Winter blues or something more?

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By Rhoda Rees, FNP

Embrace Women’s Health Clinic, Baxter


It happens every year. The cold sets in, daylight grows shorter and snow flurries fly. Naturally, this change in seasons is commonly followed by a case of the winter blues. That’s completely normal. But what if your melancholy mood is more serious than it appears?Silhouette of sad teenage girl looking out the window on a cold autumn day

Depression is a prevalent issue in our society, and sometimes, it comes with a seasonal element. Seasonal affective disorder (SAD) is a type of depression that occurs when fall and winter arrive and then resolves in the spring and summer. Left untreated, this cycle can recur every year, repeating over and over.


How do I tell the difference between SAD and winter blues?

Symptoms of winter blues are typically short-lived. Everyone is allowed a little slump during the winter doldrums, but if you feel down and out for longer than two weeks, your affliction may be more serious.

SAD symptoms include:

  • Irritability
  • Sleep problems
  • Change in appetite
  • Fatigue
  • Loss of energy
  • No interest in activities
  • Feelings of guilt or worthlessness
  • Thoughts of suicide

You might also be more at risk for SAD if you’ve experienced any form of depression or mood disorder in the past or if you have a family history of the disorder.

If you think you might be suffering from SAD, it’s important that you make an appointment to see your provider. An assessment, questionnaire and family history will help determine your diagnosis.


Can it be treated?

Treatment depends on severity. For a mild case, and if you are willing to change habits, then lifestyle alterations can be a solution. This includes a healthy diet, regular exercise and an adequate amount of sleep.

Melting snowman on the warm rainy day in the middle of January winter weather.Pursuing outside activities during the day can also be a major help. They get you out and moving around, which is a benefit to serotonin, your happy hormone. You also get a good dose of fresh air and natural light to help keep your internal clock in check.

You may experience barriers at first, so what’s it going to take to get you outside? If you aren’t motivated to try full-on exercise, would you go for a walk? Then maybe you could take it a step further by cross-country skiing or ice skating. The key is finding something outside that you would be willing to pursue.

For more severe cases of SAD, depression medication may be needed. Another option is light therapy. This involves a special red light that gives off UV rays to replenish your vitamin D supply, which decreases your risk of health conditions. Using light therapy for even one hour a day can improve symptoms. You could also ask your provider about vitamin D supplements.

Hundreds of patients every year come in with SAD, so if you receive this diagnosis, you are among a large group who have gone before you and emerged successfully. By being proactive, you and your provider can identify your barriers and develop a treatment plan to reduce symptoms and help you enjoy the winter.


About the Author: Rhoda Rees is a family nurse practitioner at Embrace Women’s Health Clinic in Baxter. She is board certified through the American Nurses Credentialing Center. Women’s health is her specialty and her passion, and she loves helping patients make educated decisions that positively impact their health.

When the holidays get you down

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By Andrea Craig, Psychiatric Mental Health Nurse Practitioner


The holidays aren’t always the most wonderful time of the year. In fact, many people I have seen in my practice over the years feel particularly disheartened or resentful of the holidays.

There’s no right way to feel during this time of year, but the pressure to feel joy and happiness can be especially discouraging. Many factors contribute to these emotions, such as finances, loneliness, and grief, but there are solutions for each of these.


For those on a budgetFrustrated dad looking at receipts and bills during Christmas time

One of the biggest causes of depression around the holidays that I see is finances. In today’s consumer-centric world, there’s heavy pressure on people to spend lots of money and to buy lots of gifts. As a result, many people feel guilty for not being able to afford gifts, parents and grandparents especially.

Despite what mainstream society wants us to think, I believe that there’s more to the holidays than giving and receiving gifts, and this time of year can be enjoyed without spending heaps of money.

If you don’t have the funds to buy gifts, first try giving the gift of time. Make a point to spend time with people. In fact, this gift may be more cherished than a new toy in the long run.

Here are some other ideas to keep the holiday expenses low:

  • Drive around town to look at lights.
  • Bake cookies.
  • Watch a movie on TV and have a cup of hot chocolate.
  • Play a board game while listening to Christmas music.
  • Only do stocking stuffers.
  • Go skating or sledding.
  • Get involved in community events, such as visiting Santa Claus or lighting ceremonies.
  • Find creative projects to make with materials found around the house.
  • Buy a few inexpensive gifts and play a game when opening them.
  • Write friends and family a personalized letter instead of getting gifts.
  • Give handmade gifts.
  • Sell old toys or clothes in order to buy new ones.
  • Volunteer for others in need.


