Episode 27: Treating Seasonal Affective Disorder with Therese Sorrentino, Part Two

00;00;09;00 – 00;00;59;24
Rick Hoaglund
We all have a natural clock. It’s known as circadian rhythm. The rhythm responds to light. It lets our bodies know when to sleep and when to wake. For millions of us, the circadian rhythm works differently between summer and winter. For example, the short days of winter upset our balance of waking sleep. The further we live from the equator, the more likely our bodies circadian rhythm is affected and we could develop Seasonal Affective Disorder. I’m Rick Hoaglund and you’re listening to OnTopic with Empathia. On our last episode, we spoke to therapist Therese Sorrentino about the disorder. Today we’re going to dive into how do we combat this seasonal affective disorder? And one of the treatment options is sun. So we may want to pack our bags and head to the tropics for some much needed vacation, therapists orders! Welcome back Therese!

00;00;59;27 – 00;01;00;28
Therese Sorrentino
Thanks for having me, Rick!

00;01;00;28 – 00;01;34;17
Rick Hoaglund
Now last episode, we went over a lot of general information about what seasonal affective disorder, or SAD, it’s called SAD, what all what some general information about it. But now we’re going to talk today a little bit more about therapy. So tell me a little bit about cognitive behavioral therapy when we’re talking specifically about someone that has SAD, what- what does that entail? Like, if I- if I am your patient, I have SAD, how- what kind of things would you have- would you be asking me, what kind of things would I be talking to you about? What does that look like?

00;01;34;19 – 00;03;13;23
Therese Sorrentino
Okay, so first of all, I need to know that everything starts with a thought. What we think is what we feel and what we feel, you know, then results in some kind of behavior. So are our thoughts and our attitude is very important and how we’re feeling. And so when we tend to feel like down or depressed or blue, our thoughts can be more negative than normal. So you can have a lot of negative thinking. So if you have a lot of negative thinking, all that’s going to do is make you feel even worse. So what cognitive behavioral therapy does is it helps a person to start paying attention to what they’re thinking about, what are you saying to yourself? You know, we all have voices going on in our head all the time. We just don’t pay attention to them. And I mean in our head, I don’t mean outside that are coming. I mean, but we have a dialog that’s going on in our in our head, and you have to pay attention to what that dialog is, because the things that you’re saying to yourself can either make you feel better or they can make you feel worse. So a therapist will help teach you that process of how to do that and then how to restructure those thoughts. And, you know, in therapy, we call that cognitive restructuring. It’s like, how do you how do you take a negative thought and turn it into something that’s more rational and more positive?

00;03;13;25 – 00;03;24;04
Rick Hoaglund
And will this help you overcome SAD, or is this just a tool to help you combat the effects of of SAD? I mean, next year you may get it again, right?

00;03;24;06 – 00;05;11;08
Therese Sorrentino
Right. Yeah. I don’t, it’s I- you know, you cannot prevent yourself from getting SAD, SAD- Seasonal Affective Disorder. You can’t prevent it, but you can learn how to manage it. And so if you do some of these these things that we’re talking about, these therapies that we’re talking about, light, exposure, vitamin D, good sleep hygiene, doing what you can, taking advantage of it. If it’s really bad and you feel like you really need it, an anti-depressant, reducing acid, reducing alcohol, drugs, and going to therapy, I mean, if you can’t implement those- those skills, then you can learn to manage it. You can feel like, you know, I’m feeling down again. Okay, all right, I need to start sitting in front of my light box again. And I know I’ve got to remember to take my vitamin D and, you know, maybe I need to go talk to a therapist because I’m, you know, maybe you’re feeling down and maybe, you know, some of that has to do with things that you’re telling yourself. I mean, we all have stories we tell ourselves are our initial reaction to things. You know, some stories that we go to and I teach people about that. And- Okay, well, we can you have a story, but you can rewrite that story! We can write a new story. We can write some affirmations for you. We can, you know, come up with a plan for. Okay. But what could you be doing right now that that would make you feel better? And so that’s why I think it is really helpful to get some get some therapy. And could the therapy could be short term? Or are we talking about, once they’re feeling better because the sun is out, it’s summertime. We’re coming out of this cold, dark part of the year and we’re going into spring and summer. Now I’m feeling better. I’m guessing at that point you could you could stop this or…?

