Latest / Pharmacy Podcast Network / Rx for the Winter Blues: Shining Light on Seasonal Depression | Pediatric Pharmacist Review

Transcript

Rx for the Winter Blues: Shining Light on Seasonal Depression | Pediatric Pharmacist Review · Pharmacy Podcast Network

0:05
Speaker 1: You are listening to the global network of podcasters dedicated
0:09
Speaker 1: to the pharmacy profession. Welcome to the Pharmacy podcast Network.
0:23
Speaker 2: Adverse drug reactions or ADRs, are a serious issue in
0:31
Speaker 2: healthcare today. The pharmacist is the last line of defense
0:35
Speaker 2: to help prevent ADRs. A rising role of the pharmacist
0:39
Speaker 2: is the specialist who focuses on our children. Pediatric pharmacy
0:43
Speaker 2: ensures safe and effective drug use and optimal medication therapy
0:47
Speaker 2: outcomes and children up to eighteen years of age. Currently,
0:50
Speaker 2: there are more than one four and fifty board certified
0:53
Speaker 2: pediatric pharmacy specialists known as BPS. If you're interested in
0:58
Speaker 2: this expanding field of pharma to see this podcast is
1:01
Speaker 2: for you. All Right, everyone, let's give it up for
1:04
Speaker 2: our host.
1:06
Speaker 3: Hey, everyone, welcome, and I hope you're a little bit surprised.
1:09
Speaker 3: It's normally justin that starts off the podcast, but today
1:13
Speaker 3: it's me, So Mary Bong is here. I am Cheap
1:16
Speaker 3: of Clinical Operations of Perfecting PEDS, and I'm so excited
1:19
Speaker 3: to be co hosting today with Brian Urban, who's our
1:21
Speaker 3: new VP of Healthcare Architecture environment. I already forgot the
1:25
Speaker 3: word Brian.
1:26
Speaker 1: A few words.
1:27
Speaker 4: Well, it is.
1:28
Speaker 5: An honor and pleasure to be co hosting with the
1:31
Speaker 5: Mary of Perfecting Peds. We have a lot of duplicate names,
1:36
Speaker 5: but there's only one chief clinical MARENI. So thank you
1:39
Speaker 5: Mary for helping me be welcome onto the Perfecting Peds
1:43
Speaker 5: team and be co hosting today and asking Tim a
1:46
Speaker 5: few questions of our own.
1:49
Speaker 1: Awesome.
1:49
Speaker 3: So, today's episode of The Pediatric Pharmacist reviews all but
1:52
Speaker 3: seasonal depression. We just had a huge change happen over
1:55
Speaker 3: the weekend. We all set our clocks backwards, which means
1:58
Speaker 3: that the days are going to become short, it'll become
2:00
Speaker 3: a little bit darker. So I wanted to have Tim Horden,
2:03
Speaker 3: who is a pediatric psych nurse practitioner who we work
2:06
Speaker 3: with so closely in Minnesota, speak a little bit about
2:08
Speaker 3: seasonal depression.
2:10
Speaker 1: Welcome Tim, Thank you so much for joining.
2:12
Speaker 4: Thank you for having me. I'm so excited to be here.
2:16
Speaker 1: You want to start off with the brief introductions?
2:18
Speaker 4: Tim, Yeah, So I'm a psychiatric nurse practitioner at People
2:21
Speaker 4: First Clinic and I founded the clinic there. We specialize
2:24
Speaker 4: in kiddos providing multidisciplinary care and then just team based
2:28
Speaker 4: care and that's where perfecting PEDS comes in so often
2:30
Speaker 4: with some precision based medicine as far as like testing
2:33
Speaker 4: and just the care based team that we kind of model.
2:36
Speaker 4: So that's a little bit about me.
2:39
Speaker 1: Awesome. And then Jenna just popped in as well, So
2:41
Speaker 1: Hello Jenna, thanks for joining us.
2:44
Speaker 6: Hi guys, how are you nice to meet you? Tim.
2:47
Speaker 6: I've heard nothing but wonderful things about you. My name's
2:51
Speaker 6: Jenna Quinn, CEO, co founder, Pets Pharmacist of four teen years,
2:57
Speaker 6: a mom of three girls. Very nice to meet you, Tim.
3:02
Speaker 4: Nice to meet you too, Jenna, three girls. I have
3:04
Speaker 4: one little three month old. You must have your hands full.
3:07
Speaker 6: It's fun chaos, eight six and three.
3:11
Speaker 4: Oh yeah, you're busy. It gets easier.
3:15
Speaker 6: Yeah, it is a good age gap, and I promise
3:17
Speaker 6: it it.
3:17
Speaker 4: Gets easier, honestly, Like my little one's sleeping eight hours,
3:21
Speaker 4: so I don't know if it could get eight like
3:23
Speaker 4: easier than that. Oh my god, you're lucky.
3:25
Speaker 6: That was never the case in the Quinn household. So
3:28
Speaker 6: that's awesome, Tim.
3:31
Speaker 1: Love it.
3:32
Speaker 3: So today we're talking about seasonal depression, which I thought
3:35
Speaker 3: was very in tune of the time, since the days
3:37
Speaker 3: are getting shorter, it might get a little bit colder.
