Frankye Myers: From Riverside Health System, this is the Healthy You podcast, where we talk about a range of health-related topics focused on improving your physical and mental health. We chat with our providers, team members, patients, and caregivers to learn more about how to maintain a healthy lifestyle and improve overall physical and mental health.
So, let's dive in to learn more about becoming a healthier you. All right. I am really excited to have in the Healthy You studio today with me. Ms. Angela Barco.
Angela Barco: Yes.
Frankye Myers: She is from Bruton. Is that right?
Angela Barco: Yep. Bruton Avenue Family Practice.
Frankye Myers: See, Bruton Avenue Family Practice. I'm excited to have you with us today. Thank you. This episode, we're going to be talking about seasonal depression and is it a real thing?
Angela Barco: It is. Yes, it is.
Frankye Myers: Okay, I look forward to hearing more about it. So, Angela, tell me. What led you in this line of work?
Angela Barco: Wow. So as far as I can remember, I've always wanted to be a nurse. Um, actually. Coming here. I was thinking about that time when I was in the first grade and my teacher made these like makeshift mirrors, you know, the mirror that you see on like, I don't know, beauty and the beast.
Yes. Well, I had like the aluminum foil. Anyway, we had to write down what we wanted to be and when we grew up. And me, of course, you know, at that time, I'm like, I'll just put nurse. But as time persisted on, you know, and to include my, my aunt is actually a nurse. I grew into like, you know, thinking maybe this is something that I really want to do.
I started off in a CNA program and, you know, graduated from that. Um, which led on to LPN, then pursuing for my RN degree, and then here I am as a nurse practitioner.
Frankye Myers: Okay. Yes. Awesome. Awesome.
Angela Barco: And I feel like I made the best choice of my life.
Frankye Myers: Awesome. What's the most rewarding part of your job?
Angela Barco: Um, being able to get my patients back to the healthiest versions of themselves, um, and just simply being able to care for them, you know, to listen to them.
And, you know, I felt like I've always, I've always loved that. I love seeing patients thrive. Yes. Yes.
Frankye Myers: Yes. I love that.
Angela Barco: Thank you.
Frankye Myers: I love that. So today we're going to be talking about seasonal depression. Uh huh. Um, that's often triggered by the change in seasons, um, and occur late in the fall. Okay. Mm hmm. So talk a little bit more about that and I'm, this, this topic is so interesting to me and I'll tell you a funny story after you kind of address that, the time frame that this occurs.
Angela Barco: Okay. Um, so. So typically when we talk about depression, um, specifically a seasonal affective disorder, which is a form of depression, um. That typically starts around, you know, the fall, winter months, um, the winter blues of what we would, you know, call it. And, um, Um, when we're talking about depression, we're thinking of, is there a chemical imbalance, you know, in our brain?
Um, so what we would look at is your neurotransmitters. So those help with, you know, mood stability. We're looking at the serotonin, we're looking at, you know, the dopamine receptors, we're looking at norepinephrine. So and there's a couple more, but those three main chemicals, um, in your brain help to regulate your mood.
Okay. Um, so. Unfortunately, in depression, that's where you have those imbalances. Um, so, you know, with depression, you're going to see, you know, of course, Irritability, you know, feeling sluggish, fatigued, not wanting to participate in things that you normally would, um, and just feeling overall, you know, saddened, um, and in some severe cases, some patients will exhibit suicidal thoughts or ideations and in more severe cases, they would want to act on those thoughts.
Frankye Myers: So yes, yes, this is, this is a serious thing. This is a very. Hard time of year, uh, because of the change, you know, but also because there's so many holidays around the change in seasons. And I know that I struggle with that myself because if you enjoy being outside, you know, by the time you get home, it's dark.
When the season changed initially, this is the funny story, um, I fell asleep. And, um, it was really like 6 p. m., but I thought it was 6 a. m. because I got home early and I fell asleep and so it was around 6 p. m., but I thought I had fallen asleep and I thought it was 6 a. m. and time for me to get ready for work.
