Overview: Navigating the fall transition with nurse Felicia
Columnist Felicia Permenter, debuts her new health column Take Care with Nurse Felicia. In this first installment, Nurse Felicia breaks down how autumn light loss triggers Seasonal Affective Disorder (SAD), why Black Minnesotans face unique Vitamin D challenges, and how to communicate effectively with your primary care provider before the winter blues set in.
Did you know that during the month of September we lose roughly three minutes of daylight per day? That may not seem like much, especially compared with places like Alaska, where days can shorten by close to 10 minutes in the fall and winter months.
As we move into the new season, the sun will rise later and set earlier, and environmental changes have a direct impact on our health. Light is the primary signal your body uses to keep time and maintain a healthy rhythm. Morning sunlight triggers a natural rise in cortisol, melatonin (the sleep hormone) shuts off, and that cascade tells your body it’s time to wake up and start the day. When that morning signal shifts, it can throw off your hormones, your mood and your schedule.
Seasonal Affective Disorder, also known as seasonal depression or the “winter blues,” starts in the fall. It is a form of depression tied to less sunlight and changes in your internal body clock. Common signs include:
- Low mood or general sadness
- Loss of interest in the things you enjoy
- Low energy or excessive tiredness and sleepiness
- Eating or craving more carbohydrates
Vitamin D can help when you’re feeling SAD. It helps your brain make serotonin, one of the four main “happy hormones,” which is responsible for mood regulation, digestion and sleep. When vitamin D levels drop, serotonin drops too, leading to low mood, poor digestion and disrupted sleep. Our skin absorbs vitamin D from the sun, but people with more melanin need more sun exposure to make enough of it. National survey data has consistently found higher rates of vitamin D insufficiency among Black Americans, and Minnesota’s short fall and winter days do not help.
Fatty fish, such as salmon, mackerel and sardines, and egg yolks are good food sources of vitamin D, but food alone rarely closes the gap. Ask your doctor whether testing or a supplement makes sense for you. Don’t guess at a dose. More is not always better with vitamin D, and the right amount depends on your levels and what your body needs.
Depression is also underdiagnosed and undertreated in Black and Hispanic communities, in part because of what gets missed in the exam room. Depression can show up as physical complaints, including exhaustion, body aches, irritability and trouble concentrating. Screening tools and clinical training tend to lean toward a narrower picture, one focused more on visible sadness and depressive mood. When you talk with your doctor, lead with the pattern rather than the feeling:
- Tell your provider when the symptoms started and what they actually look like, including sleep, appetite and energy.
- Explain what you’ve stopped doing in your day-to-day life, especially things that once brought you joy.
- Share that these symptoms happened last fall and seem to happen around the same time every year.
- Ask directly about your options, including light therapy, seasonal talk therapy, and vitamin D testing and supplements.
Fall is one of the most demanding seasons we have in Minnesota. It’s the season where everything is changing, and our bodies are affected by that change more than we realize. Here’s what you can do to ease into this seasonal transition:
- Get outside in the morning. Spend 10 to 15 minutes outside within an hour of waking, even on a gray day. An overcast morning outdoors delivers more natural light than any room in your house. This is free, and way underrated.
- Consider a light box. Bright light therapy is a noninvasive first-line treatment. Spending 20 to 30 minutes each morning is usually enough. Boxes run $50 to $150 and may sometimes be covered by insurance, so ask your doctor about this option. Remember, no staring into the light.
- Keep your wake time steady. A consistent wake time does more for your body clock than a consistent bedtime.
- Get your vitamin D checked. At your next visit, ask about checking your levels and whether a supplement makes sense for you.
- Put things on the calendar now. SAD pulls you toward withdrawal, and withdrawal and isolation make depression worse. Standing commitments and prescheduled events help keep you engaged and connected to your community. It’s also good to have someone in your circle who will notice when things are off or if you don’t show up.
- Keep moving. Regular exercise has a genuine antidepressant effect. Moving your fitness routine to the morning or lunch hour helps you move your body before nightfall and maintain your routine through the long winter.
Using these strategies for self-management works well for mild cases of SAD, but you never have to tough it out alone. It may be time to seek professional help if:
- Symptoms have lasted more than two weeks and aren’t budging.
- You’re missing work, school or obligations you care about.
- You’ve noticed this same pattern for two or more winters.
- You’ve lost interest in nearly everything, or feel hopeless about it getting better.
If you’re in crisis or thinking about harming yourself, call or text 988 anytime for the Suicide and Crisis Lifeline.
If you find yourself sleeping more, craving carbohydrates and pulling away from people as the light drops, that’s a recognized condition with real treatments, and treatment does work. Talk therapy, light therapy and vitamin D supplements are all effective options. Lean on your people and reach out to your care team when you need additional help. We are all in this together.
Take care, Nurse Felicia
Felicia Permenter, APRN, NBC-HWC, is a family nurse practitioner at Right Spot Wellness in Roseville. For questions or comments, contact her at 651-313-5857, admin@rightspotwellness.com or www.rightspotwellness.com.