3:40
Speaker 3: So we first wanted to talk to Tim about what
3:42
Speaker 3: biological or environmental factors do you think our thoughts to
3:45
Speaker 3: cause seasonal depression besides just the days getting darker, because
3:49
Speaker 3: I know a lot of people have this theory about sunshine.
3:53
Speaker 4: Yeah, no, most definitely. So we think it's a multi
3:55
Speaker 4: factorial process. We know, less sunicitting in the back of
3:59
Speaker 4: our eye, and that changes within the brain. Certain changes
4:02
Speaker 4: essentially cause more melatonin to be created, and we think
4:05
Speaker 4: there's less chemicals available for you know, serotonin to be
4:08
Speaker 4: synthesized in those sorts of pieces because all of our
4:11
Speaker 4: building blocks start with the B vitamins and those sorts
4:13
Speaker 4: of pieces. We also think, you know, nature's healing in general.
4:16
Speaker 4: I don't have to tell any of you that. Most likely,
4:18
Speaker 4: so less time outside, less time kind of enjoying that
4:21
Speaker 4: sunshine really does impact people and they're less active socially
4:25
Speaker 4: those sorts of pieces as well. So we think it's
4:27
Speaker 4: a multifactorial process and that kind of leads to certain
4:32
Speaker 4: changes within the brain.
4:34
Speaker 2: Yeah.
4:34
Speaker 3: I feel like my cousins are very in tune with
4:36
Speaker 3: that because they just move to Seattle and I am
4:39
Speaker 3: literally just like in the sunshine all day in Florida.
4:43
Speaker 3: So my aunt doesn't believe that seasonal depression is real.
4:45
Speaker 3: And they were trying to explain to their mom, like, no,
4:47
Speaker 3: this is real, Like we're moving to Seattle, It's going
4:49
Speaker 3: to be so much darker, like so many things are
4:51
Speaker 3: going to change, and their mom just does not believe
4:54
Speaker 3: it at all. But I do agree that sunshine plays
4:55
Speaker 3: a huge factor in.
4:56
Speaker 4: It, definitely, and there's other factors too. So those effets
5:00
Speaker 4: female at birth, we think they're a little bit more
5:02
Speaker 4: impacted than certain other kind of you know people are too,
5:05
Speaker 4: So it's definitely real. The research kind of proves that out.
5:10
Speaker 6: Okay, I'll go next, Tim, How can lifestyle changes like
5:14
Speaker 6: light exposure which we just alluded to, exercise or diet
5:19
Speaker 6: help reduce these symptoms? I know, for me, exercise is
5:23
Speaker 6: my sanity, but I love to hear from you what
5:27
Speaker 6: tricks you have.
5:29
Speaker 4: Definitely, so exercise helps you build your brain chemistry, and essentially,
5:34
Speaker 4: I'll give me one second here, apologies.
5:37
Speaker 6: This is even better.
5:38
Speaker 3: If we get any able to join, then we'll welcome
5:41
Speaker 3: a cameo.
5:44
Speaker 1: We love a good baby joining.
5:46
Speaker 3: Yes, Oh my goodness, baby therapy definitely helps I would
5:53
Speaker 3: say cuddling babies.
5:56
Speaker 4: Then hit like right there, yep. So lifestyle pieces definitely,
6:02
Speaker 4: you know, are implicated in it. Exercise helps its build
6:05
Speaker 4: our brain chemistry generally, so if we're able to get
6:07
Speaker 4: good exercise in that definitely has some research to support
6:10
Speaker 4: seasonal effective disorder. The B vitamins as well can definitely
6:14
Speaker 4: impact things. So a little frontloading of that healthy B
6:16
Speaker 4: vitamins within our food those sorts of things as well,
6:19
Speaker 4: that kind of helps us build our brain chemistry and
6:21
Speaker 4: kind of fend off some of those difficulties that we
6:24
Speaker 4: have in the seasonal kind of weather. Other than that,
6:27
Speaker 4: Vitamin D is also implicated in as well, but the
6:30
Speaker 4: research kind of supports the fact that if you're deficient
6:33
Speaker 4: in vitamin D, that's where kind of the difficulties kind
6:36
Speaker 4: of arise with our brain chemistry. But we think there's
6:38
Speaker 4: some connection there too.
6:39
Speaker 3: We always recommend the vitamins usually because always think the
6:42
Speaker 3: vitamins for brain, and then vitamin D is kind of
6:44
Speaker 3: like your sunshine vitamin, So that totally makes sense.
6:47
Speaker 4: Yeah, most definitely, and it makes a big difference, especially
6:50
Speaker 4: people that are deficient. I've literally seen people with a
6:52
Speaker 4: vitamin D level of six. Come in my office, you know,
6:55
Speaker 4: I load them up. Fifty thousand I use and then
6:57
Speaker 4: they don't need me anymore. It's pretty great.
6:59
Speaker 5: So well, Tim, I find this fascinating because this is
7:02
Speaker 5: probably the first podcast I've ever co hosted or been
7:05
Speaker 5: on that we have a guest this many years younger
7:10
Speaker 5: than everybody else, and that isn't isn't yet speaking. So
7:14
Speaker 5: this is like a little treat for and so fitting.
7:19
Speaker 4: Yeah, I appreciate it.