00;05;30;20 – 00;06;15;09
Therese Sorrentino
Yeah, I think I think it can be short term! I don’t think it has to be a long term. I think it can be that long enough that you learn some coping skills and you learn- you learn some management. How do you manage depression? You know, it’s like I teach people all the time how to manage depression. How do you manage anxiety? And you learn those skills. And the idea is that, you know, once you learn these skills, you apply them outside of the therapy session, you take them out, you apply them to your life and you learn how to incorporate those in your life. And so you can do that. You don’t have to be in therapy long term unless you really like it so much and you’re getting so much out of it. You want to- you want to keep coming like some of my patients do. Some of my patients never leave me!

00;06;15;11 – 00;06;37;10
Rick Hoaglund
It sounded like it’s kind of a holistic way that you have to look at this, though, because it’s not just therapy may work for parts of it. Just vitamin D might work for part of it. Life- light exposure may or may not be a part of this, is it- You’re you have to look at it at as a holistic approach, too, I’m guessing, right? Like you want to do all these things.

00;06;37;13 – 00;09;43;12
Therese Sorrentino
Absolutely. I mean, I do that with any kind of a mental health disorder. A mood disorder is always have to take a holistic approach, which means you’ve got to look at the the physical component and cover your cover your bases, make sure there’s not something physically wrong with you, because we don’t want to overlook that, too. I mean, there could be something else going on physically. And so sometimes I will tell people, I think you need to go see your doctor, get a get a checkup, get some bloodwork done. Let’s make sure there’s nothing else going on here. Maybe get your hormones checked. You know, is is are your hormones playing a factor here? Let’s cover those bases. Let’s make sure there’s nothing physical going on. And then, you know, then the other part of it is, okay, so you know what? What’s going on mentally with you and what can we do to work with your thoughts, your therapy behaviors, you know, lifestyle changes maybe. Do you need to make some lifestyle changes? That’s all part of the holistic approach. And then and then for some people, even what’s going on spiritually with you, you know, did do would it be helpful for you to go to church to pray? I teach everybody I see to meditate because that is the other thing. Meditation is, I think, huge in terms of being able to help people. It it can change the brain chemistry because it changes the neural pathways in your brain. It’s called- do you want to hear the psychological term? It’s called neuroplasticity, but it can literally and I’ve talked to a psychiatrist who said sometimes it can work as well as taking an antidepressant if you’re meditating on a regular basis. And a lot of people have misconceptions about what meditation is and they have different ideas, that that’s religious thing or you’ve got to be able to have like an hour to sit down on a pillow and meditate. And no, none of that’s true. One, it’s not a religious thing. It’s if you meditated 5 minutes a day, you could get benefit from 5 minutes a day. You don’t have to sit down for 30 minutes or a long period of time. It’s not complicated. People think, I can’t keep thoughts from coming into my head. And I go, Well, no, you can’t, because we always have thoughts. One thought after another after another. And Buddhists call that monkey chatter monkey brain. It’s not about that. It’s about starting to become more conscious about your thoughts, which as you become more conscious about your thoughts and what you’re feeling and what’s going on in your body, you can just be more conscious in your life and that, you know, the meditation can really make a difference.

00;09;43;14 – 00;10;02;04
Rick Hoaglund
So that’s something that people could do at home really without any supervision, I’ll call it. So you don’t necessarily need to have a therapist with you. You don’t need to have a doctor with you if you’re- if you’re, if you’re meditating, there’s no- there’s no harm to that, right? There’s no bad side to it?

