Seasonal Affective Disorder

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As we leave the bright days of summer behind and head into fall, some of us welcome the change in season. Leaves changing colors, cozy sweaters, and the refreshing crispness of the air can feel like an exciting new phase of life. However, for others, the shift toward darker, longer, and colder days are an unwelcome and anxiety-provoking transition.

Seasonal Affective Disorder (SAD) is a mood disorder that follows a cyclical pattern. Seasonal Affective Disorder affects approximately 5% of the population, while another 15% experience more mild versions of SAD. What sets SAD apart from depression is that the person experiencing SAD typically begins to experience symptoms — which are similar to those of depression —  in the fall and winter but feels relief from them during the spring and summer. Someone with depression may feel the symptoms regardless of the season.

What are the symptoms of SAD?

SAD can be debilitating and the symptoms can include: 

  • depressed mood
  • social withdrawal
  • lack of pleasure in activities
  • hopelessness
  • irritability
  • mental dysfunction
  • difficulty waking in the morning
  • daytime fatigue
  • carbohydrate cravings followed by weight gain
  • lack of energy 
  • suicidality

What causes SAD?

Although we do not fully understand the biology of SAD, we believe that a disturbance in circadian rhythms plays a role. Melatonin secretion takes place at night in low light. Scientists hypothesize that, in those with SAD, the longer period of melatonin secretion induces depression. Another hypothesis suggests that a phase shift in circadian rhythms is at least partially responsible for the development of symptoms.  With the later dawn and diminished light in winter circadian rhythms are delayed relative to the clock and sleep time. As some mammals respond to this change with hibernation, the SAD symptoms of hypersomnia, increased appetite, and weight gain may be a form of this response.

The retina responds to light and plays a major role in circadian rhythms. In the winter, the retina increases its sensitivity to light. It is thought that those with SAD may have an impairment of their retina, which causes the sensitivity to be diminished. 

How do you treat SAD?

There are effective means to treat SAD. The methods listed below are a combination of lifestyle practices you can begin at home and treatments by medical professionals. If you’re able to manage your symptoms at home, that’s wonderful. But if you begin to feel suicidal, or have other concerns about the symptoms you’re experiencing, please see your doctor right away.

Light therapy

  • Bright light therapy: Bright light therapy has been shown to be an effective treatment for SAD. It requires sitting in front of (16-30 inches away) a lightbox that emits white light using fluorescent bulbs at 10,000 lux.  Treatment should begin shortly after waking and last approximately 30 minutes.
  • Dawn Simulation: Dawn simulation therapy takes place during the last 30 to 90 minutes of sleep.  As opposed to the bright light used in bright light therapy dawn simulation uses a less intense light that gradually increases to room light level and coincides with the person’s normal waking time. This can be preferred as it doesn’t require making time to sit in front of the bright light in the morning. 

Outdoor activity

Getting outdoors daily, especially on bright days, is universally prescribed for those with SAD.

Exercise

Research has shown that aerobic exercise can help to alleviate the symptoms of SAD.

Psychotherapy

Psychotherapy is an effective and important adjunctive treatment for SAD.  Gaining insight into thought patterns and developing a reframe or alternative perspective can shift some of the symptoms experienced by those with SAD.

Sleep Hygiene

Maintaining a regular sleep (light-dark) cycle is important.  Following the other aspects of good sleep hygiene in order to preserve restorative sleep is critical for patients with SAD.  

If you believe you may be experiencing the symptoms of SAD it is important to begin treating symptoms early. Make an appointment with your physician to discuss your symptoms and develop a personalized care plan so you can start feeling better soon.

5 Tips for Eating Healthy While You Travel

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Are you traveling this holiday season to visit family or friends? In addition to long lines at airports and unrelenting traffic, another challenge with travel can be the food. Airport and rest stop food can be one of the toughest blows to your healthy eating habits, but it doesn’t have to be. Here are a few tips for eating healthy while traveling:

