Seasonal Affective Disorder in the Sunshine? You Bet!

By Katelyn Millinor, LPC | Behavioral Health Quality Manager

Seasonal Affective Disorder (SAD) is a type of depression that happens or changes with the season, with symptoms lasting 4 to 5 months every year. And while many people associate SAD with dark, cold, winter months, people living in sunny Central Arizona can and do suffer from SAD just like everyone else, but ours usually happens when temperatures heat up.

Get ready! Things are about to heat up—but probably not your mood. 

Desert dwellers, like residents in the Valley of the Sun, tend to thrive in the winter months engaging in time outdoors. However, when summer months come, the extreme heat and sun can take a toll on our bodies and our mood. Millions of Americans suffer from SAD but may not recognize the have the condition.

Seasonal Affective Disorder Symptoms

Symptoms may differ based on season and for summer Seasonal Affective Disorder, symptoms may include:

  • trouble sleeping
  • poor appetite
  • restlessness
  • irritability
  • anxiety

To read more about symptoms, visit the National Institutes of Mental Health on Seasonal Affective Disorder. Additionally, if you already have depression or anxiety, this seasonal change could worsen your symptoms.  

Since the timing of SAD is predictable with the seasons, you may be able to get ahead of by doing preventative care to help with symptoms. Ways to reduce or help symptoms can include talking with your primary care provider, a counselor, a nutritionist, or a psychiatric provider. One of the best things you and your counselor or other provider can help you with is developing coping skills and understanding the signs and symptoms that may be helpful to jump start your seasonal self-care routine.

For most people, staying cool, regular physical activity, adequate sleep, and socialization can reduce symptoms.

Talk to your NOAH healthcare provider if you begin to experience SAD or have questions about this or other health, wellness, or mental health issues you may be facing.

How to Set and Evaluate New Goals

By Nicole Vaudrin O’Reilly, MS, RD |Nutrition Educator

A lot of us know what we could do to be healthier. The hard part is putting these ideas into practice.  One way to get motivate around new goals for a healthier life – without becoming overwhelmed or discouraged – is to treat it like a self-experiment. This turns it into a process, rather than the idea of flipping a switch. Best of all, it removes the damaging self-talk that holds many of us back, for example ‘I ate pizza and cake today. I’m no good at dieting. I might as well give up,’ because it isn’t an all-or-nothing process.

This process looks a lot like doing experiments in science class. Here’s how it works:

  1. Ask yourself some questions.
    • What area of my health do I want to improve?
    • Do I want to eat healthier?
    • Would exercising more be good for me?
    • Should I try to get more sleep and reduce my stress?
  2. Research: Take a week or more to study yourself and your habits.
    • Keep a notebook, voice memos, or something similar nearby to write or record what you do during your week.
    • Write or record what you eat, what exercise you do, what causes you stress, what time you go to sleep and wake up, and whatever else you are trying to improve.
    • Then record WHY you made these choices (if you know). For example, if you want to improve your diet, you may want to track:
      • What foods you eat, how much, and what times of day?
      • How you feel throughout the day. Were you feeling– starving, rushed, stressed, bored, anxious, depressed, restless, etc.?
      • Why did you choose those foods?
    • Look for patterns, like eating too much because you skipped a meal, or getting fast food on busy days at work/school, or running late makes you stressed, etc.
  3. Create a plan to reach your new goals: With all that great information you recorded above, think about what would help you make better choices. Choose one or more to try out, for example:
    • If boredom makes you overeat, distract yourself by taking the dog for a walk, stretching, reading, putting away the laundry, or something else not related to food.
    • Drink a glass of water when you want to snack and take that time to decide whether you’re hungry or not.
    • If the food options around are a problem, try cut-up vegetables, fruit, low-fat yogurt, nuts, whole grain crackers, lightly buttered popcorn, etc.
    • If you need more sleep, set a daily timer to head to bed at an earlier time.
  4. Experiment: Try one of your new plans for at least a week and see what happens.
    • Some plans might be ready to go, but others may need to be more specific. Like changing “I will go to sleep earlier” to “I’ll set an alarm to go to bed by 10 p.m.”
  5. Collect and Analyze Information: Keep some notes like in #2 above.
    • How often were you able to meet your goal (every day, two times a week, never)?
    • What helped you be successful? What got in your way?
      • For example, if your goal was to drink a glass of water before snacking, “This seemed to work during the day at work, but I still ate junk food at home while watching TV.”
  6. Go back to your plan and re-test.
    • If you met your goal, congratulations! Keep it going until it becomes a habit.
      • Do regular check-ins every week in the beginning and then monthly as you build new habits.
    • If you didn’t meet your goal, change your plan and try again.
      • You continue to drink water during the day when at work, and then add a new goal to only buy healthier snacks for TV time.