7:24
Speaker 5: So I've helped the biopharma of space in a few
7:29
Speaker 5: different ways, So I instantly think of their perspective, which
7:34
Speaker 5: is throw a drug at this, try a therapy at this.
7:37
Speaker 5: And I sure that's a part of a recommendation that
7:41
Speaker 5: might come from a leader like yourself, But there's probably
7:45
Speaker 5: all different types of therapies now aside from a prescribed
7:49
Speaker 5: medication or a supplement over the counter treatment. Are there
7:54
Speaker 5: light therapy medications that can be coupled with a prescribed therapy?
8:00
Speaker 5: Do you advise that or is it? Is it really
8:01
Speaker 5: an experiment for someone to have to walk through and
8:04
Speaker 5: get comfortable with.
8:05
Speaker 4: Yeah, I always love a good experiment, and like I
8:08
Speaker 4: usually start with light therapy so I always tell my
8:10
Speaker 4: patients just like you want ten thousand dollars, remember you're
8:13
Speaker 4: gonna want ten thousand lucks in your light. And it's
8:16
Speaker 4: just about a half hour to forty five minutes a day.
8:18
Speaker 4: You want it to be armed lenked away from you,
8:20
Speaker 4: and it can really make a world a difference. So
8:22
Speaker 4: do it while you're kind of getting ready in the morning,
8:24
Speaker 4: those sorts of things and just forty five minutes, and
8:27
Speaker 4: it can really make a big difference. Other than that, honestly,
8:31
Speaker 4: food make food your medicine, so you know, getting those
8:34
Speaker 4: good healthy salads and the B vitamins those sorts of
8:37
Speaker 4: pieces too. While abutrin has some good data with it
8:40
Speaker 4: as well, but honestly, like I tend to go with
8:43
Speaker 4: the you know, kind of natural stuff.
8:44
Speaker 6: First.
8:47
Speaker 5: I love that you went there because the one individual
8:49
Speaker 5: I think of, now, that's I guess a longevity if
8:53
Speaker 5: you if you will. Influencer Brian Johnson had his Netflix
8:59
Speaker 5: debut several months ago, and he does light therapy first
9:03
Speaker 5: thing in the morning, and he'll stand there by the
9:05
Speaker 5: bathroom mirror for about fifteen twenty minutes and then he
9:08
Speaker 5: begins this very regimented day. So I think of that,
9:12
Speaker 5: but it doesn't have to be that regimented, as you said,
9:14
Speaker 5: as long as you can fit it in and try
9:17
Speaker 5: it experiment. So great, great answer. That was a really
9:20
Speaker 5: cool topic for us to discuss.
9:22
Speaker 3: And I feel like just like a walk might help too,
9:25
Speaker 3: Like it doesn't have to be like so regimented. Its
9:27
Speaker 3: just like standing in front of the mirror. But I
9:29
Speaker 3: feel like just taking a stroll around the block and
9:32
Speaker 3: trying I mean, if you have I guess, Okay, I'm
9:34
Speaker 3: a little biased because I have sunshine here, but if
9:37
Speaker 3: you're in an area that's a.
9:38
Speaker 4: Lot of sunshine.
9:39
Speaker 3: Yeah, But I guess if you're in an area, just
9:42
Speaker 3: the physical activity of like taking a walk, even if
9:44
Speaker 3: it's like a cold and dreary one, just having your
9:47
Speaker 3: blood pumping and using that modality of exercise.
9:49
Speaker 4: Health, especially in the afternoon, so on your desk, putting
9:52
Speaker 4: the light out just for forty five minutes, just armslength
9:55
Speaker 4: away from you, like you can make a world of difference.
9:57
Speaker 4: You'll feel more motivated kind of as your evening for
9:59
Speaker 4: grea and maybe just a little less worn down.
10:04
Speaker 3: And then is there any room for like I know
10:06
Speaker 3: red light therapy is a huge thing right now, for skin,
10:08
Speaker 3: But I wonder is there any research for like red
10:10
Speaker 3: light therapy and mood.
10:12
Speaker 4: Ooh, that's interesting. I haven't read that. And I think
10:16
Speaker 4: the ten Thousand Lucks and the white light that quality
10:19
Speaker 4: of light is really important. But honestly, I haven't reviewed
10:21
Speaker 4: the research on that. I'd be curious.
10:23
Speaker 6: What are there early warning signs that someone might be
10:25
Speaker 6: experiencing seasonal depression?
10:28
Speaker 4: Yeah? I think what I usually see in people is
10:31
Speaker 4: just decreased energy, and then we think circadian rhythms start
10:34
Speaker 4: to be impacted pretty quickly, so you know, you're sleeping
10:37
Speaker 4: a little bit more, you're not sleeping quite right, you're
10:39
Speaker 4: not getting to bed at the right time. Those sorts
10:42
Speaker 4: of pieces, they're one of the kind of warning signs
10:44
Speaker 4: that things are kind of off in your brain and
10:46
Speaker 4: that melatonin production is kind of picking up, and then
10:48
Speaker 4: there's less synthesis for other brain chemicals and things.
10:51
Speaker 3: That sounds pretty similar from like normal depression, So how
10:54
Speaker 3: would that differ from regular depression?