  • Carry raw or dry roasted nuts and apples or mandarins with you – this is a great go to snack that will sustain you and sustain getting knocked around in your bag.
  • Chop veggies before you travel – take 5 minutes the night before your trip to slice a red pepper and chop a couple carrots or celery stalks. Put them in a Ziploc bag and pack along a travel size packet of hummus or almond butter for a crunchy, healthy snack.
  • Jerky has improved since the days of “slim jims” and there are now several high quality options available (be sure to read the ingredient label looking for things like “grass-fed” and no added sugar). Jerky is a great choice because it’s high in protein and doesn’t need refrigeration. Some quality brands: Nick’s Sticks, Paleo Valley, Epic, Chomps, Tanka, Krave all available on Amazon, sometimes at Whole Foods
  • Pack healthy sweet treats like homemade muffins, 70% or higher dark chocolate, and Lara Bars to avoid giving in to that candy bar or Starbucks baked good.
  • Hydrate, hydrate, hydrate…with water that is! Aim to drink half your weight in water ounces every day. Many times when you feel hunger, you’re actually dehydrated. Staying hydrated also helps flush out toxins and keep your immune system strong.

If you get stuck having to choose something while you’re on the road, choose protein and veggies, something like a chicken salad or a soup would be a great choice. Most importantly, if all else fails, don’t beat yourself up about a poor choice, but do make a commitment to get back on track with your real food habits at your next meal or snack.

Best wishes to you for a healthy and happy holiday season! If you’d like some guidance and support to help reach your health goals in the new year, you can schedule a nutrition consultation HERE.

Recipes For Saying Goodbye to Summer, and Hello Fall!

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As we finally welcome real summer weather here in San Francisco, it can be difficult to remember that a seasonal change is upon us. But if you frequent the farmer’s market, you’re likely seeing the return of brussels sprouts, artichokes, sweet potatoes, and hearty winter squashes. September and October are also a great time to enjoy the end of zucchini, tomato, and corn season.

Here are some recipes to help you enjoy the last of summer’s produce bounty and welcome in fall’s sturdier veggies.

Enjoy!

Zucchini Gazpacho with Basil

Flourless Almond Butter Zucchini Muffins
NOTE: I typically omit the chocolate chips and they are still delicious. A huge hit with kids and an excellent protein packed snack.

Tomato & Fig Salad with Basil
Delicious way to combine late summer tomatoes and early fall figs.

Kale & Brussels Sprouts Salad

Pumpkin Spice Smoothie
Healthy and delicious alternative to pumpkin spice lattes.

Pumpkin Cranberry Muffins
One of my all time favorite muffin recipes!

Do you have any favorite season recipes? Please share with us on our Facebook page.

Fall Into Your Groove

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With fall comes the return to busy routines of work, school, and perhaps preparing the home for upcoming winter festivities or holiday travel. Increased exposure to people in close quarters and increased demands on our time and energy may bring “back to school” colds and respiratory ailments that affect the whole family.

In traditional life, fall was the time of harvest, for gathering our resources to guard against the adversity and scarcity of winter. It was the season to lay in supplies and eat heartily before fresh foods diminish.

In Traditional Chinese Medicine, fall is the season of supporting the lungs, sinuses, and immune system with specific foods, treatments, and herbs.

In 2018, our bodies still carry a connection to nature and we still benefit from living in harmony with each season. What can you do this fall to support your lungs, sinuses, and immune system and ward off colds and flus?

Tips for finding your fall groove:

  1. Eat seasonal foods: There are still many kinds of fresh produce to be had in fall, but our cooking style should change with the season. Prepare vegetables warm and serve with aromatic seasonings, grilled, or roasted meats and warm grains. Minimize cheese, milk, and cream to keep phlegm at a minimum.
    • Examples: Roasted squash, caramelized red onions with cumin, star anise or ginger over quinoa. Roasted sweet potatoes with garlic and thyme served with grilled lamb sausage.
  2. Eat local, raw honey: See my article highlighting a local beekeeper and purchase local raw honey here.
  3. Breathe: Take a few minutes morning and night to sit quietly and inhale for a count of 4, hold 2 and exhale for a count of 4. Practice breathing into the very back and bottom of your lungs. This will both calm your nervous system and bring more oxygen into your body. Both are great for bolstering immune function.
  4. Sleep: Our bodies do most of their repair and restoration during sleep. Without it, your health, mood, and immunity can start to break down. Eight hours is vital for the prevention of a host of ills. If you have trouble sleeping, I offer acupuncture for insomnia.
  5. Take herbs to support your health: Depending on your area of weakness, it can make sense to have a few specific herbal formulas to have on hand like Yin Qiao for colds,  Respitrol CF for cough, Immune + to prevent colds, Pinellia XPT to expectorate phlegm and Pueraria Clear Sinus to clear phlegm and congestion from the nose.
  6. Get Acupuncture:  Weekly in the fall before the holiday season takes over. This is especially important for those who catch colds and flus frequently.
  7. Enjoy your life: This is the most underrated yet essential element for health. Do what you love, with people you love and who inspire you, and take the time to enjoy and appreciate what is right here, right now. The fall offers unique pleasures to enjoy like changing leaves, sweaters, and in the Bay Area, extended summer. Enjoy it all!

