Taking Back Half the Year: Strategies to Move Through Winter with More Joy

Every year, beginning around September, clients begin to talk about “the dread”… the dread of cold weather and the darkness that comes with it.

Here in Maryland, it can stay porch weather warm, at times, into November. So why, one might ask, are we sacrificing our happiness before we even have to dig out our sweaters?

Seasonal Affective Disorder (SAD) affects only 5% of adults in the United States, but 10%-20% of adults have a milder form of SAD, which can be significant enough to impact mood, family relationships, productivity at work, and healthcare costs. Women are four times more likely to be diagnosed with SAD than men.

Symptoms of SAD and its milder forms, often called “winter blues” or “seasonal depression,” include:

• Fatigue and low energy

• Depressed mood most of the day, nearly every day

• Difficulty concentrating and loss of interest in typically enjoyed activities

• Oversleeping (hypersomnia) and changes in appetite (craving carbohydrates like chips and cookies)

• Weight gain

The good news is, there are proven strategies to help manage SAD, no matter the severity. These include:

• Maximize exposure to natural light: bundle up and take a quick walk outside even when it’s cloudy; sit near windows with curtains open when indoors.

• Light therapy: light boxes can be used to mimic natural sunlight. Use for 20-30 minutes each morning. You can find a variety of choices on amazon.com (read those reviews to see which one might be best for you!).

• Exercise regularly: get the happy endorphins going …even when it’s cold, there are lots of ways to exercise indoors. Take advantage of online motivation with low impact, quick walking videos like this one. I also encourage you to brave the cold if conditions are safe – you get the benefit of light AND exercise in one punch!

• Maintain social connections: Schedule zoom meetings, keep in touch with friends and family via email/text, and be intentional about calling someone 2-3 times per week. Don’t wait for people to call you!

• Eat a healthy diet: We tend to crave “quick fix” foods more in winter – our brains want the chips and cookies that give us instant comfort, but this is followed by a blood sugar crash that worsens our mood and decreases energy. Instead, prioritize more sustainable mood boosting foods like omega-3 fatty acids (salmon, walnuts) and complex carbs (like oats and sweet potatoes).

• Prioritize good quality sleep: keep a consistent sleep schedule and limit screen time an hour before bedtime to improve sleep quality.

• Practice mindfulness: use an app like Headspace to learn how simple breathing exercises can promote an overall sense of peace and calm.

• Start a gratitude journal: jotting down one simple thing you are grateful for each day (such as: “it may be cold, but I am grateful to have a warm bed to sleep in”) helps keep your focus on all that is good in your life.

• Embrace the season: There is a Danish concept called “hygge (pronounced Hooga) mindset,” which involves slowing down, being present in the moment, and enjoying the pleasures that we can adopt in cold weather. Think fuzzy clothes, jigsaw puzzles, or curling up with a blanket to watch a favorite movie.

Which of these ideas resonate with you? I encourage you to pick one thing that seems most doable and commit to giving it a try each day this winter. I wish you a more joyful, energized winter – and remember, the spring will come again!

Chronic Pain – How Can Mindfulness Help?

Chronic pain, or pain lasting longer than three months, impacts more than 50 million adults in the United States, according to the CDC. It affects people’s everyday lives, work, and is linked to depression, dementia syndromes, substance abuse, and higher suicide risk.

Our brains and bodies have a complex system for processing pain.

- First, pain is detected through nociceptors (sensory receptors located throughout the body) and peripheral nerves.

- Second, pain signals are transmitted to the spinal cord and the spinothalamic tract carries the pain signals to the brain, specifically the thalamus.

- Third, various regions of the brain are involved in pain processing.

The limbic system and prefrontal cortex are involved in remembering past experiences and emotional aspects of pain, as well as attention, interpretation, and response to current pain being experienced. It is these brain regions that are impacted when mindfulness-based approaches to pain are practiced.

Mindfulness is the practice of focusing attention on the present moment in a non-judgmental and accepting way. It helps manage and decrease pain through these mechanisms:

1. Attention Regulation:

• Shifting Focus: Mindfulness helps individuals shift their focus away from the pain, reducing the intensity of pain perception.

• Decreased Rumination: By reducing negative thought patterns and rumination aboutpain, mindfulness can diminish the emotional distress associated with it.

2. Emotional Regulation

• Reducing Stress and Anxiety: Mindfulness practices can lower stress and anxiety levels, which can exacerbate the perception of pain.

• Enhanced Emotional Resilience: Improved emotional regulation can help individuals cope better with the emotional aspects of chronic pain.