10:58
Speaker 4: In my patients, it tends to be more like a
11:00
Speaker 4: cyclical nature, and they feel it creeping on, so it's
11:03
Speaker 4: over like two to three weeks. Like I just had
11:05
Speaker 4: a patient in my office last week and they're like,
11:06
Speaker 4: I just have no energy. I happens to me every
11:09
Speaker 4: single year around this time, and then I really can't sleep.
11:13
Speaker 4: So I think it usually comes in in about a
11:16
Speaker 4: couple weeks and it's kind of irrespective of what's going
11:18
Speaker 4: on in their life. But the symptoms tend to be
11:20
Speaker 4: a little less severe than some of the other depression
11:23
Speaker 4: symptoms that I tend to see, and it more tends
11:26
Speaker 4: to focus on kind of energy levels in those.
11:28
Speaker 3: Pieces, I guess follow up to that you have like
11:30
Speaker 3: the gears turning for me. So because it's seasonal depression,
11:33
Speaker 3: like let's see it goes away in the summer. Do
11:36
Speaker 3: you see patients with cyclical seasonal depression where it's like
11:39
Speaker 3: an annual thing and it can't really be cured.
11:41
Speaker 1: It just always happens.
11:44
Speaker 4: I do, But then I tend to lean into the
11:45
Speaker 4: holistic approaches, so a little bit of supplements. I tend
11:48
Speaker 4: to not lean into medicine. I have probably of my
11:51
Speaker 4: six inner patients, maybe six that go on well futrin
11:54
Speaker 4: kind of over the winter months, but most of the
11:56
Speaker 4: time I can manage it with supplements, exercise, and those
11:58
Speaker 4: sorts of pieces. So think those ways to build your
12:01
Speaker 4: brain chemistry in a really really natural way. But definitely
12:04
Speaker 4: people tend to know, and I tend to lean into
12:07
Speaker 4: it and kind of ask questions and kind of see
12:08
Speaker 4: if there's that cyclical piece, if they notice patterns right
12:11
Speaker 4: around this time of year. But most of the time
12:12
Speaker 4: people really do know.
12:14
Speaker 5: I've heard seasonal depression just as a common mouth term
12:19
Speaker 5: for folks to just say, ob down this time of year.
12:23
Speaker 5: It's coming to the holidays and there's less light and
12:26
Speaker 5: you know, there's a lot of expenses and travel maybe
12:30
Speaker 5: or maybe the opposite. I don't have family in the area,
12:32
Speaker 5: and that social impact sitting on someone's emotions is it
12:38
Speaker 5: can be depressive.
12:39
Speaker 4: So is that true at all?
12:43
Speaker 5: Is that a part of it or do you think
12:45
Speaker 5: that seasonal depression is more of a longer trend line
12:49
Speaker 5: for someone to be aware of that it's not just
12:52
Speaker 5: this time of year, it's just the impacts of the
12:54
Speaker 5: environment you might be in. It's maybe a trend line
12:56
Speaker 5: that you need to monitor because you could be maybe
12:59
Speaker 5: clinically depressed.
13:01
Speaker 4: Yeah, I think that's the main misconception. I think people
13:04
Speaker 4: look at it as just a winter blues. Well, it's
13:06
Speaker 4: definitely more than that. And it clinically impacts people, impacts
13:09
Speaker 4: energy levels, it impacts focus, it really gets in the
13:12
Speaker 4: way of their life. And so really kind of getting
13:15
Speaker 4: away from that misconception about it just being winter blues.
13:18
Speaker 4: Hey I'm just down in the winter. Well, no, there's
13:20
Speaker 4: probably also a chemical piece to it. If it tends
13:22
Speaker 4: to happen every year and it really starts to get
13:25
Speaker 4: in your way with mental health, that's really the key
13:27
Speaker 4: when it really starts to get in your way, and
13:29
Speaker 4: there are treatments, right, so light therapy, I mean, it
13:32
Speaker 4: sounds like voodoo, but it's really really not. Like We've
13:34
Speaker 4: got dozens of studies to support that, and it's only
13:37
Speaker 4: an hour a day, you know, even forty five minutes
13:39
Speaker 4: is a lot of the protocols, and so it really
13:41
Speaker 4: is super treatable, whether you know it's taking a look
13:44
Speaker 4: at vitamin D with your provider, taking a look at
13:47
Speaker 4: CBT kind of skills as well, and kind of reframing
13:50
Speaker 4: how you look at things can really make a huge difference,
13:53
Speaker 4: and just kind of those motivational pieces around you know,
13:56
Speaker 4: like you know, Marius at getting outside all of those pieces.
14:00
Speaker 4: Really it's more than winter blues. It has to get
14:02
Speaker 4: in the way of your life, and it is treatable
14:05
Speaker 4: and we can really do wonderful things with it.
14:07
Speaker 3: And you did say that a lot of it is
14:09
Speaker 3: like lifestyle and managing your own supplements.
14:11
Speaker 1: But when should someone seek professional help.
14:14
Speaker 4: Yeah, so I think the piece is when it starts
14:17
Speaker 4: to be, you know, a couple of weeks and it
14:20
Speaker 4: starts to get in the way of work or your
14:21
Speaker 4: family life or the person you want to be. That's
14:24
Speaker 4: really when you start should start talking to your doctor,
14:26
Speaker 4: you know, your nurse practitioner. Those sorts of pieces, so
14:31
Speaker 4: you know, when there starts to be patterns, and then
14:32
Speaker 4: it gets in the way of the things that you
14:34
Speaker 4: really enjoy and you can't get out of it on
14:36
Speaker 4: your own. So you know, you can't get to the gym,
14:38
Speaker 4: you know, you can't eat well those sorts of pieces
14:41
Speaker 4: and it starts in book it or impacting things generally.
