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Coach on Call It was great to talk with you. Thank you for your interest in. I hope you find this tip sheet helpful. Please give me a call if you have more questions about this or other topics. As your UPMC Health Plan health coach, I m ready to help in any way I can. During the darker days of winter, many people tend to have less energy and feel down more often. This mild but noticeable change in mood, sometimes called the winter blues, is common. The cause may be related to changes in our internal clock or circadian rhythm, which responds to light and darkness. Some people have more difficult changes in mood a medical condition called Seasonal Affective Disorder (SAD), which: Occurs every year when the daylight hours get shorter. Lasts until the days start getting longer again, unless treated. Is more common in people who live in northern climates. SAD is a form of depression. The symptoms may include: Persistent sad, anxious, or empty feelings Fatigue Trouble sleeping or oversleeping Changes in weight Trouble concentrating Feeling hopeless or worthless Loss of interest or pleasure in activities you used to enjoy, such as hobbies and being with friends Thoughts of death or suicide A healthier life is life on is the on line the for you! line for you! Copyright 2016 UPMC Health Plan Inc. All rights reserved C ON C BEAT WINTER BLUES 16WP0168 (MCG) 9/13/16 PDF

Page 2 of 5 Coach on Call Below are some ways to ease the winter blues, which are helpful for coping with SAD as well: Be more active. Exercise has been proven to increase energy and ease depression and anxiety. Being active outdoors has the added benefit of exposure to sunlight. Bundle up and walk, bike, or enjoy winter sports, such as snowshoeing and cross-country skiing. Find an exercise buddy or join a team. Being active with others offsets the isolation that is common with depression. It can also boost your motivation to stay active because you know others are depending on your company and support. Eat a healthy diet. Eat three regular meals and one or two healthy snacks per day. Avoid skipping meals, which can lower your blood sugar and cause mood swings. At meals make about half your plate fruits and vegetables, one quarter lean protein foods, and one quarter grains. Make at least half of the grains you eat whole grains. Include a serving of nonfat or 1-percent dairy food (milk, yogurt, cheese) with meals. Limit foods with added sugars. Sugar can cause your blood sugar to spike and then fall quickly, leading to mood swings. Avoid drinks with added sugar. Drink plenty of water. Limit alcohol. Alcohol is a depressant. It also disrupts sleep. Alcohol may help you get to sleep, but overall you will sleep less well, especially in the second half of the night. If you do drink alcohol, limit it to no more than one drink per day if you are a woman of any age or if you are a man older than age 65. Limit it to no more than two drinks a day if you are a man age 65 or younger. Do something you enjoy every day. If needed, put it on your calendar and treat it like other appointments. Schedule something special to look forward to. For example, plan to go to a concert or sporting event. Plan a vacation or weekend away. Stay social. Go out for lunch with friends. Invite someone you want to get to know better out for coffee. Volunteer. Enroll in a class. Go to church. Join an interest group.

Page 3 of 5 Reach out for support. When you feel blue, talk to someone supportive. Everyone needs encouragement at times. Give someone a call or exchange emails. Get enough sleep but not too much. Stay on a regular schedule. Set up a routine so you get seven to eight hours of sleep. Get up at the same time each day even if you have to force yourself. Stay up until bedtime even if you are sleepy earlier. Try not to nap. Stay awake during the day, no matter how tired you may feel. Avoid stimulants after 4 p.m. Coffee, tea, cola drinks, and appetite suppressants all disrupt sleep. Avoid alcohol as bedtime approaches. Remember alcohol can reduce the quality of your sleep. Try to get some sun every day. Open your blinds and curtains. Sit closer to windows. Take a walk outside during your coffee breaks and lunch hour. Outdoor light can help even on cloudy or cold days, especially if you get outside within two hours of getting up in the morning. Talk with your doctor if you think you may have SAD. Treatment options include antidepressant medicines, talk therapy, and light therapy. Each can reduce SAD symptoms when used alone or in combination with the others. A number of antidepressants are available. The first one you try may work well. But tell your doctor if it does not ease your symptoms or causes side effects that bother you. Your doctor can prescribe another until you find one that is right for you. In the most common kind of talk therapy for SAD, you learn to change self-defeating thoughts to ones that are more realistic and hopeful. You also get support for scheduling and doing activities you enjoy. Talk therapy can help you make positive changes in your relationships as well. In light therapy, you sit in front of a special light box, usually for 30 minutes in the morning. The box shines a bright light that mimics sunlight. Studies have shown that light therapy relieves SAD symptoms for as many as 7 out of 10 people after a few weeks. Light therapy may be more effective when used along with antidepressants and/or talk therapy.

Page 4 of 5 Stay under the care of your doctor while using light therapy. Everyone is different. Some people should follow specific instructions or avoid light therapy. Be sure to report any side effects. Keep in mind that depression and the symptoms of the winter blues or SAD have many causes. Talk with your doctor. Discuss treatment options and follow up with your doctor about your progress over time. Take Action My SMART goal for this week Check when completed Do your best to reach the SMART* goal you set with your health coach. Write it here. Check the box when you have completed it. Staying on the path to wellness When you are ready, choose one or two tips above that you would like to put into action. Set a weekly SMART goal for each one. Write your goals here. Check the boxes when you have completed them. SMART Goal 1: SMART Goal 2:

Page 5 of 5 *SMART goals are specific, measurable, appropriate, realistic, and timely. For example, On Monday I will invite a friend to go for a walk together sometime this week. I will also check what movies are playing and schedule a time to go this weekend. SMART goals help you succeed! If you have any trouble setting your weekly SMART goals, ask your health coach for help. The information in this tip sheet is for educational purposes only. It is not intended or implied to be a substitute for professional medical advice. Before making changes, always talk to your doctor about what is right for you. Sources: Seasonal Affective Disorder. Mayo Clinic, Mayo Foundation for Medical Education and Research. Available at http://www.mayoclinic.org/diseases-conditions/seasonal-affectivedisorder/in-depth/seasonal-affective-disorder-treatment/art-20048298?p=1. Accessed on October 21, 2015. Beat the Winter Blues: Shedding Light on Seasonal Sadness. NIH News, National Institutes of Health. Available at https://newsinhealth.nih.gov/issue/jan2013/feature1. Accessed on October 21, 2015. Seasonal Affective Disorder. Medline Plus, National Institutes of Health. Available at https:// www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder.html. Accessed October 21, 2015. Seasonal Affective Disorder. Mayo Clinic. Available at http://www.mayoclinic.org/diseasesconditions/seasonal-affective-disorder/basics/lifestyle-home-remedies/con-20021047. Accessed November 11, 2015. UPMC_17_1169