00;10;02;05 – 00;11;27;00
Therese Sorrentino
No, it’s absolutely- it’s simple and there’s some great apps out there! There are some that don’t charge anything. I know there’s apps that are advertised on TV, but they you know, a lot of them charge. But there’s apps out there that are free or, you know, people can even go on YouTube or whatever. And I always say, you know, listen to a voice guided meditation first. You don’t have to do silent meditation, which is a little harder. Start with voice guided because they’ll take you through the breathing. And that’s the other thing is I teach people how to breathe and how to relax their body, so they’re laying down to go to sleep. I’ll say do a body scan, you know, start with the top of your head, Go down through each and every part of your body. See if you’ve got all your muscles relaxed, your relaxing, your muscles, it taking some deep breaths. And then, you know, you can listen to a voice guided meditation. And there’s lots of them out there for sleep. And there’s ones that you can listen to first thing in the morning. And speaking of which, and I didn’t mention there’s even clocks out there that you can buy that turn on in the morning to wake you up with a light. I forgot about those. Yeah, you can even get to the alarm clock that has that- that feature to it, which is it’s what it’s meant for. But yeah, it’s, it’s really meditation is not as complicated as people sometimes think it is.

00;11;27;03 – 00;11;37;03
Rick Hoaglund
And that could help draw you out of this depression, whether it’s winter blues or whether it’s actually SAD. Meditation could help draw you out from that, right?

00;11;37;06 – 00;12;59;05
Therese Sorrentino
Absolutely. I think it really if you do it, you have to do it regularly. Consistently. You can’t just do it. I don’t know, every once in a while, even if you did 5 minutes every day, I mean, it just can always help with helping you to feel more centered and more grounded and calmer, just and more conscious, which then flows out into every aspect of your life. And so yeah, it’s, it can- it what it does is, is it gets you from being reactive to responding. So instead of reacting and being reactive to things, you respond to things because it slows you down. You’re in, you’re more in the moment? It teaches you to have to be in the moment. So you’re in the moment. You can slow down your conscious and then you can think about, okay, what do I want to say? What do I want to do? And helps you to regulate those emotions so that you don’t, aren’t disregulated and reactive. Because a lot of times people come into therapy and going, you know, they’re very disregulated, their emotions are all over the place. And so for somebody like that, you know, meditation is just a real asset to- to have.

00;12;59;08 – 00;13;33;25
Rick Hoaglund
So we’re coming into a part of the year where we are starting to, you know, in the next month or so, we’ll start having more light and things. Is it still okay for someone to seek help right now if they feel like they have SAD or should they wait until next year? I know that sounds funny, but we are starting to see more light. The holidays are passed, things are getting better and maybe people are starting to feel a little bit better because they’re getting a little bit more light. At this point, do they still need to seek out help for SAD or do they wait until next year?

00;13;33;27 – 00;14;59;17
Therese Sorrentino
No, they should seek help now because all you’re doing is learning! You’re learning tools and techniques that really you can use all year round. And you don’t have to just use those during those months is these are things that tools you have in your toolbox that you can learn. And, you know, doing therapy is just- it’s a great opportunity to grow in. It’s just in, you know, I think it’s a sign of courage, not weakness. But sometimes I think people go, Well, you only go to therapy if you’re weak or, you know, there’s something really seriously wrong with you. And that’s not true. Everybody can benefit from therapy at in their lives at different times for all kinds of different reasons. And now, fortunately, we’re seeing more more people realizing that and coming into therapy and even more men now coming into therapy than ever did before. But it’s- it’s always an opportunity to talk about what’s going on in your life and get some help to and coping skills to work through those things. So you know yeah, if it gets you into therapy, great. But you should, Yeah. Take advantage of it. Whether whether you’re having SAD or not! So if, if I know that I have it, it’s the, it’s the end of the year and I think I’m getting this, right? So getting tools in my toolbox so that when it happens again next year, I’m now a more resilient person. I have tools to be able to combat. I have the ability to get through sad because SAD can be can, can have an effect on your life. You know, you talked about alcohol and drug drugs may be a part of this. You might use them more than you normally would. No sleep, I’m guessing, that you could start having thoughts that you wouldn’t want to have as well.