So I ran upstairs, I started getting dressed, um, I text someone and I have, I have proof to show it and I said, Good morning, I'm running a little behind. Wow. That's how turned around that was. Wow. And it took me about an hour. It's funny, but it's true. It took me about an hour to realize that I was all turned around.
Wow. So, I mean, because it was so dark, I'm thinking, Oh my goodness, it's getting ready to be daylight. But when it didn't start to get daylight, I just readjusted, but I'd fallen asleep early. So this time is really, really hard. It's a funny story, but it's not so funny. I'm fine. I'm glad you're here because I.
If I do need additional assessment, I do know where to go. But it was, it was like, my goodness, it was so dark. So I know, I know it's hard and kids that want to be outside. Um, and then the weather is not as accommodating. So talk a little bit about not only this seasonal portion from the time change perspective, but all the various holidays that go on, you know, during this time that compound that, um, Yeah.
So, you know, depressive states, right?
Angela Barco: So again, like you were just mentioning, you know, it can mess with your circadian rhythm. Obviously it definitely affected yours and that situation. But like you, you know, just kind of. Go off of what you were just mentioning, you know, um, the colder weather, you're not really wanting to go out, you know, it's getting darker earlier.
Um, it's not as shiny and bright outside, like in the summer and spring months, you know, and that can really affect someone's mood, you know, because they, you know, irritability and so forth. So, um, that's where it. It gets that seasonal affective disorder because, in some cases, some people can have those exacerbated symptoms, um, in those winter months because of those seasonal changes.
Right. Um, but anyway, so, you know, it's imperative that, you know, we talk to our PCP and, you know, if we do see a psychiatrist or a psychologist about those concerns that you're having. And, um, again, you know, just with the holiday season coming up, it could be, you know, an anniversary of some sort of traumatic events, um, or situation that has happened and that can also naturally cause that depression.
Have You're thinking about that situation that happened during that time. Grief, loss.
Frankye Myers: Exactly, yes. So, you know, you know, all days won't be sunny, right? Exactly. So, when should, for our listeners, when should you be somewhat alarmed? Um, and for me, there's always that bounce back or that resiliency factor, right?
And so, when should it be triggered for them, maybe I should get help, right?
Angela Barco: Absolutely. You know, if, again, if you're starting to have, you know, those saddened thoughts, it is, you can't shake it, you know, um, you're starting to have, you know, the what ifs of what if I, okay, I wasn't here would things get better, you know, um, when you really start to have those symptoms, then, you know, definitely reach out to your primary care, um, doctor to see what exactly we can, you know, help you with.
Frankye Myers: Okay. Okay. Okay, um, what do you think, are there other things that you would want our viewers to know about, um, this particular time, or this, or SAD, this particular disorder?
Angela Barco: Yeah, so, you know, anytime you come to your provider, um, with these concerns, of course, We're gonna want to do a physical exam on you.
That's number one because there are certain things that can happen like vitamin imbalances, you know Other forms of chemical imbalances, blood imbalances, electrolyte imbalances that can actually mimic depression symptoms. So of course a physical exam is always imperative to start with first. You know, taking lab work to make sure that those labs are not, you know, sub therapeutic.
Because if it's a simple change You know, we can, you know, make those positive changes with medication management then in hopes of, you know, getting them back to that therapeutic level. So, okay. Yep. So just checking and, you know, making sure that. . The inside the blood work is okay, you know? And like I said, vitamins, especially vitamin D.
Yes. Vitamin D, you know, we get that from the sun. Yes. So again, it goes back to that seasonal thing. Right. We're not out as much. We're not as out as much, you know?
Frankye Myers: And even if we're out, we sometimes can't take in enough. Right,
Angela Barco: exactly. Okay. And vitamin D definitely has been known to, um, especially the deficiency in it, has been known to cause depression symptoms.
So getting that vitamin D. Um, labs checked is imperative as well.