14:44
Speaker 4: I think that's always when to seek medical advice.
14:48
Speaker 1: It's always hard because there's so much fluating out there.
14:50
Speaker 3: Because I know a lot of my patients are teenagers
14:53
Speaker 3: or like younger adults, and they'll be like, oh, I
14:55
Speaker 3: saw this on TikTok, and I think I have like
14:58
Speaker 3: Amy fffs at that, so they'll spit out a random
15:01
Speaker 3: like acronymic, how do you know about that?
15:03
Speaker 1: So I feel like a lot of.
15:04
Speaker 3: Kids these days are now looking towards like social media
15:07
Speaker 3: to self treat.
15:08
Speaker 1: So I'm like just wondering at what point.
15:11
Speaker 3: But that's a great point that when they just cannot
15:13
Speaker 3: be themselves is a great time to really seek professional health.
15:17
Speaker 4: Yeah, and some of that can be a really positive things.
15:19
Speaker 4: Awareness is important so people don't take certain things that
15:22
Speaker 4: they can't on their shoulders, and you know, when it's
15:25
Speaker 4: really getting the way of things, you know, seeking kind
15:27
Speaker 4: of professional guidance like me or your therapist, and kind
15:30
Speaker 4: of digging into the symptoms of whether they mirror like
15:33
Speaker 4: a clinical depression. So I just think of clinical depression,
15:36
Speaker 4: you know, as a sign that there's an organic difficulty,
15:39
Speaker 4: and then we have DSM criteria for that, and the
15:42
Speaker 4: DSM criteria for seasonal effective disorder mirror that. So that's
15:46
Speaker 4: kind of the big piece there.
15:50
Speaker 6: Obviously, this is regional, so you're out in Minnesota, you
15:53
Speaker 6: probably get a ton of it. I'm thinking here on
15:55
Speaker 6: the East Coast, I definitely feel it. It doesn't like,
15:59
Speaker 6: you know, it doesn't change my quality of life, and
16:02
Speaker 6: I can like fight it, but I can. I definitely
16:04
Speaker 6: feel like even at getting darker so earlier, like I'm like,
16:08
Speaker 6: oh my god, I'm so tired. And that was like
16:10
Speaker 6: at like five o'clock yesterday. My kids were asking at
16:15
Speaker 6: like five point thirty last night it was time for bed,
16:17
Speaker 6: Like we.
16:17
Speaker 1: Were all.
16:20
Speaker 4: Like what time is it?
16:24
Speaker 6: They like, savings, can you share a story or experience
16:29
Speaker 6: of someone coping with seasonal depression? And you know, my
16:35
Speaker 6: one question to you is with like the cyclical medicating,
16:40
Speaker 6: I do find although this is a little bit different
16:43
Speaker 6: but very similar, Like some people have massive anxiety and
16:46
Speaker 6: depression around going to school and stuff. So a lot
16:49
Speaker 6: of times how I frame it to people, it's like,
16:52
Speaker 6: you're not on these for life, Like if you need
16:55
Speaker 6: these for eight months, it's okay, obviously we're going to
16:59
Speaker 6: wean you off and we you on safely. But I
17:01
Speaker 6: think that's another thing that I like to touch on
17:05
Speaker 6: with their patients when they're in like these very seasonal
17:09
Speaker 6: or episodic episodes.
17:12
Speaker 4: Yeah, and that's one of my kind of experience as well.
17:15
Speaker 4: So I had a seventeen year old girl in my
17:17
Speaker 4: office last week who thought she had seasonal effective disorder.
17:21
Speaker 4: We did lab work. Her vitamin D was kind of
17:23
Speaker 4: borderline in the low thirty range, so we added a
17:26
Speaker 4: little vitamin D like for good mental health, we want
17:28
Speaker 4: that kind of in the fifty range. Then we took
17:30
Speaker 4: a look at kind of food and exercise and those
17:33
Speaker 4: sorts of pieces, and that was kind of the trend
17:35
Speaker 4: for her. So she stopped going to the gym. That's
17:37
Speaker 4: really helpful for her. She stopped kind of eating really well.
17:40
Speaker 4: She was skipping school a little bit here and there,
17:43
Speaker 4: and the gym I think is the really missing piece
17:45
Speaker 4: for her, you know. And then you kind of get
17:47
Speaker 4: down on yourself and those sorts of pieces, and then
17:49
Speaker 4: it just feels like, oh my gosh, I had like
17:51
Speaker 4: six months to get through. So working kind of those
17:54
Speaker 4: CBT skills that rot reframing kind of that way of
17:57
Speaker 4: thinking as well, hey, you will get through this. This
17:59
Speaker 4: isn't and you know, kind of the end of the world.