For help finding your fall groove, Dr. Giulietta Octavio uses acupuncture, Chinese Medicine, nutrition, Gua Sha, counseling, Chi Nei Tsang, cupping, and herbal medicine to help patients in the Bay Area, at WholeFamily MD and Integral Body. For more information or to schedule an appointment, click here.

Recipes: Summer Smoothies & Salads

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The summer farmer’s market bounty is here! Although we are lucky in the Bay Area to have an excellent variety of produce available all year long, some options are especially best this time of year like berries, cucumbers, tomatoes, green beans, eggplant, and summer squashes. We hope you enjoy these nutritious and delicious salad and smoothie recipes. If you have a favorite summer recipe, please share with us on our Facebook page – we’d love to hear from you!

SALADS

Spinach, Fennel, & Mint Salad (4 servings)

2 cups spinach

1 bulb fennel, sliced thin

12 strawberries, sliced

½ cup mint

½ cup slivered almonds

Optional: add chicken or salmon as a protein

Toss together and dress with Healthy Italian Dressing (recipe below) or simply olive oil, lemon juice and sea salt.

 

Tomato & Cucumber Salad (4 servings)

1 pint of cherry tomatoes, halved

1 large cucumber, diced (peeled if desired)

Toss together with Heathy Italian Dressing (makes 2 cups so you will have extra):

½ cup flax oil

½ cup extra virgin olive oil

½ cup lemon juice

½ cup raw apple cider vinegar

1 garlic clove, crushed

¼ teaspoon honey

1 pinch of sea salt, more to taste

½ teaspoon each of dried basil and oregano

 

Green Bean, Walnut, & Feta Salad

1 1/2 lbs. fresh green beans, trimmed and cut into about 2-inch pieces

1 cup chopped walnuts

3/4 cup diced shallot

1 cup crumbled Feta cheese

3/4 cup extra virgin olive oil

1/4 cup white wine vinegar

1/4 cup fresh mint leaves, minced

3 cloves garlic, minced

1/2 teaspoon salt

1/4 teaspoon black pepper

  • Bring a large pot of water to a boil. Add green beans and cook for only 3 minutes. Drain well and immediately plunge into ice water to stop the cooking process. Drain again and pat dry with paper towels.
  • Place green beans in a large bowl. Add walnuts, red onion, and Feta; gently stir to combine.
  • Combine olive oil, white wine vinegar, mint, garlic, salt, and pepper in the bowl of a food processor; pulse a few times to blend. Pour dressing over the bean mixture and toss.
  • Chill for about an hour before serving.

Zucchini Noodles with Dairy Free Pesto

2 – 3 zucchini

2 cups, loosely packed basil leaves

1/2 cup pine nuts (or pecans or walnuts)

1 clove fresh garlic

1/4 to 1/2 cup extra virgin olive oil, as needed

Sea salt, to taste

  • To make pesto, combine basil, nuts, and garlic in a food processor and process the mixture until it turns into a coarse meal. Slowly add extra virgin olive oil in a steady drizzle as you pulse the processor on and off. Process until it becomes a smooth, light paste. Add enough olive oil to keep it moist and spreadable. Season with sea salt, to taste.
  • Chop off ends of zucchini and use vegetable peeler or spiralizer to create zucchini noodles, place “noodles” in a steamer basket and steam for about 5 minutes, until tender, but still crisp.
  • Toss noodles with pesto. Can be enjoyed hot, room temperature or chilled.
  • Make it a meal: add cooked shrimp or salmon or chicken

SMOOTHIES

Smoothies are an excellent way to get extra vegetables and superfoods into your diet. Here are some unique and delicious combos:

Cucumber, Parsley, Pineapple Smoothie (2 servings)

3/4 cup water or coconut water (more for a thinner smoothie)