Frankye Myers: I'm going to go take my vitamins that I haven't taken since this morning. So,
Angela Barco: and your thyroid, your thyroid can also, if those thyroid levels are, you know, off a little bit, it can also to cause, you know, some depression symptoms. Okay. So ruling that out, you know, is, is important.
Frankye Myers: Yep. Um, and I just, I value that relationship with my. PCP, my provider, um, are there things that you do, obviously when you come in, you're going to do an assessment, but are there things that you do on the front end, um, For someone who may not even be aware that they're feeling that way When you interact with your clients and patients.
Angela Barco: Oh, yeah, absolutely. So again just talking to your patient, you know Trying to get an understanding of their concerns is always number one, you know listening to your patient There's different tools that we can utilize which is a depression screening tool. Okay Um, like the PHQ 9, which is nine very, um, straightforward questions that we ask patients, um, that will kind of, you know, gauge as to how severe is this depression or, or are they simply having depression, you know, so using those tools definitely help.
Frankye Myers: Can you give an example of a couple of the questions maybe on
that
assessment?
Angela Barco: Yeah, sure. So, um, one of the questions is, you know, Are you feeling irritable? Okay. You know, um, how many times throughout the day or the week are you not wanting to, you know, engage in activities that you're normally used to engaging?
Just, you know, very straightforward, very specific questions.
Frankye Myers: Yes. Very good. Very good. If someone is struggling during this time, what resources are out? For out there for our viewers that they can connect with if they're having those hopeless helpless thoughts And some of the things that you talked about
Angela Barco: Well, yeah, there's, I mean, there's plenty of resources.
There's different centers, um, you know, if it's something that your primary care unfortunately cannot handle in office, then of course we would outsource you to maybe psychiatry or just general counseling, um, during that time to kind of, you know, help you and get over that hump. Okay.
Frankye Myers: Very good. What if somebody wanted to reach out to you specifically?
Would you tell our viewers how to connect with you?
Angela Barco: Yeah, so you can reach me at, you know, Bruton Avenue Family Practice, um, calling our office, scheduling an appointment, MyChart, you know, is a great way with communication as well.
Frankye Myers: Okay, I think it's so important for our viewers to know that you're not alone.
Absolutely. That there are resources and support for you and, um, the goal of us talking with you today is for them to understand how to access those resources. Right. Right. Um, so I thank you so much for your time. Oh, thank you for having me. Yes, yes, please come back. Yes. Um, and I assure you, I haven't had another episode since my clock was turned around, but, um.
It is, it is hard right now to, you know, because it, it gets dark so early, so, um.
Angela Barco: Absolutely. And you know, um, just to kind of, you know, hang on a little bit, but you know, we can. Do cognitive therapy, you know, just being able to, like I said, talk about those things and, um, putting a game plan in place, you know, um, coping mechanisms that definitely help and, you know, and in some cases we would use medical management or medication management, excuse me, so increasing, if you're already on an antidepressant, sometimes, you know, we'll increase your dose, um, or just put you on a low dose to kind of help you get over and get that chemical balance.
Yes.
Frankye Myers: Yes. That's great information. I know sometimes as I interact with people and talk about, um, depression, they worry about the side effects. That's why it's so important to have that relationship and follow up with your primary care physician or even a psychiatrist or therapist. Um, I don't know if you want to touch on that a little bit, but those things are looked at to make sure that you're safely treated.
Angela Barco: Absolutely. Absolutely. Safety is, is number one, you know, um, and again, listening to your patient and so that you and your provider can come to an understanding and group together to come up with a game plan on how to combat. And get you at a therapeutic level. Absolutely. Yes.
Frankye Myers: Thanks again.
Angela Barco: Thank you for having me.
Frankye Myers: Please come back anytime. Yes.
Angela Barco: Yes. Oh, let's come back. Thank you.
Frankye Myers: Thank you for listening to this episode of Healthy You. We're so glad you were able to join us today and learn more about this topic. If you would like to explore more, go to riversideonline.com.