18:01
Speaker 4: It's a few months and it's predictable that way. So
18:04
Speaker 4: we took a look at labs. We decided to kind
18:07
Speaker 4: of hold off on starting any will future right now
18:10
Speaker 4: and see how kind of exercise and good food and
18:12
Speaker 4: those sorts of pieces kind of help her, but you know,
18:14
Speaker 4: we're definitely keeping a close eye on it. And then
18:17
Speaker 4: it's social support as well. So who can you like
18:20
Speaker 4: buddy up with and get to the gym with to
18:21
Speaker 4: make sure you get outside or you know, get to
18:24
Speaker 4: the gym those sorts of pieces. But honestly, medicine isn't
18:28
Speaker 4: the answer a lot of times. It's just kind of
18:30
Speaker 4: adapting to how your brain works and how your brain works.
18:32
Speaker 6: Every winter, yeah, I keep my neighbor keeps me accountable and.
18:41
Speaker 4: We go to the gym.
18:42
Speaker 6: Oh Jim every morning at six fifteen. And like once
18:45
Speaker 6: I like slacker day or two, I get called out,
18:48
Speaker 6: I'm my go all right, got it, going to get
18:51
Speaker 6: back on the horse. But yeah, I mean I've I'm
18:56
Speaker 6: very open that I like since Adolesson, SAD, anxiety and
19:00
Speaker 6: CBT has been like the best thing for me, not
19:03
Speaker 6: only personally but professionally as well. So like when things
19:07
Speaker 6: don't go my way, it's like, Okay, I don't like
19:10
Speaker 6: catastrophize it. I'm like, you're going to get through this.
19:12
Speaker 6: This is a low point, but like how many other
19:14
Speaker 6: things have you gotten through? So I think it's just
19:17
Speaker 6: like a great life skill too when people can actually
19:20
Speaker 6: lean into it.
19:21
Speaker 4: Yeah, our thoughts, you know, impact our actions and it's
19:24
Speaker 4: a big circle. So if we can kind of stop
19:27
Speaker 4: that process and break that process when it comes to
19:29
Speaker 4: this too, like the motivation picks up, the energy picks up,
19:32
Speaker 4: and once we get a habit going, it can make
19:34
Speaker 4: a huge difference for people and exercise. I always say
19:37
Speaker 4: it to all my patients. It really is the silver
19:39
Speaker 4: bullet pretty much for everything. So whether it's inflammation in
19:43
Speaker 4: our body and how we build our brain chemistry, helping
19:46
Speaker 4: our brain chemistry be built, like helping that conversion between
19:49
Speaker 4: trip to fan happen within our brain, it really can
19:52
Speaker 4: just help with so much. And then if you can't
19:53
Speaker 4: pull it together with those sorts of pieces and good food,
19:57
Speaker 4: that's kind of where people like me kind of come
19:58
Speaker 4: in maybe with a little extra medicine boost. And I
20:01
Speaker 4: think just baby dos as a well fut drink can
20:04
Speaker 4: really really be helpful because it can be activating like
20:06
Speaker 4: you mentioned and kind of lead to anxiety and those
20:08
Speaker 4: sorts of pieces. That's why I think holistic treatments in
20:11
Speaker 4: general are just a little softer, a little bit more helpful,
20:15
Speaker 4: and then it really empowers people and they kind of
20:17
Speaker 4: advocate for themselves too.
20:19
Speaker 3: I totally agree that it takes just like a few
20:21
Speaker 3: habits every day. So I teach pilates in the morning,
20:25
Speaker 3: usually before going into work, and that's like my motivator
20:27
Speaker 3: also to work out, because I'm already there.
20:29
Speaker 1: There's no excuse like you have to do it.
20:31
Speaker 3: But I always tell people, I'm like, even if futures
20:33
Speaker 3: try something different for two reps today, it'll become three tomorrow,
20:37
Speaker 3: and then by next week it'll become a habit. So
20:39
Speaker 3: just like taking it little by little, I think is
20:42
Speaker 3: really important. And I think with a lot of our
20:44
Speaker 3: patients and like seeing them longitudinally, just having someone check
20:47
Speaker 3: in on you once a month and ask, hey, did
20:50
Speaker 3: you schedule that Pzke appointment? Did you finally reach out
20:53
Speaker 3: to Tim? Like do you know when your appointment is
20:56
Speaker 3: with Tim? But having just the little things that build
20:58
Speaker 3: a date on a day to date definitely help people,
21:01
Speaker 3: especially when it comes to like working out and stuff.
21:03
Speaker 3: And I wish health insurance covered gym memberships because that's
21:06
Speaker 3: one thing that our patients ask us all the time
21:08
Speaker 3: because they can't afford it sometimes and in colder areas,
21:11
Speaker 3: it's hard to like just get outside and run, it.
21:14
Speaker 4: Is, And they're getting so expensive too. I mean there's
21:16
Speaker 4: the planet fitness in the world, but I mean, really
21:18
Speaker 4: it helps us so many different things, and it helps
21:20
Speaker 4: us avoid more costly treatment. Now that doesn't make a
21:23
Speaker 4: whole lot of sense to me too, And we have
21:25
Speaker 4: research to the effect of like going to the gym
21:27
Speaker 4: helps your focus throughout the day. Right, it's going to
21:29
Speaker 4: boost dopamine, it's going to help with nora epine fr
21:31
Speaker 4: and all those sorts of pieces too, which are a
21:33
Speaker 4: lot of the same chemicals that kind of help with
21:35
Speaker 4: seasonal effective disorder if we think of well a future
21:38
Speaker 4: and like that's exactly what it's targeting. So if you
21:40
Speaker 4: can hit the gym, you know, kind of get them
21:42
Speaker 4: up that way, like it can make a big difference.
