Aspects of the COVID-19 pandemic can contribute to both individual and collective trauma. In a rapid review published in a 2020 issue of The Lancet, researchers found that isolation and quarantine contributed to a number of negative psychological effects including panic, depression, hopelessness, anxiety, stress, grief, confusion, anger, and even PTSD.

Research on past pandemics including earlier SARS and Ebola outbreaks provides some clues into the potential long-term collective impact of the COVID-19 pandemic. Commonly observed reactions include panic, depression, hopelessness, anxiety, stress, grief, and PTSD.

Some steps that you can take that may help manage collective trauma include:

Limit Media Exposure

Research on the aftereffects of 9/11 found that people who reported watching more television coverage of the attack experienced greater negative psychological effects. People who watched four to seven hours a day of news coverage of the attack were four times as likely to report PTSD-like symptoms.

Stay Connected with Others

Even if working from home requires limiting your face-to-face contact with other people, it is important to maintain your social connections. Thanks to technology, it’s possible to get creative and continue meeting friends, family, co-workers, and others virtually.

Rely on Trustworthy Information

People experience greater stress and panic if they are not able to accurately and realistically gauge the risk of a threat. While emotions can sometimes cloud judgment, particularly in stressful situations, research suggests that people are pretty good at making accurate assessments of the potential danger if they are provided with trustworthy, reliable information. Helping people make good choices by providing honest, transparent facts is imperative.

Utilize Mental Health Resources

Consider visiting a mental health professional either in person or via telehealth. One benefit of the pandemic is that there are many more online options than there were previously. Please reach out to us at WCWCW or another trusted healthcare provider if you need help.

02 Jun 2021
Questions you should ask yourself when considering professional help

Knowing when to seek professional help can be difficult. Here are a few questions to help guide your decision.

1) How severe are my symptoms? How large is their negative impact on my life?

2) How long have I been in this state of distress?

3) Am I becoming more avoidant or isolative due to this change in mood?

4) Am I less able to properly care for myself (eat, shower, exercise, go to work)?

5) Are friends and family noticing the change in my behavior and expressing their concern for me?

6) Am I beginning to feel hopeless?

There are also specific circumstances when you might consider seeking help:

  • The first is when you have thoughts, emotions or behaviors that are out of control, especially when they are affecting your relationships, your work or your sense of well-being. Never feel embarrassed to ask for help at times when you are upset or depressed.
  • Next is when you are struggling to deal with life’s painful challenges – such as a major illness, the loss of a loved one, divorce or job problems. These issues may be your own, but could also include those of others you care about.
  • The third is when the use of alcohol or drugs interferes with your health, your emotions, your relationships, your job or your ability to fulfill your daily responsibilities.
  • Another is when you are confused, fraught with emotions and need the perspectives of a caring yet unbiased person to help sort among difficult choices.
  • And lastly, when you feel that life is no longer worth living, that you are hopeless and have reached the end of the line, and you would rather die than feel the pain of the present. In the midst of such distress, you are not prepared to make life-or-death decisions. Ask for help.

Connect with our talented specialists and get help from the comfort of your home today.

 

GET STARTED

16 May 2021
Symptoms of an Eating Disorder: Parents, Know the Signs

The unfortunate truth is that eating disorders are prevalent in our society. According to surveys conducted by the National Eating Disorders Association (www.nationaleatingdisorders.org), current estimates are that 20 million women and 10 million men in the US will have an eating disorder at some point in their lives.

Parents are often the very first to recognize or suspect that their own daughter or son may be showing behavioral symptoms of suffering from an eating disorder.  Those afflicted can be embarrassed, ashamed and may not even feel worthy of treatment. They can be secretive and may also go to great lengths to hide their disorder, so it is important to educate yourself and understand the signs and ways to identify the problem and seek treatment as soon as possible.

