Summertime Blues: A Seasonal Depression

It is July and we are in the thick of summer. Excessive heat and the rainy season are upon us. Besides staying dry, it is important to remember to keep oneself hydrated during these days of high temperatures. The summer is a time to get away from the seemingly constant demands placed upon us throughout the year. As things slow down. it is important to take the time to relax, vacation, and recharge for the fall. Soon children will be going back to school, the pace of work will increase, and the fall will be here. Don’t let the summer days and the time to vacation slip by.

In this July E-letter, we provide information about Summertime Blues, our Ask the Doc question is about motivating children, and our email of the month is about Retirement and 10 things to keep in mind. We hope you find the enclosed information helpful. As always, we appreciate your questions and feedback.

Testings. If you are concerned about your child’s school placement for the next school year, this would be a good time to have them evaluated. Recent questions from parents have ranged from should their child be retained to whether they are gifted to whether they have a disability that can qualify for accommodations at school. Our practice does different types of evaluations to help answer those questions and information about these evaluations can be found on our website. If you have more specific questions, please contact Dr. Kimmel who would be happy to answer them.

Research Study. We are pleased to announce that we will be participating in a four month research study with Life Extension Institute assessing the effects of cognitive therapy, nutritional supplements, and medications on weight management in overweight individuals. Dr. Kimmel and Denise Champagne will be conducting cognitive therapy groups for a sample of 40 subjects who will be followed by three physicians. For more information, contact our administrative assistant, Jillian, at 954 755-2885.

Parent Education and Family Stabilization Course. For several months now, we have been offering the Parent Education and Family Stabilization Course. Sometimes referred to as the Divorce Class, it is required by the State of Florida for all parents divorcing or separating even if not legally married. We have provided this course many times and have designed it as a 4-hour, one-session presentation that focuses on ensuring that parents protect their children from the effects of divorce or separation by setting aside their differences and focusing on the children’s need for both parents in their lives. The course also provides information about divorce as loss, gives an overview of the Florida laws and statutes related to divorce and custody issues, and offers information on how children react to divorce based on their ages.  The course is offered live on a flexible schedule, based on the availability of those attending the course.  Please contact our Administrative Assistant, Jillian, at 954 755-2885 for additional information.

Low Cost Counseling. Denise Champagne, M.S., is offering low cost counseling as a mental health intern. She is currently seeing patients and is available to take on new patients. This allows those individuals who cannot afford treatment to obtain it and allows her to complete the required number of additional clinical hours for full licensure. If you or someone you know is in need of counseling but just cannot afford it, please call the office and ask for Denise. All treatment provided by Denise will be reviewed and supervised by Dr. Kimmel.

Qualified Supervisor. Dr. Joel Kimmel has been certified by the State of Florida to supervise mental health counselors seeking supervision to meet the licensing requirements. If you or anyone you know needs a qualified supervisor to meet these requirements, contact Dr. Kimmel for further information.

Our E-Letter this month focuses on Summertime Blues which is depression that comes on in the spring, lasts through the summer, and leaves in the winter. Referred to as Summer Seasonal Affective Disorder (SAD) or Reverse SAD, Summertime Blues affects less than one percent of the U.S. population, about 2/3 of who are women. It is more prevalent in the South and its incidence decreases as the latitude diminishes. Symptoms of Summer SAD include feelings of hopelessness, anxiety, irritability, loss of interest in activities, joylessness, insomnia, decreased appetite and weight loss. People with Summer SAD have great difficulty coping with heat and the sun. Many people isolate by staying in air-conditioned homes refusing to go outside.

The causes of Summertime Blues are unclear but it is thought that circadian rhythms, the body’s clock, may misalign due to increased sunlight and temperature. In addition, changes in serotonin and melatonin levels can contribute to summer depression. Additional factors that may contribute include:

• Disrupted regular schedules leading to increased anxiety. Routines are varied with additional demands of occupying children who are out of school. Sleep and eating habits are also changed due to different schedules.
• Body image issues. The heat causes people to wear less clothes and consequently show more of their bodies. More time is also spent at the beach, pools, or at vacation resorts with bodies becoming more visible and people becoming more anxious. Some people who are very self-conscious will become embarrassed about their looks.
• Financial concerns. Summer activities such as vacations, camp, and babysitters can be costly and increase financial anxiety.
• Isolation due to the inability to tolerate heat. People tend to stay indoors and exercise, socializing, and eating suffer.