00;15;36;15 – 00;18;00;22
Therese Sorrentino
Right! But here’s the other thing that we haven’t talked about, and that’s that- that sense, you know, which is a form of depression, seasonal depression can turn in to a major depressive episode. It can turn into a clinical depression, it can get worse. That happens sometimes. And so it’s- it’s important that, you know, if, if it continues to go on and it can you feel worse or it intensifies and you really need to see a therapist or you need to see your doctor, because then that might be an indication that it’s turned into a clinical depression. If you have a psychological depression, and that’s usually caused them some sort of stressor in your life or something that’s happened and you’re feeling down maybe going through a breakup or, you know, maybe you lost jobs, something happened and and you work through that. Clinical depression is a little different because then you have- sometimes it can come out of nowhere. And that might be how SAD feels sometimes, that it can come out of nowhere. Like, I don’t know why I’m feeling like this. Nothing bad is happening in my life. You know, I’ve got a good life. Why am I feeling like this? Well, then that’s a pretty good indication that there’s there’s something chemical going on that there’s it’s a that your brain chemistry is being affected and you’re having clinical symptoms. You know, you’re not sleeping r c ight. Your appetites affected. You’re either eating too much or not enough. You can’t concentrate. You’re you you have no motivation to do anything. And things that you enjoyed doing before you don’t really enjoy doing now. Nothing appeals to you. You just feel really flat and not motivated. And then when people get like that and sometimes maybe it’s hard to keep getting up and going to work or taking care of their hygiene themselves or their house just don’t feel like they want to do anything. And so, you know, you have to be aware that if it can get worse and if it does, you definitely want to seek some help.

00;18;15;18 – 00;19;37;11
Rick Hoaglund
So do you have any advice for someone that might be listening that has self-diagnosed? I will say it that way, self-diagnosed that they may have SAD? What advice do you have for them?

00;15;36;15 – 00;19;37;11
Therese Sorrentino
Well, if they’ve self-diagnosed, they have SAD, and then I’m assuming they’re doing some Google-aid online, because I do have people that come in and have diagnosed themselves and I go, Where did you come up with that diagnosis? And they’ll say, I saw this book. I read it on the back of a book, or I, I Googled it and and I know that I have this. And so people will do that. So if you can- if you can Google and self diagnose yourself, you can certainly Google and find out what are some things that you can do if you think you have that. And it as we talked about previously, there’s things that you can do without having to go get help. If you, for whatever reason, can’t do that. The things we talked about like the light therapy and and vitamin D and meditation and then- then the other therapies that, you know, maybe seeing a therapist or going and seeing a seeing a doctor and getting it, maybe you need an antidepressant, but, you know, I think do what you can do yourself to help yourself at home? And if it- and if it helps and it improves, great. If it doesn’t, then you need to see somebody.

00;19;37;13 – 00;19;53;27
Rick Hoaglund
What do you say to people who have been told that they should just snap out of it, that, you know, everyone goes through this and it’s- it’s you know, you’re healthy, you’re, you’re- you’re young or you’re whatever, just get over it! What do you say?

00;19;54;00 – 00;20;41;26
Therese Sorrentino
Yeah, I tell people that that’s not true! That- don’t listen to that because it’s not that easy to- it’s not always something you can you can’t just snap yourself out of it. You know, how you feel is how you feel. We can’t always control how we feel and you can’t always just snap yourself out of it because if you could, you would. So there, you know, people are telling you that I don’t know what they’re talking about. They’re misinformed. So don’t you know, I’d say don’t let them make you feel bad! You know, you- you have every right to feel the way you feel. And and it’s it’s not that, you know, it’s not that easy. It takes work!

00;20;41;28 – 00;20;56;25
Rick Hoaglund
Do you have any message or something maybe we haven’t covered? Something that you’d like to bring up about SAD or maybe even just general mental health that you’d like our listeners to- to, to hear from you?