A Caucasian woman is indoors in her living room. There is a Christmas tree in the background.

For those who are lonely

Another cause of sadness around the holidays is not having anyone to spend time with. This is especially difficult if you see other people celebrating together.

Because it’s supposed to be such a happy time of year, if you don’t feel any of that joy due to loneliness, it intensifies your negative feelings.

If you’re feeling up to it, try some of these methods to combat loneliness:

  • See what’s available in the community in terms of activities or celebrations.
  • Get involved in a local church. Even if you don’t share the faith, churches can offer other solutions in terms of companionship and feeling involved.
  • Seek out others around you who are in a similar circumstance. Though it may not feel like it, there are many others who are experiencing what you are.
  • Volunteer. This can take your mind off of loneliness by focusing on the needs of others.


For those who are grieving

Sometimes, the holidays bring up past feelings of grief or intensify new ones. This is especially hard during the first year and the first holiday.

A Depressed adult male looks out a window past christmas decorations with christmas lights in the background.Instead of trying to suppress thoughts of your loved one during the holidays, I encourage you to embrace those thoughts.

Try starting a new tradition in memory of that person. For instance, purchase an ornament in honor of that person to hang on the tree. Share stories about them to make them a special part of the holiday. Include their favorite foods in the holiday menu.

This might make you feel guilty about enjoying the holiday without your loved one. I just want you to know that it’s OK to celebrate the holiday and to feel happiness. But it’s also OK if you don’t feel like celebrating.

For those spending time with a grieving individual, ask how you can best support them, and try to make things less stressful, perhaps by taking care of the meal or hosting. Some people would feel better by not participating in the holiday at all, and that’s OK. It’s just important to give this individual the chance to say yes or no.


About the Author: Andrea Craig works in behavioral health at Tri-County Health Care and is board certified as a psychiatric mental health nurse practitioner. She is a graduate of the College of St. Scholastica in Duluth.

My Personal Journey – Mental Health Awareness Month

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Guest Blog By: Jode Freyholtz-London, Executive Director – Wellness in the Woods

Did you ever have to write an essay in school, maybe 2nd grade about “what I want to be when I grow up”? If I recall… this was 50 years ago….. mine was something like being a teacher or a nurse, a position appropriate for women in the rural part of Minnesota I grew up in. Life didn’t exactly work out the way I had planned at the age of 7. In fact I didn’t attend college until I was 40+ years old. I certainly didn’t write having a mental health crisis into that essay.

I have never left central, rural Minnesota and consider this part of the world my lifelong home. In 2005 after spending most of my career working to support people who live with a mental health diagnosis, I became the person who had to seek services. My introduction to depression, anxiety and eventually the “title” of Post Traumatic Stress Disordered person was Sept 18th, 2005 when after an initial phone call to the crisis line, I drug myself into my local TCHC clinic to visit with my most wonderful, life-saving nurse practitioner, Amy Severson. She took the time to actually ask me what was happening in my life and not just look for “what was wrong with me”.

The total lack of light and joy in my life at that point led me to thoughts of suicide, hopelessness and fear of an unknown future. This experience, which I now believe was a learning opportunity gave me the knowledge and perception to live life on the “other side of support”. I was fortunate to have a group of colleagues in the mental health field to guide me into a path of recovery. Their care and compassion along with prayers of support, phone calls, handholding and plenty of hugs, partnered with professionals that made the way though the darkest moments bearable.

Jode advocating on the Hill in 2014

Jode advocating on the Hill in 2014

In May, mental health awareness month, we celebrate what recovery means to the 61.5 million people or 25% in the US who live with a mental illness. We know from recent needs assessments that people in our community do not seek treatment because of the stigma and fear surrounding the label of “mentally ill” and so suffer for years in their own internal pain. It is our responsibility as a “caring” community to be courageous enough to reach out to our neighbors and family members, to say the uncomfortable words associated with emotional struggles and highlight the story of what living in recovery can mean in the lives of those who find the support needed to move forward.

Jode’s Bio: She is the founder and executive director of Wellness in the Woods and has worked in the non-profit, human services field for over 30 years. She has experience as a mental health practitioner, an employment specialist, program coordination in chemical dependency and supported employment programs, advocacy, crisis response and stabilization, certified peer specialist, QPR instructor and wellness trainer.

*If you are one of the millions struggling with depression or other life issues, visit our website at to see the resources we have available at Tri-County Health Care. We want to help you feel better. Click or call 218-631-1100 to make an appointment with one of our qualified providers.