Since Summertime Blues is a seasonal depression, traditional treatments include taking antidepressant medications and melatonin. Cognitive Behavior Therapy can also be quite helpful in eliminating symptoms. Exposing oneself for a few minutes to early morning sunlight has been shown to be quite helpful. Other activities to keep in mind include not isolating oneself indoors but to socialize with others. Having consistent exercise routines and regular eating and sleeping patterns will reduce stress. Meditation, yoga, and other relaxation activities will also reduce stress. Journaling one’s feelings and pursuing new hobbies will alleviate depression. In addition, it is important to stay optimistic and remember that the Fall is only a few months away and that the depression will lift.

We offer the following information on Summertime Blues: A Seasonal Disorder:

• Summertime Blues (SB) occur when spring changes to summer and people tend to feel depressed and irritable
• Summertime Blues has been thought of as reverse SAD (Seasonal Affective Disorder); a condition where people get depressed due to a change in the season, usually winter
• Genetically, more than 2/3 of people with Summertime Blues have a relative with a major mood disorder
• Symptoms of SB include: depression, anxiety, decreased appetite, insomnia, irritability, loss of interest in usual activities, social withdrawal, anhedonia, feelings of hopelessness, difficulty concentrating, and an inability to cope with heat
• SB symptoms tend to let up in the Fall but will return with the onset of Spring
• Common descriptions of people with SB report that they fell like the sun is piercing their skin or that they are attacked by the sun
• Too much or too strong sunlight or high temperatures and humidity are thought to play a major role in summertime depression
• Many people with SB in fact stay inside in air conditioned rooms rather than go outside
• SB affects less than one percent of the population, about 2/3 of which are women, and is more prevalent geographically where temperatures are higher
• Factors thought to cause SB include:
  • changes in a person’s melatonin and serotonin levels and in circadian rhythms, the body’s biological clock, due to increased sunlight
  • disrupted  schedules, especially eating and sleeping, which increases stress
  • wearing less clothes which can increase body image issues and embarrassment
  • activities during the summer such as vacations and camp which can greatly increase feelings of being financially strapped
  • difficulty tolerating the summer heat which may lead to isolation in air conditioned homes, less exercise, and eating poorly
• Traditional treatment includes antidepressant medication often started in the winter
• Another common treatment is taking Melatonin which is a hormone that affects seasonal rhythms in people and helps regulate day and night cycles

• Understand you have SB, don’t beat yourself up, and remember that it is temporary
• Try to expose yourself to early morning sunlight for a few minutes
• Put yourself on a regular schedule so that you have activities for the day and plan fun events to look forward to
• Keep a consistent exercise routine and regular eating and sleeping patterns
• Don’t isolate, push yourself to be around people, and socialize
• Write your feelings in a journal which can be a great antidote for depression
• Pursue new interests or hobbies and volunteer for charitable work
• Practice yoga, meditation, and other relaxation activities
• Seek professional help to decrease and eliminate the symptoms of depression

JW writes: My children have been doing nothing all summer. They say they are bored and spend most of their time on video games and watching television. They do have summer reading but refuse to do it saying they will do it before school starts. They don’t want to go outside because they say it’s too hot. They also say their friends also do nothing and stay at home. I can’t get them motivated to do anything. I‘ve tried punishing them by taking away their phones but nothing changes. What do you think I should do?

Dr. Joel Kimmel replies….What you are describing is a very common problem we hear from parents at this time of the year. They come in to our offices very frustrated with similar sounding complaints. Often, they do what you have done and start by punishing as a way of motivating but usually that doesn’t work.