Whatever your new goals are, we know you can make progress! NOAH’s comprehensive team is here to support and guide you through this process. If you want to reduce stress, our behavioral health team is here for you, and if you want to make healthier choices with food and exercise, our nutrition services team can help you and review your goals regularly. By doing self-experiments, you learn more about yourself and how to work with your preferences and current habits to make healthy changes.

It’s Time For Your Flu Shot

By Dr. Nikita Mathew, DO PGY1

“Every year, 10 to 40 million people are affected by the influenza virus, resulting in 140,000 to 960,000 hospitalizations annually.”

Centers for Disease Control and Prevention

Flu season typically runs from October through February every year. One of the best ways to stay healthy is with the vaccine anytime during the flu season. Flu symptoms include:

  • fever
  • fatigue
  • sore throat
  • body aches

5 common questions about the flu vaccine

  1. Can I get the flu shot? Everyone over the age of 6 months is eligible for the flu vaccine. This includes special populations such as pregnant women, adults with chronic health conditions, and those over 65 years old. Exceptions to the flu vaccine are very limited, and include children less than 6 months old and those who had severe allergic reactions to the flu vaccine. You may have heard that those with egg allergies cannot get the flu shot, but the CDC recommends that these individuals still get the vaccine, but they may need to be monitored briefly afterward in a healthcare setting for allergic symptoms. There are also egg-free vaccines available.
  2. Why do I have to get the flu shot every year? The influenza virus changes year to year, so the flu vaccine you got last year likely will not protect you from the specific strain that is widespread this year. Researchers develop vaccines that will fight this year’s particular strain of the virus to maximize your protection. In addition, your immunity decreases over time so getting the vaccine annually helps build up your immunity again.
  3. When should I get the vaccine? The influenza virus is seasonal, typically starting in mid-October and peaking in winter. Your body will produce sufficient antibodies within two weeks after getting the vaccine. This is why the CDC recommends getting your flu shot sometime between September and late October. However, it’s never too late to get one, even past October. Flu shots will continue to be available well into winter and can protect you from the remainder of the flu season.
  4. Why do I feel like I have the flu after getting the shot? The flu vaccine contains an inactivated strain of the virus, meaning it cannot cause the flu but it does trigger your body’s immune response. This can result in body aches or a low-grade fever, but these symptoms are significantly less severe than those caused by the actual flu virus and resolve in 1-2 days, if present at all.
  5. How will the flu season be affected by COVID-19? Getting the flu shot is important every year, but especially this year in light of COVID-19. The pandemic has already stretched hospitals and healthcare resources pretty thin. Being vaccinated against the flu and reducing the risk of hospitalization is essential to help avoid an overlapping peak of influenza and coronavirus this winter. The flu shot will not make you more or less susceptible to COVID-19 since the viruses are completely separate.

Getting vaccinated not only helps protect you, but also helps protect your community and eases the burden on hospitals and the healthcare industry. Flu shots are currently available at NOAH clinics, so schedule an appointment today!

Tips for Kids During The Summer Months by Katelyn Millinor, LPC

“With summer temperatures usually exceeding 100 degrees, it’s safer to turn to indoor activities and keep kids out of the sun.”

Most families around the country are enjoying time outside engaging in fun summer activities. In the Arizona valley that seems almost impossible. Keeping our kids busy during the summer months can be challenging. Here are some low or no cost options for summer fun.