1 large cucumber (1/2 of an English cucumber)

1 bunch flat leaf parsley, leaves only

2 lemons, peeled and seeded

2 cups pineapple, fresh or frozen

Optional: 2 scoops Vital Proteins Collagen Peptides protein powder

 

Blueberry Cauliflower Smoothie (2 servings)

3/4 cup blueberries, fresh or frozen

1/2 cup frozen riced cauliflower

1/2 cup loosely packed spinach

1 teaspoon cinnamon

1/2 teaspoon powdered ginger

2 tablespoon hemp hearts

Generous pinch salt

Splash vanilla extract

1 ripe banana

Water – more for thin, less for thick

 

Ruby Smoothie (1 serving)

1 ¼ cup unsweetened almond milk (or other liquid of your choice)

½ cup raspberries, fresh or frozen

3 strawberries

2 Tablespoons ground flaxseeds

1 Tablespoon chia seeds

2 Tablespoons almond butter

Spring Produce is Here!

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March ushers in the beginning of spring and new seasonal produce at the farmers market. We can start to say goodbye to the sturdier root veggies of winter and say hello to the lighter veggies of spring. One of my favorite vegetables that comes into season this month is asparagus. Read on to learn a bit more about it and enjoy some new recipes.

Asparagus

Incredibly high in a variety of antioxidants, asparagus is an anti-inflammatory superstar. It’s rich in vitamin K (for optimal bone health) and folate (for optimal nervous system and cardiovascular function). It’s also an excellent source of prebiotic fiber – the soluble fiber that feeds your gut flora and therefore supports your good gut bacteria.

It’s simple to prepare and so delicious!

Tips for Buying and Storing:

  • Choose stalks that are dark green and firm with closed tips
  • Wrap ends in a damp paper towel and store in fridge crisper
  • Best used within 2 days of purchasing

Preparation Tips & Recipes:

  • Hold asparagus at each end, bend gently, and snap off the hard stem end – it will naturally break where the tender stalk meets the tough stem
  • Roasted:
    • Toss with olive oil, salt, pepper, & garlic powder
    • Spread into one layer on baking sheet
    • Roast asparagus at 400 degrees for 10 minutes (less if stalks are very skinny)
    • Add a squeeze of lemon before serving
  • Steamed:
    • Cut asparagus into bite size pieces
    • Steam in steamer basket for about 3 minutes until tender but still crisp
    • Toss with olive oil or butter and your favorite seasonings
    • To have cold asparagus for later use, after steaming place asparagus into ice cold water to stop cooking process and keep it crisp

I hope you enjoy adding asparagus into your meals! Click here to see what other foods are coming into season in the Bay Area this spring. Bon Appetit!

Angela Ross, Certified Nutrition Consultant

Seasonal Bites

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As summer transitions to fall, we start to see a shift in the produce available at the farmer’s markets. Check out CUESA’s Seasonality Chart to see what’s in season now in the Bay Area.

Here’s a delicious and healthy recipe that gives you an opportunity to use up the last of summer’s abundant zucchini and enjoy apples as they come into season.

Zucchini Apple Muffins

Ingredients

3/4 cup of applesauce

3 eggs

1 teaspoon vanilla

1-2 Tablespoons honey (optional)

2 cups almond flour

2 Tablespoons coconut flour

1/4 teaspoon sea salt

1/2 teaspoon baking soda

2 teaspoons cinnamon

1 teaspoon apple cider vinegar

1 heaping cup of shredded zucchini (Place in a clean, dry dish towel and squeeze out as much liquid as possible.)

1 medium apple, peeled and diced into 1/4 inch chunks

Instructions

  1. Preheat your oven to 350 degrees and grease muffin tin with coconut oil.
  2. In a bowl, combine the applesauce, eggs, vanilla, and honey (if using). Mix well.
  3. In a separate bowl, combine the almond flour, coconut flour, sea salt, baking soda, and cinnamon.
  4. Pour the wet ingredients into the dry. Add in the apple cider vinegar, diced apples, and shredded zucchini. Mix well.
  5. Portion out the batter into 12 muffin liners.
  6. Bake for 25-28 minutes – until a knife inserted into the middle of the muffin comes out clean.
  7. Remove from the oven and let the muffins cool.
  8. Store any leftover muffins in an airtight container in the refrigerator or wrap individually in plastic wrap and freeze.