People are mostly motivated in 2 ways; by fear of punishment and by rewards. We have found through our experience that what often works to motivate children, especially teenagers, is the giving of rewards. But the rewards have to be reasonable and not excessive and tied to the performance of a behavior. Rewards also should be given after the behavior and not before. Remember that children and teenagers are often self-focused so you need to present the request in a way that they see that it benefits them. So I would suggest a rewards approach as follows:

1. Clearly identify what expectations you have for your children over the summer. This would include school requirements, home chores, and social activities.
2. Explain how doing these activities would benefit them including less pressure from you.
3. Remove some of the privileges that they get now for doing nothing. Allowances or spending money can be earned, just not given. Certain privileges such as learning to drive or going shopping can also be earned.
4. Identify the reward for performance of the behavior you want them to do. Make the reward reasonable and something you can actually give. It doesn’t have to be money. It can be a privilege or activity. However, be specific and don’t negotiate. Again, do not give the reward before the behavior. Follow up with a verbal reinforcement such as “that was a good job.”

For example, if you want your child to do his summer reading, you can remove the privileges of going to the mall or watching television. Explain that your children can have these privileges back when they get their reading done and not before. Also, identify how getting this done would benefit them. Specify how much of the reading needs to be done before the reward is given. Upon completion of the task, give the reward with a “good job” comment.  I hope this helps you but you may need to practice these steps until you have success.

We would like to thank Bobby V. for sending us the following email:

Retirement: 10 Tips To Keep In Mind

1. Do not retire. If you’re over-aged, retire and get all the benefits but find another income-generating job or open a business that will keep you active physically and mentally. Travel and bond with true friends, play golf, tennis or any sport, learn a new hobby and volunteer in your community. Solve crossword puzzles, play Bridge, Scrabble, write your memoirs and above all, read …this will keep you alert and keep Alzheimer’s at bay.
2. Live in your own place to enjoy independence, privacy and a solo life. If you move in with your children, your rank or degree of importance is reduced to that of a bed spacer who has no place of honor or, worse, like crumbling furniture merely displayed with no added value.
3. Hold on to your nest egg, bank deposits and assets. If you want to help your children, do give, but not to the extent that you wipe out your life’s earnings. Staying solvent and in the black is a good hedge against all kinds of tempests. You will sleep better, you will not be afraid to express your opinion and you will be confident about yourself.
4. Don’t believe your children’s promise to care for you when you grow old. Priorities change. Many children are not guilt-ridden or filled with a sense of moral obligation when the wife and offspring take top billing in their lives.
5. Expand your circle of friends to include young ones who will definitely outlive your old Best Friends Forever.  Keep up with new inventions, trends, music and lifestyle including all the scams and schemes you should guard against. Remember that when you mix with the young, you also open a fresh avenue to channel your thoughts, experiences and values through so that the lessons you learned are not lost, forgotten or buried with you.
6. Be well groomed and smelling fresh of spring water all the time. There’s nothing more depressing than seeing people exhale when you walk by because you reek of baul (camphor chest) or lupa (dirt). Old age or bust, don’t look and smell like a corpse when you’re not one yet.
7. Do not meddle in the life of your children. If they ask for your counsel, give it, but be ready to accept that they may not take it. Their situations in life cannot be compared to the situations that you experienced in your life. The playing field has changed and they need to develop their own set of survival skills. If you raised them to be street smart, they can handle themselves in tough situations and be able to read people. Champion and encourage their dreams and desires but on their own terms.
8. Do not use old age as your shield and justification for turning grumpy. There’s nothing more annoying than an arrogant, old fool. Welcome each day as another chance to be kind and forgiving, to yourself and to others.
9. Listen to what others may say. Do not throw your weight around just because you are a septuagenarian or a nonagenarian. You are not a depository of knowledge. Even if the roles have been reversed, make growing old a fun-filled, pleasant experience for you and your brood.
10. Pray always and focus on your eternal life. You will definitely leave everything behind, a final journey detached from burden and care. Be more accepting that, sooner, not later, you will croak. Prepare your swan song with a humble and contrite heart.