Indoor activities

  • DIY arts and crafts.
  • Board games/ card games.
  • Reading (consider audiobooks).
  • Puzzles.
  • Scavenger hunts.
  • YouTube videos to learn a new skill (consider cooking, yoga, painting).
  • Apps (find an age-appropriate app that encourages learning).
  • Remember, it only takes about 10 minutes of play to connect with your child. Consider making time to play with your child daily. Try to choose activities that match your child’s development and age.
  • Around the community.
  • Children’s Museum of Phoenix.
  • Local Public Libraries (most offer story time for younger kids as well as some classes/events for older children such as computer coding and college prep).
  • Arizona Science Center.
  • Local parks or pools.
  • Local sports (Minor League Baseball plays at 7:00PM throughout the valley from mid-June until early-September and it’s free to attend).
  • McCormick-Stillman Railroad Park.
  • Adobe Mountain Desert Railroad Park.
  • Local art/craft classes (City of Tempe hosts Free Art Friday for preschoolers and their parents).
  • Karate, gymnastics, or other types of classes available in the community.

Arizona has extreme temperatures during the summer. Here are some tips protect your child and family.

Sun and heat tips

  • Plan errands and recreational activities for the early morning and evening. Avoid being outside from 10 AM to 4 PM when the sun is the hottest. Consider starting each day with a morning walk or taking an evening bike ride.
  • Teach your children to wear shoes outside. The concrete or pavement can be hot enough to cause second-degree burns.
  • Check the temperature of buckles and car seats as they can reach the temperature of a hot skillet. Park in covered parking or under shade whenever possible or use a wind shield sunshade.
  • Keep water with you. Pack extra bottles in the car in case of an emergency.
  • Wear sunscreen. Make sunscreen part of your morning routine. Lather up your kids before dressing them to ensure they’re protected, even if you’re not around water.

Summer doesn’t have to be boring. Feel free to ask any of our NOAH providers for suggestions on summer activities in your community and how to stay safe in the heat.

Summer Fun – Pool Safety Tips by Dr. Amit Jain, Pediatrician

Swimming is a great way to beat the summer heat here in Arizona, and is a fun activity for children to pass the summer by. Drowning is the third most common cause of unintentional – injury related deaths. The highest at risk are children ages 1-4 years old (drowning is the leading cause of unintentional deaths in children ages 1-4). As such, we here at NOAH wanted to share some important water safety tips!

  • Never leave children alone, even for a moment, in or near pool areas or other bodies of water (lakes, beaches, and even bathtubs or buckets of water)!
  • Install a fence at least 4 feet tall around the pool, which should ideally surround the pool on all 4 sides and completely separated the pool from your home and yard. It should not have any gaps that a small child could slip over, under, or through. The gate should be a self-closing and self-latching gate that cannot be opened / reached by a small child.
  • Newer technology offers alarms, both for the gate and within the pool, that can alert you to anyone around the pool.
  • When any inexperienced swimmer is around the pool area, make sure there is a designated adult for supervision. This adult should not be under the influence, should not have any distractions (cell phone turned off or handed off to another adult), and preferably knows how to swim and perform CPR.
  • Keep rescue equipment such as a shepherd’s hook and a life preserver to reach / throw for rescues.
  • Avoid inflatable swim aids such as floaties, as they are not a substitution for proper life-preserving equipment such as life jackets.
  • Consider swim lessons for your child if over the age of 1, as it may reduce the risk of drowning. Talk to your child’s pediatrician about your child’s developmental readiness to take swim lessons.
  • Talk to your pool operator to make sure your pool / spa and its drains are compliant with the pool and spa safety act.
  • Be safe and have a fun-filled summer!

At NOAH, we want to make sure that you have the proper tools, education and resources to protect you and your family while swimming.

Summer Fun – Sun Safety Tips by Dr. Amit Jain, Pediatrician

There’s nothing better than having fun outdoors during school vacations. However, especially during summer here in Arizona, we here at NOAH want to remind everyone of some sun safety tips to keep protected while having some outdoor fun.

Dr. Amit Jain, Pediatrician

Protecting yourself and your children from harmful ultraviolet light exposure is important to prevent melanoma, a deadly form of skin cancer, which often strikes those who have been severely sunburned, especially during infancy and childhood.