21:45
Speaker 1: Now you can tell the dasa agena does in the morning.
21:48
Speaker 6: Oh, I'm freaking ready to run. So it's a lot.
21:51
Speaker 6: I'm a lot. I'm a lot. I'm already a lot.
21:53
Speaker 6: So that's an extra a lot. I just want to
21:56
Speaker 6: say a few pharmacy dorky plugs. So like obviously the
22:00
Speaker 6: vitamin D, the B twelve I need be twelve shots
22:02
Speaker 6: because I have CELIAX, Tim, so I don't really absorb
22:04
Speaker 6: it that well, and all that can be covered under
22:07
Speaker 6: your insurance for like the patients most of the time,
22:10
Speaker 6: not all the time, but just something to think as
22:13
Speaker 6: far as call savings. And then for well Beatried, you
22:17
Speaker 6: said something that not a lot of providers appreciate, which
22:20
Speaker 6: is it can be activating and cause anxiety. So that's
22:24
Speaker 6: a very common misconception. It's not going to treat your anxiety,
22:27
Speaker 6: will help your depression. The other fun dorky pharmacy fact
22:33
Speaker 6: which Tim, I'm sure you already know, but for our listeners,
22:36
Speaker 6: like my biggest bugaboo with well betried is that people
22:39
Speaker 6: don't screen for seizures and then bolimia and anarexia past
22:45
Speaker 6: medical history. And that's like where I find so many
22:49
Speaker 6: times that like a provider missed that screening and then
22:53
Speaker 6: god forbid, many times they've gone to have seizure. So
22:57
Speaker 6: just getting a little dorky on the clinical pearls of
23:00
Speaker 6: well betritten for our listeners.
23:03
Speaker 4: And I think people like it because it doesn't tend
23:06
Speaker 4: to have some of the side effects, and like it
23:08
Speaker 4: does have side effects, it will decrease your appetite and
23:11
Speaker 4: if you're not eating, you know, you're not building your
23:13
Speaker 4: brain chemistry well. And then I think people often like
23:17
Speaker 4: the energy boost and they mistake energy for a focus,
23:20
Speaker 4: which can kind of be problematic in and of itself too,
23:22
Speaker 4: like they're like, hey, like I can do things, and
23:25
Speaker 4: like are you checking in with your anxiety? Are you
23:27
Speaker 4: checking in with your body? All of those sorts of
23:29
Speaker 4: pieces that can really impact your life as well, But
23:32
Speaker 4: it's not side effect free. I think other nightmares too,
23:35
Speaker 4: are one of the more like disturbing side effects that
23:38
Speaker 4: I see people have, and they're not just nightmares, they're
23:40
Speaker 4: like vivid nightmares that people are just like this is
23:44
Speaker 4: really upsetting. And I think a lot of providers miss
23:47
Speaker 4: that as well, right, Like if you're acting out your
23:49
Speaker 4: dreams and accidentally hitting your spouse in the middle of
23:51
Speaker 4: the night, like that's probably not sustainable. So it's definitely
23:56
Speaker 4: not side effect free. And then I think a lot
23:58
Speaker 4: of providers tend to like increase it into the four fifty.
24:01
Speaker 4: But if we're not getting benefit at three hundred, like
24:03
Speaker 4: I don't think there's much reason to go in my breed.
24:07
Speaker 3: And then what role do you think Pharmaco geno makes
24:10
Speaker 3: place in seasonal depression.
24:13
Speaker 4: Oh well, I mean I could go on for ages
24:16
Speaker 4: on that, but I mean you can look at the
24:19
Speaker 4: testing and you can have hints into your brain chemistry, right,
24:22
Speaker 4: So how do you break down your brain chemistry and
24:25
Speaker 4: certain parts of your brain that's incredibly helpful, Right, Like
24:28
Speaker 4: if you have a valvel com t like I know,
24:31
Speaker 4: for example, you're going to break down dopamine and more
24:33
Speaker 4: epineffor and more quickly in your brain. If I know that,
24:37
Speaker 4: it's those patients that do tend to struggle with seasonal
24:39
Speaker 4: effective disorder a little bit more they burn through it.
24:42
Speaker 4: So we're going to talk about how to get those
24:44
Speaker 4: things up and in a really healthy way. And then
24:47
Speaker 4: how you build your brain chemistry. Do you have the
24:49
Speaker 4: mthf our genetic mutation as well? That makes that tougher
24:52
Speaker 4: and can to lead to more information and those sorts
24:55
Speaker 4: of things too, And I think like it really empowers
24:58
Speaker 4: patients too, Right, do you know what medicines work well
25:02
Speaker 4: with your body? Like you can do the digging and
25:04
Speaker 4: I'm never intimidated by that. So not only do we
25:06
Speaker 4: know like how you build it, how you break it down,
25:09
Speaker 4: and then kind of how you even transport certain serotonin
25:13
Speaker 4: kind of markers and those sorts of things. Like it's
25:15
Speaker 4: fun stuff like you can make a big difference for people.
25:18
Speaker 1: Yeah, always tell them it's like the blueprint of fear medicine.