Individuals suffering from eating disorders drastically change their relationship with normal eating. Typical sufferers will go to great lengths to limit calories. Eating disorders can involve different techniques from not eating or restricting overall food intake, to binging and purging meals, and in some cases abusing over the counter or prescription medication. If you suspect your child is possibly showing signs, what do you look for and what are the next steps to take? Here are some of the warning signs:

Restricting Food or Dieting

• Making excuses to avoid meals/situations involving food (had a big meal, isn’t hungry, upset stomach)
• Eating tiny portions or only low-calorie foods and often banning entire categories of foods such as carbs and fat
• Obsessively counting calories, reading food labels and weighing portions
• Developing restrictive food rituals such as eating foods in a certain order or rearranging food on a plate, excessive cutting or chewing
• Taking diet pills, prescription stimulants or even illegal “speed-like” drugs to eliminate appetite

Bingeing

• Unexplained disappearance of large amounts of food in short periods of time
• Lots of empty food packages and wrappers, often hidden at the bottom of the trash
• Hoarding or hiding stashes of high-calorie foods such as junk food and sweets
• Secrecy and isolation; may eat normally around others, only to binge late at night or in a private spot where they won’t be discovered or disturbed

Purging

• Disappearing during or right after a meal to make frequent trips to the bathroom
• Showering, bathing or running water after eating to hide the sound of purging
• Using excessive amounts of mouthwash, breath minds, or perfume to disguise the smell of vomiting
• Taking laxatives, diuretics or enemas
• Periods of fasting or compulsive, intense exercising, especially after eating
• Frequent complaints of sore throat, upset stomach, diarrhea or constipation
• Discolored teeth (the result of repeated vomiting)
• Backs of finger joints are callused or discolored from using fingers to induce vomiting.

Distorted Body Image and Altered Appearance

• Extreme preoccupation with body or weight (e.g. constant weigh-ins, spending lots of time in front of the mirror inspecting and criticizing their body)
• Significant weight loss, rapid weight gain, or constantly fluctuating weight
• Frequent comments about feeling fat or overweight, or a fear of gaining weight
• Wearing baggy clothes or multiple layers to hide weight

If some of these warning signs are familiar, it’s important to speak up. You should set aside a time to speak to your loved one about your concerns. It’s also very important not to use any language that indicates blame, but instead take a concerned approach. And discussing the need for professional help and guidance in encouraged. Don’t be afraid to have the conversation or worried you may say the wrong thing, it’s more important to speak up. Without treatment, eating disorders only get worse.

You should be prepared for an emotional response from your loved one. Individuals suffering from eating disorders are often afraid to ask for help or don’t believe they deserve help. They will often deny that there is an issue, or will become defensive. However, it is important to educate yourself and to also not give up after one or two discussions. Eating disorders are a very serious illness and in many cases, require the ongoing guidance and help of professional licensed counselors and therapists who have expertise and are trained in this area.

If you think you have a child, teen or young adult suffering from an eating disorder, you can contact us for help at the Washington Center for Women’s and Children’s Wellness at 301-881-9464 or reach out to us via email at info@wcwcw.org.

03 May 2021
The Health and Wellness Benefits of Meditation

The practice of meditation has existed for thousands of years, and it was originally meant to help deepen one’s spiritual self. However, today it has evolved to also be used as a purposeful way of quieting the mind, and encouraging deep relaxation and stress control.

When practiced regularly, meditation provides tremendous health and wellness benefits. It can help you manage your stress level, lower your heart rate and can even teach you how to calm yourself and slow down your breathing in stressful situations.  According to the Mayo Clinic, some of the benefits from regular meditation include:

Gaining a new perspective on stressful situations

• Building skills to manage stress

• Increased self-awareness

• Focusing on the present

• Reducing negative emotions

• Increased imagination and creativity

• Increased patience and tolerance 

Studies prove that meditation training changes the “mental muscles” in the brain by increasing activity in the portions dedicated to processing stress, focus, and calmness, 1  making it the perfect complement to conventional treatments for mood, anxiety, eating and sleep disorders, as well as ADHD. This is such an important finding, that WCWCW decided to stop just recommending meditation and to start providing it to patients (see more info on this at the end of this article!).