The first line of defense against the scorching summer sun is proper clothing and keeping in the shade.

  • Try to limit sun exposure during the peak intensity hours between 10am and 4pm.
  • Take frequent shade breaks if staying out in the sun for long periods of time.
  • Cotton clothing is protective and can also help whisk away moisture to keep you cool while playing outside. Pick tightly woven fabrics for best protection.
  • Wear a hat: wide brimmed for best protection of your child’s entire face, including the nose, cheeks, chin, ears, and back of the neck.
  • Get your children sunglasses with UV protection. Those from the dollar store, Walmart, Walgreen’s, or similar stores are nice, economical options that can be easily replaced if they break or get lost, as long as they’re labeled as having UV protection.
  • Protect your children with a sunscreen that has an SPF (Sun Protection Factor) of 15 or greater. SPF 15 or 30 should be sufficient for most common uses. Apply this to all areas not covered by clothing. Don’t forget the ears, back of the neck, arms, and legs. Carefully apply around the eyes, avoiding eyelids.
  • Choose a sunscreen that has the words “Broad Spectrum” on it – that will cover both UVA and UVB rays. Try to avoid sunscreens that contain oxybenzone that may have hormonal properties.
  • Before applying sunscreen for the first time, test a small amount on your child’s back for an allergic reaction.
  • Apply sunscreen at least 30 minutes before sun exposure, as it can take this long to become active.
  • Reapply sunscreen at least every 1 hour.
  • If playing in the water, reapply sunscreen every half an hour, and use a waterproof sunscreen.
  • For infants less than 6 months old, avoid direct sun exposure – keep them under shade with a canopy or under a tree. Use wide brimmed hats to help cover their face, ears, and neck. Dress babies in lightweight clothing that covers their arms and legs as well. If this is not available, apply small amounts of sunscreen with a minimum SPF of 15 to your baby’s face, hands, and legs.
  • Don’t forget to use sun protection even on cloudy days, as the harmful ultraviolet rays from the sun can even come through clouds.

Contact your pediatrician if you develop a sunburn, rash, or blistering.
For more information: https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Sun-Safety.aspx

Asthma Awareness in Children by Dr. Patricia Avila, Pediatrician

“Asthma in children is one of the most common long term (chronic) diseases. It is estimated to affect 1 in every 10 children in the US. If your child has Asthma one of the most important things you must do is to learn as much as you can about Asthma. Being educated about your child’s Asthma will help you work together with your child’s doctor to control their Asthma and have the absolute best outcome.”

Dr. Patty Avila, Pediatrician

What is Asthma?

  1. It is a disease of the lungs that causes the airways or tubes that bring air into the lungs to become swollen and inflamed. The muscles around the airways become tight and it makes it hard to breath. This leads to episodes of coughing, wheezing, feeling breathless, chest pain/chest tightness, and feeling more tired than usual.
  2. It is more common in children where there is a parent or sibling or close relative with Asthma, Allergies, and/or Eczema. Children with Asthma often develop Allergies or Eczema as well. These are sometimes present before they develop Asthma.
  3. There is no cure for Asthma. There are medications and things you as a parent/caregiver can do to help control it. Know what the signs/symptoms of Asthma are, how to avoid triggers, and follow your doctor’s treatment plan. This is especially important to prevent and decrease the damage to your child’s lungs. It will also help avoid your child needing emergency medical treatment.

What causes an Asthma Attack?

  • An Asthma attack happens when your child is exposed to “triggers” things that cause your child’s Asthma to get worse.
  • An Asthma attack also happens when a child does not take their medications as prescribed.

Common triggers include:

  • Allergens – including outdoor allergens like pollen, animal dander, dust mites, mold, and cockroaches.
  • Infections – including the common cold, the flu, sinus infections, and pneumonias.
  • Irritants – including cigarette smoke or other smoke, pollution, strong odors like perfumes or scented candles, and cleaning products.
  • Changes in weather – cold and dry, very humid, or extremely hot weather.
  • Exercise.
  • Stress and strong emotions.

How can you help control your child’s Asthma and how is it treated? Avoid triggers. It may not be possible to completely avoid all possible triggers, but there are some changes you can make that will help.