3. Sensory Modulation

• Pain Perception: Mindfulness can alter the way the brain processes pain signals, potentially reducing the subjective experience of pain.

• Increased Tolerance: By fostering a non-reactive awareness, mindfulness can increase pain tolerance and decrease pain-related distress.

4. Brain Changes

• Neuroplasticity: Regular mindfulness practice can lead to structural and functional changes in the brain, such as increased gray matter density in areas involved in pain modulation and emotional regulation.

• Functional Connectivity: Mindfulness can enhance the connectivity between brain regions involved in attention, sensory processing, and emotional regulation.

HOW?

Many people resist pain, and adopt a punishing or resentful attitude toward their bodies for experiencing it. Instead, mindfulness experts tell us to acknowledge our pain, label it (where, intensity, nature of the pain, such as whether it is shooting or dull), and accept it. Using a mantra such as, “I feel and accept this pain” can be helpful.

Next, redirect your attention to areas of strength. Rather than focusing your attention on what the pain won’t let you do, how have you been strong today? Maybe you were able to fold a load of laundry, maybe just getting out of bed was the victory. However, small, notice, label, and celebrate the ways big and small that you accept your pain and keep going.

It is also helpful to make yourself feel safe and calm in the midst of pain. Breathing exercises and body scans can be helpful to calm the nervous system and reduce reactivity to pain.

Harvard Health Publishing has a body scan practice here

Our brains are skilled at holding on to negative experiences and emotional reactions to pain, so it is important to counteract that by intentionally turning our focus toward the positive. Mantras likes the ones below can help:

 I feel you. I hear you. And I accept you.

 I am strong. I am resilient. I trust my body.

 Is this a mountain or a molehill?

 I am safe, I am loved.

 Look how far I’ve come.

Try saying these, even when it doesn’t feel genuine – you may be surprised at how quickly they begin to feel like your truth. Meditation apps like Headspace have meditations that specifically address pain and may be helpful as you get started.

Know this, though: You are more than your pain, and you can have experiences that aren’t painful. Wishing you pain free moments in the summer ahead!

Sources:

Chronic Pain Among Adults — United States, 2019–2021 | MMWR (cdc.gov)

3 Anxiety Hacks You Can Use Today

I often hear from clients that it is really difficult to apply the tools they learn from my practice, in the midst of severe anxiety symptoms. And they’re right.

When our brains ramp up with anxiety, it behaves in the same way it does if there is a true and immediate emergency. For example, if there is a fire, our brains start the chemical processes to shut everything down in the body except what is needed to RUN.

The frontal lobe, responsible for reasoning and judgment, powers down so that other, more primal instincts (RUN) can power up. That is why, when feeling very anxious, it is hard for us to say, “I need to apply some of the strategies I learned from Dr. Black so that I can curb this anxiety.”

The part of our brain needed to think that and apply it is essentially asleep.

The solution is to try anxiety decreasing practices when we are NOT anxious, so they become instinctive and easier to apply when we ARE.

Below are three simple strategies that you can use at work, in the car, with other people, anytime. I encourage clients to try different strategies, see what works best, and then do those practices 1-3 times/day whether anxious or not.

The strategies I will give you today access the parasympathetic nervous system – that’s the side that tells our brain to calm down and relax. When accessed consistently, the parasympathetic nervous system becomes quicker and more adept at curbing anxiety when we need it.

Try these simple exercises today:

1. Take 5-10 deep breaths, focusing on making the exhale longer than your inhale – this activates your parasympathetic nervous system which essentially tells your brain, “There is no emergency, you’re safe, you can calm down and relax”.

You might inhale to a count of 4, and exhale to a count of 6-8. The number of breaths doesn’t matter, as long as the exhale is longer than the inhale.

2. Put your senses to work and ground yourself in the “now”. You do this by saying, “what are 3 things I can see, what are 2 things I can feel, what is one thing I can smell”?

This is a good exercise to do when your mind is “spinning” on something from the past or future, that you can do nothing about in the present. By using your senses to embrace the present moment, you get out of your head and into your present environment.

3. 4-7-8 breathing: Inhale for a count of 4, hold your breath for a count of 7, exhale like you are blowing out birthday candles for a count of 8.

When done 2-3x/day consistently, this breathing exercise lowers the heart rate, blood pressure, and regulates the hormone cortisol, responsible for the body’s “flight or fight” response.

Remember, it is better to get ahead of anxiety than chase it. Learn what the earliest signs of anxiety are for you and use these strategies before anxiety ramps up and becomes unmanageable.

Enjoy the calm !