(Read more about Angela Ross, CNC and her nutritional coaching practice HERE.)

photo from thisisgoodhome.com

Healthy Habits For a Busy Month

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September is an action month – no matter if you have school aged children or not. September always has an air of back to school, back to work, back to business. As schedules get busy it can be easy to slip into unhealthy patterns; that’s why it’s useful to establish some key routines that help keep you on track with healthy habits so you can have the energy and good health you need to get it all done. Here are 3 simple, healthy habits. Which ones can you implement so that you continue to feel your best, even as life gets busy?

  • Drink Water – Are you drinking enough water? A good rule of thumb is to drink half your body weight in water ounces per day. For example, if you are 150 pounds aim to drink 75 ounces of water per day. Have a hard time reaching your water goal? Carry a water bottle with you and schedule reminders in your phone to drink some water every 60-90 minutes. Keeping well hydrated has so many benefits including flushing out toxins, boosting immunity, improving bowel movements, and providing an energy boost.
  • Carry Healthy Snacks – To avoid the 3pm slump and junk food grab, carry healthy snacks instead. You can keep them in your purse / bag or make a healthy snack drawer at your desk or office fridge. Some ideas:
    • Raw or dry roasted nuts
    • Nut butter with apple or pear slices
    • Hummus with veggie sticks (ie: peppers, cucumbers, snap peas, jicama, carrots)
    • Jerky (healthy brands: Epic, Tanka, Chomps, Nick’s Sticks)
    • Healthy snack bars (Larabar, Kit’s Organic, RXBars)
    • Hardboiled egg (make a dozen for the week)
    • Smoothie (make at home and bring with you in a thermos)
    • Kale Chips
    • Seaweed snack (Sea Snax brand is great)
    • Homemade muffin (see yummy recipe)
    • Or maybe you don’t need a snack at all! Perhaps you need some water, fresh air, deep breaths, a walk around the block, or a 5 minute stretch session. When that afternoon slump happens ask yourself, “How am I feeling, and what do I need?” The answer may surprise you!
  • Bedtime routine – Do you wake feeling refreshed? If not, check in on your sleep habits and see where you can make changes.
    • Aim for lights out between 10:00-10:30pm to allow for optimal restorative sleep
    • Turn off all screens 30-60 minutes before lights out
    • Experiment with a relaxing routine before lights out. Choose one or two: a cup of chamomile tea, epsom salt bath, stretches, deep breathing/meditation, journaling, or reading a book/magazine.
    • Use blackout curtains, an eye mask, and/or earplugs to assist with restful sleep

Which of the healthy habits above can you implement? Share with on our Facebook page. We’d love to hear from you!

(Read more about Angela Ross, CNC and her nutritional coaching practice HERE.)

Staying Healthy During Cold and Flu Season

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Late fall through early spring is traditionally cold and flu season. To stay as healthy as possible and to keep those around you healthy, consider these tips:

  1. Wash your hands – Your hands touch all kinds of shared surfaces through the day and a quick stop to wash your hands with warm water and a little soap can really make a difference. How do you get your kids to wash well? Teach them to wash while they sing the Happy Birthday song twice, or about 20 seconds. Alcohol based hand sanitizer is better than nothing, but, the pressure from the water on your hands does a better job.
  2. Wash your surfaces – Keep things clean around the house to avoid picking up infections from others.
  3. Avoid others who are sick – Do your best to avoid friends, family and coworkers who are sick. We can do our part to help each other by staying home from work and keeping kids home from school when they are sick. The general rule is stay home 24 hours past the last fever before heading back to work or school.
  4. Cover your mouth with your elbow when you cough
  5. Keep your hands away from your face – Especially your nose, eyes, and mouth which are easy germ entry points.
  6. If you get sick, take care of yourself! – It’s true. Let yourself sleep the amount that you need. Drink lots of fluids. Eat nutritious food. Don’t smoke. All these things are important for prevention and treatment of illness.
  7. Is it more than a cold or flu? – The flu virus can be very serious. Sometimes the flu can even set you up for a more serious infection like pneumonia. If you are ill for more than 5 days, short of breath, unable to keep fluids down, or are suffering from dehydration, severe pain, or are unable to take care of yourself, please contact our office so that we can help you to get the care that you need.