25:21
Speaker 3: Like I in my world of perfect world, everyone will
25:24
Speaker 3: be born with pharmacogenomics like already set out, So then
25:27
Speaker 3: you already know instead of guessing for the rest of
25:30
Speaker 3: your life and like kind of shooting in the dark
25:31
Speaker 3: on what will work, you actually know like what you're
25:33
Speaker 3: susceptible for, what will work best for you at what
25:36
Speaker 3: dose and what frequency. So I just think it's like amazing,
25:39
Speaker 3: and I'm so glad we align on that.
25:42
Speaker 4: It's super important rather than just increasing medicines. Now the
25:45
Speaker 4: research can be a little bit mixed about, you know,
25:48
Speaker 4: improving outcomes, but a lot of those studies it's tough,
25:52
Speaker 4: right because like these are hard to treat people in general.
25:54
Speaker 4: You know, they have treatments resistant depression, those sorts of pieces.
25:58
Speaker 4: So we have to look at the patient and not
26:00
Speaker 4: treat them like a textbook. And I think, you know,
26:02
Speaker 4: gene side testing really allows us to do that, and
26:05
Speaker 4: then they have faith kind of in the medicine that
26:07
Speaker 4: we're choosing, and then we can use the lowest effective
26:09
Speaker 4: dose as well. Like if they burn through a medicine,
26:12
Speaker 4: maybe I don't want to use that medicine because essentially
26:16
Speaker 4: I'm going to get to have to hire doses with it,
26:18
Speaker 4: and then you can get side effects because you know
26:20
Speaker 4: the anxiety and depression. You know that's implicated and where
26:23
Speaker 4: in your brain right, But then you're going to have
26:25
Speaker 4: systemic side effects as well. So I never want to
26:28
Speaker 4: use a high dose of a medicine. Iff I can
26:29
Speaker 4: avoid it. But gene sit kind of gives you that
26:31
Speaker 4: blueprint to all of it.
26:32
Speaker 5: Well, Tam, this has been fascinating in particular for me
26:35
Speaker 5: because I think you are more I don't want to
26:38
Speaker 5: stay on the functional end, but you're more on the
26:41
Speaker 5: living end of how someone can be more thoughtful and
26:45
Speaker 5: treatment of this time of season and maybe these types
26:48
Speaker 5: of symptoms. Rather than just a single track of hey
26:52
Speaker 5: prescribe this or hey just do this, you take a
26:55
Speaker 5: multifaceted approach of looking at what might fit for someone's
27:00
Speaker 5: maybe cultural competencies and health and understanding in their own
27:06
Speaker 5: world that they're living in a day to day basis.
27:08
Speaker 5: So really insightful things and thank you for the extra
27:12
Speaker 5: guest on the show as well.
27:14
Speaker 4: No problem. I really think the functional, multi discipline approach
27:17
Speaker 4: is how healing happens because everybody's a little bit different
27:20
Speaker 4: and we have to do what works for them and
27:23
Speaker 4: take the time to kind of learn and see what
27:25
Speaker 4: works rather than just throwing a medicine at it. That's
27:27
Speaker 4: the easy approach.
27:28
Speaker 1: Awesome, Well, thank you so much for joining us today.
27:31
Speaker 3: It was honestly amazing, and I'm like thoroughly impressed that
27:34
Speaker 3: you have the gene mutations memorized. I wish I had
27:37
Speaker 3: that kind of brain power, but that was pretty awesome.
27:40
Speaker 3: And I have one last question for you. What was
27:42
Speaker 3: your TikTok video on I don't have tiktoks. I wouldn't
27:45
Speaker 3: be able to see it.
27:46
Speaker 4: Oh, what do you mean.
27:48
Speaker 1: When I emailed you?
27:49
Speaker 3: When I emailed you about seasonal depression, You're like, oh
27:51
Speaker 3: my gosh, I just did a TikTok video on it.
27:53
Speaker 4: Yeah, how to spot it? And then I talked about,
27:56
Speaker 4: you know, the lamp actually having or the sab and
27:58
Speaker 4: I'm having a lot of research support it. That's the
28:01
Speaker 4: main thing I hear from my clients. I think it's
28:03
Speaker 4: kind of you know, hokey or and then I'm like, well,
28:06
Speaker 4: we can pull up like the ten studies together and
28:09
Speaker 4: so it's just a simple twenty dollars on Amazon that
28:12
Speaker 4: can make a huge difference. So I just kind of
28:13
Speaker 4: touch based on that with TikTok and kind of a
28:15
Speaker 4: fun way.
28:16
Speaker 1: Awesome love it. Need I need to steal a phone
28:19
Speaker 1: from someone.
28:22
Speaker 4: I think I have quite a few videos out there now.
28:23
Speaker 4: It's kind of there's so much misinformation out there that
28:27
Speaker 4: we kind of need to combat that as professionals and
28:29
Speaker 4: come together to do it. So you should get on there.
28:32
Speaker 3: Let's see how good I am at that. But thank
28:35
Speaker 3: you so much for joining. I hope you have a
28:37
Speaker 3: great week you too.
28:39
Speaker 4: Nice to see everybody.
28:40
Speaker 2: That's all for today's episode. Thanks for listening, and remember
28:44
Speaker 2: to subscribe on Apple Podcasts and leave us a review.