Meditation also offers additional health benefits and may help people manage symptoms of medical conditions including:

• Asthma

• Cancer

• Chronic Pain

• Heart Disease

• High Blood Pressure

• Irritable bowel syndrome

• Tension Headaches 

How long is a meditation and what is involved?

A typical meditation can be anywhere from 5 to 30 minutes or more. If you are just starting out, it might be helpful to participate in a group or guided meditation, where people share a setting, and someone skilled in meditation provides direction and guidance. A guided meditation can be a great way to get introduced into meditation, and teach you the foundations of breathing and quieting your mind.

A meditation session will usually begin with the individual in a comfortable position, sometimes seated on a cushion on the floor. The setting will be typically very comfortable with low lighting, and a quiet environment. The guide will provide directions on breathing and paying attention to your breaths. The idea is to free your mind of distracting thoughts as much as possible, and focus on the quiet around you and the simple sound and motion of your breath. You can also pay attention to various parts of your body as you become aware of each area as it relaxes more deeply.

When I prescribe meditation, my patients will often respond “I know I should meditate but I’ve tried and I’m not any good at it! I keep thinking about my to-do list or my kids or what’s for dinner tonight…..” The important thing to remember is that meditation is a practice, meaning that no matter how many years you’ve meditated, the goal is not to simply start out with no thoughts whatsoever. The goal is to continue to have thoughts (because you will) but become less “interested” in them – to notice that they’re there but to decide you’re not going to attend to them right now.

Making the time and space to make meditation a regular part of your routine in itself is an act of self-care that will lead to positive results. Over time you will improve your ability to more easily access the meditative state, release your stress and manage your thoughts for clarity. In the hustle and demands of our too busy lives, learning how to quiet your mind, slow your breathing and find a relaxed state can have multiple benefits to your life, health and even your productivity!

Washington Center for Women’s and Children’s Wellness has recently announced the launch of Recharj Bethesda, at 6430 Rockledge Drive, Suite 400 in Bethesda. Starting November 15th, Recharj Bethesda is providing guided meditation 3 times a day at the WCWCW Bethesda office location.  For hours and sign up information visit www.Recharj.com.

1,Creswell, J.D., et.alAlterations in Resting-State Functional Connectivity Link Mindfulness Meditation With Reduced Interleukin-6: A Randomized Controlled Trial; July 1, 2016, Volume 80, Issue 1, Pages 53-61.
13 Apr 2021
Seasonal Affective Disorder

As the seasons change and sometimes as the days get shorter, some of us can experience changes in mood and in energy.  For some people, this could be signs of “SAD” or Seasonal Affective Disorder.

Seasonal Affective Disorder (SAD) is a type of depression that’s related to changes in seasons – SAD begins and ends at about the same time every year. Many individuals with SAD begin to show symptoms that begin in the fall and continue into the winter months. You may feel tired, or have less energy. You may also feel moody or cranky.

In some less frequent cases, people may show symptoms that begin in the spring or summer. But in both cases, symptoms may start out as mild but become more frequent or severe as the season progresses.


Signs and symptoms of SAD may include:

• Feeling depressed most of the day, nearly every day
• Losing interest in activities you once enjoyed
• Having low energy
• Having problems with sleeping
• Experiencing changes in your appetite or weight
• Feeling sluggish or agitated
• Having difficulty concentrating
• Feeling hopeless, worthless or guilty
• Having frequent thoughts of death or suicide


Fall and Winter SAD

Symptoms specific to winter-onset SAD, sometimes called winter depression, may include:

• Oversleeping
• Appetite changes, especially a craving for foods high in carbohydrates
• Weight gain
• Tiredness or low energy


Spring and Summer SAD

Symptoms specific to summer-onset seasonal affective disorder, sometimes called summer depression, may include:

• Trouble sleeping (insomnia)
• Poor appetite
• Weight loss
• Agitation or anxiety


Seasonal Changes in Bipolar Disorder

In some people with bipolar disorder, spring and summer can bring on symptoms of mania or a less intense form of mania (hypomania) and fall and winter can be a time of depression.