00;20;56;27 – 00;24;48;23
Therese Sorrentino
Well, I think I think as a society, we are getting better about recognizing that we can all benefit from mental health from time to time in our lives, that it’s losing some of the stigma that it used to have, which I’m really happy about. And that’s because, you know, now we’re sometimes hearing famous people talk about and admit that they’ve gone to therapy and how much therapy has helped them. And, you know, I tell people, it’s not a sign of weakness. It’s a sign of strength to go to therapy because you are facing your own demons and you are dealing with things that some people, you know, are afraid to look at. It’s not easy to look at yourself and to deal with some of these things or admit that, you know, maybe you are feeling down or you’re having anxiety and- and that’s that’s okay. And, you know, there’s no reason for you not to get some support and some help. And you can go to therapy and you can talk about anything you want to talk about. It doesn’t matter. I tell my clients all the time talking about whatever you want to talk about, you’re you’re not confined to only talk about this. I assume you know what’s going on in your life. What do you feel like? You need some help with? And sometimes, you know, sometimes people just need someone to talk to! And they just need to be able to, you know, vocalize what they’re feeling, what’s going on, and they need to get it out. And sometimes just talking about it and just getting it out and talking about it with somebody that’s objective or neutral and you have confidentiality because you talk with somebody and whatever you talk about stays there. You know, nobody’s going to know what you talked about. And we can all benefit from having a safe place just to kind of get out some of our our feelings or our, you know, our concerns in our lives. So, yeah, I really encourage people, if you haven’t tried it, I would encourage you to- to try it, because it really, it’s really going to be a benefit to you in your life regardless. You don’t- you don’t have to feel like you’ve got a diag- you know, a severe diagnosis like it’s not like it used to be. People thought if you went to therapy, you know, they’re gonna put you in a straitjacket and put you in the hospital and you must be crazy! You know, you’re hearing voices and you’re schizophrenic. And I mean, it used to be that way, I think, at one time. So people thought, Well, if I go to therapy, they’re going to think I’m literally nuts! And- but it’s not, it’s not like that anymore. In fact, I think there’s so many more people going to therapy that I’m hearing from people all the time that they are having difficulties finding providers, that they’ve called like 12 providers and they can’t get in to see anybody. And I think that’s just because there’s so many more people now are finally recognizing that they can reach out or through their you know, even through their employer, you know, their employee assistance program, which, you know, gives them some free sessions. So even if they feel like they can’t afford it, you know, it’s good for them to check with their employer, their H.R., to see if they have some free mental health benefits that you could use as maybe they just maybe they just need to talk to somebody three times or six times just to get some feedback on a particular situation. I’m going through this and I’m not sure what I should do.

00;24;48;25 – 00;25;02;17
Rick Hoaglund
Thank you very much for all you’ve told us the last two episodes, and I appreciate having you on our podcast! Hopefully you’ll come back and we’ll talk about some other subjects in the future. I would really appreciate it! Thank you very much, Therese!

00;25;02;20 – 00;25;11;21
Therese Sorrentino
Thank you, Rick! I hope you do have me back. And I really hope that that this is going to be beneficial to some of the people that are listening to it.

00;25;11;24 – 00;26;38;21
Rick Hoaglund
Seeing a therapist can help you in many ways. You’ll learn more about seasonal affective disorder and what you can do to lessen its effects. Therapy can also help you develop skills, helping you recognize and manage SAD’s effects and behaviors. Some of the main goals are to identify and address potential triggers like shorter days or overcast skies and understand what you need to do to keep the effects of SAD from interfering in your daily life. Therapists also provide support, education and guidance. A mental health professional will help you connect with community resources, health care providers and others for support. If you’re feeling depressed and have suicidal thoughts, please seek help. You can call 9-8-8 in the United States to connect you to a counselor. Or you can dial 800-273-TALK. If you’re in a country other than the United States, please contact your government’s suicide lifeline. Reaching out to someone is a huge step in preventing suicide. To hear other episodes of OnTopic with Empathia, visit our website, www.Empathia.com. Follow us on social media @Empathia, and subscribe to OnTopic with Empathia to hear new episodes as soon as they go live. I’m Rick Hoaglund – thanks for listening to OnTopic with Empathia!