  • Allergens. Have your child take their allergy medications during allergy season. Keep windows and doors shut during allergy season. Avoid outdoor activities when pollen counts are high.
  • Dust mites. Use mattresses and pillow covers. Vacuum and dust regularly. Wash bedding once a week. Limit and wash stuffed animals.
  • Furry pets. Keep pets out of your child’s bedroom. Wash pets more often.
  • Use HEPA filters.
  • Fix any water leaks that could lead to mold.
  • Infections. Make sure your child and family receive their yearly Flu vaccine. Having Asthma increases your child’s risk for severe Flu illness that can trigger an Asthma attack.
  • Use good hand hygiene.
  • Irritants. Do NOT allow anyone to smoke in your home or car. Avoid public places where smoking is allowed. Avoid use of perfumes, scented candles, incense, paints, and cleaning supplies that can irritate your child’s lungs. Check your local forecast for air quality and keep your child indoors when the pollution is bad.
  • Weather. Avoid outdoor activities in extreme weather conditions.
  • Exercise. If your child’s Asthma is triggered by exercise have your child take his/her Albuterol 15-30 minutes prior to activity to prevent these symptoms. Encourage your child to exercise and participate in sports. Know what medications help control his/her Asthma so that they can continue to be active.
  • Medications. Includes inhaled medications in the form of MDIs also known as inhalers or “pumps” and nebulizers that are given by a machine. Rescue or quick relief medications like Albuterol help during an Asthma attack. They help open the airways or tubes that bring air to the lungs. Long term controller medications like inhaled corticosteroids help improve the inflammation of the lungs. When these medications are used daily your child is less likely to have an Asthma attack.

Develop an Asthma Action Plan.

This plan is made with the help of your child’s doctor. It will help you and your child know what medications to use and when. It will also help you and your child know what to do in the case of an emergency. Share this plan with the school as well. It is important, because your child spends a good amount of time there and the school will know exactly what to do to help your child.

By becoming knowledgeable about your child’s Asthma, avoiding triggers, and following a good Asthma Action Plan you are taking important steps in keeping your child healthy. Have your child see his/her doctor at least 2 times per year to make sure their Asthma is under control. Do not forget to make sure your child and family receive a yearly Flu vaccine. Your child should be able to enjoy everyday activities and participate in sports without any problems breathing if their Asthma is under control.

Safe Practice When Entering a Home During the Coronavirus Pandemic

Your home:

  • Home entry doors should have hand sanitizer available for everyone who enters the home
  • If you have older family members living at your home – discuss having them use a separate entry if possible and isolate if needed from high volume areas
  • If family members were with larger groups – change clothes near the entryway and clean area
  • Discuss the CDC home base actions recommendations

Visiting a home:

  • Call ahead to make sure they are expecting visitors
  • Let them know if you are not ill
  • Make sure they are not ill or been around someone possibly ill
  • Ask about having hand sanitizer or any other precautions at their home’s entry
  • Ask if it would be better to delay your visit

From the CDC:

Practice good personal health habits and plan for home-based actions

Practice everyday preventive actions now. Remind everyone in your household of the importance of practicing everyday preventive actions that can help prevent the spread of respiratory illnesses:

  • Avoid close contact with people who are sick.
  • Stay home when you are sick, except to get medical care.
  • Cover your coughs and sneezes with a tissue.
  • Clean frequently touched surfaces and objects daily (e.g., tables, countertops, light switches, doorknobs, and cabinet handles) using a regular household detergent and water.
  • If surfaces are dirty, they should be cleaned using a detergent and water prior to disinfection. For disinfection, a list of products with Environmental Protection Agency (EPA)-approved emerging viral pathogens claims, maintained by the American Chemistry Council Center for Biocide Chemistries (CBC), is available at Novel Coronavirus (COVID-19) Fighting Products. Always follow the manufacturer’s instructions for all cleaning and disinfection products.
  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Always wash your hands with soap and water if your hands are visibly dirty.

https://www.cdc.gov/coronavirus/2019-ncov/prepare/get-your-household-ready-for-COVID-19.html

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