When to see a doctor

Treatment for SAD may include light therapy (phototherapy), medications and psychotherapy.

It’s normal to have some days when you feel down. But if you feel down for days at a time and you can’t get motivated to do activities you normally enjoy, you should see your doctor. This is especially important if your sleep patterns and appetite have changed, you turn to alcohol for comfort or relaxation, or your feel hopeless or thing about suicide.

The specific cause of seasonal affective disorder remains unknown. Some factors that may come into play include:

Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may cause winter-onset SAD. This decrease in sunlight may disrupt your body’s internal clock and lad to feelings of depression.

Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression.

Melatonin levels. The change is season can disrupt the balance of the body’s level of melatonin, which plays a role in sleep patterns and mood.


Risk Factors

Seasonal affective disorder is diagnosed more often in women than in men. And SAD occurs more frequently in younger adults than in older adults.

Factors that may increase your risk of seasonal affective disorder include:

Family history. People with SAD may be more likely to have blood relatives with SAD or another form of depression.

Having major depression or bipolar disorder. Symptoms of depression may worsen seasonally if you have one of these conditions.

Living far from the equator. SAD appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter and longer days during the summer months.

It is important to take signs and symptoms of seasonal affective disorder seriously. As with other types of depression, SAD can get worse and lead to problems if it’s not treated. These can include:

• Social withdrawal
• School or work problems
• Substance abuse
• Other mental health disorders such as anxiety or eating disorders
• Suicidal thoughts or behavior

Treatment can help prevent complications, especially if SAD is diagnosed and treated before symptoms get bad. Contact us at Washington Center for Women’s and Children’s Wellness to make an appointment.

16 Mar 2021
How to Recognize Depression

How to Recognize Depression

Feeling down from time to time is a normal part of life, but when emotions such as hopelessness and despair take hold and just won’t go away, you may have depression. Depression makes it tough to function and enjoy life like you once did. Just trying to get through the day can be overwhelming. But no matter how hopeless you feel, you can get better. By understanding the cause of your depression and recognizing the different symptoms and types of depression, you can take the first step to feeling better and overcoming the problem.

What Is Depression?

Depression is a common and debilitating mood disorder. More than just sadness in response to life’s struggles and setbacks, depression changes how you think, feel, and function in daily activities. It can interfere with your ability to work, study, eat, sleep, and enjoy life. The feelings of helplessness, hopelessness, and worthlessness can be intense and unrelenting, with little, if any, relief.

While some people describe depression as “living in a black hole” or having a feeling of impending doom, others feel lifeless, empty, and apathetic. No matter how you experience depression, left untreated it can become a serious health condition. But it’so important to remember that feelings of helplessness and hopelessness are symptoms of depression—not the reality of your situation.

Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they have lasted—the more likely it is that you’re dealing with depression.

Symptoms can include:

Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.

Loss of interest in daily activities. You don’t care anymore about former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.

Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.

Sleep changes. Either insomnia, especially waking in the early hours of the morning or oversleeping.

Anger or irritability.  Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.

Loss of energy.  Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.

Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.

Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.

Concentration problems. Trouble focusing, making decisions or remembering things.

Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

Depression and Suicide Risk

Depression left untreated can also be a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and seek help immediately. Let them know your concerns. Talking openly about your concerns can save a life.

If you think you or a loved one are dealing with depression, contact Washington Center for Women’s and Children’s Wellness to make an appointment to speak to one of our physicians. We can provide the evaluation, support, and treatment you need to get you feeling good about life again. Contact us today for an appointment at 301-881-9464.

Side bar