Winter Health & Wellness 2023

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Health and

Wellness

Pages 8-14

JANUARY 12 - 18, 2023 | PAGE 7

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SAD During the Winter: How Seasonal Depression Affects All Ages

BY KYLEE TOLAND

FALLS CHURCH NEWS-PRESS

When Daylight saving time ends in November and the days seem to become shorter and slower, it also seems to slow down some people’s serotonin levels as well.

For those wondering why they may feel down as fall season comes to a close and winter begins, they may be suffering from Seasonal Affective Disorder (SAD) — also referred to as “seasonal depression.” Common symptoms include feeling sadness most of the days, anxiety, trouble concentrating and more.

For those who have never heard about SAD, it might be hard to differentiate seasonal affective disorder with the more well-known “winter blues.” According to the Cleveland Clinic, about 5 percent of adults in the U.S. experience the disorder, and it tends to start in young adulthood — between the ages 18 and 30 — and affect women more than men, though researchers are still trying to find out why. The “winter blues” affects about 10 percent to 20 percent of Americans and has milder symptoms compared to SAD. Michael Repie, the senior director of clinical services at Dominion Hospital in Falls Church, said SAD is “a form of depression” that can have symptoms that last four to five months or longer. Describing it as having a “recurrent, seasonal pattern,” Repie stated SAD is mostly winter-related, with many common symptoms “not too dissimilar to hibernation in some species.”

“While hibernation is an essential mechanism for animals to conserve energy when sufficient food isn’t readily available,” Repie said, “[SAD] symptoms may match those of Major Depression.

Along with anxiety and depression, Repie said SAD can also cause social withdrawal, oversleeping, overeating and weight gain.

HEALTH BENEFITS OF SUNLIGHT

According to Repie, SAD by itself is “not common,” affecting less than 3 percent of the general population. However, if an individual has pre-existing mental health issues, such as depression, anxiety or substance abuse, then it may place them at greater risk for SAD, with as much as “25 percent prevalence” across some conditions.

As for ways SAD can be treated and handled by the people affected by it, Repie stated mood changes and temporarily “feeling down” can be “normal responses” to stress around the shortest day of the year, “just before Christmas.”

While SAD may be related to the holidays “and all that’s associated,” Repie said things can be “more serious.”

If an individual is down for many days and cannot get motivated to do activities that they normally enjoy, it may be more than the “winter blues.”

“If sleep patterns, or appetite has changed, or if one feels hopeless, thinks about suicide, or uses drugs or alcohol to cope, then it is time to seek support,” Repie said. “Help is available!”

Treatment for SAD can include medications — such as antidepressants —, psychotherapy and, most commonly, light therapy — sometimes called “phototherapy” — that can include light boxes to increase one’s serotonin levels.

As for what people should know about SAD to either help themselves or others, Repie said the Seasonal Pattern Assessment Questionnaire (SPAQ) is a clinical tool that can be used in primary care settings where clients are “accustomed to coming for treatment” and health professionals can help identify those who may be affected.

“It is a free instrument in the public domain and it is a retrospective, self-administered tool for which no training is required” Repie said.

“It may be used as part of a more complete assessment to ascertain if further treatment is required.”

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The 7-Day Happiness Challenge Quiz J����� D��� NEW YORK TIMES

These questions were designed with Dr. Robert Waldinger, a professor of psychiatry at Harvard Medical School, to help you take stock of the range and strength of your social ties.

1. Do you feel satisfied with the number of close friends you have?

A. Yes B. No 2. Are you comfortable striking up casual conversations with people?

A. Yes B. No 3. How many family members do you have close relationships with?

A. None B. One to three C. Four or more 4. How many people could you call in the middle of the night if you needed help?

A. None B. One C. Two or three D. Four or more 5. When was the last time you expressed gratitude to someone important in your life?

A. Can’t remember B. More than a month ago C. Within the past month D. Within the past week

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10. How often do you talk to acquaintances in your neighborhood, on your commute or in your workplace or school?

A. Never B. Rarely C. Sometimes D. Often E. Daily 11. Do you feel satisfied with the connections you have with people at work?

A. No B. Yes 12. When was the last time you initiated a social plan with someone?

A. Can’t remember B. In the past month C. In the past week 13. When was the last time you said “yes” when someone initiated a social plan with you?

A. Can’t remember B. In the past month C. In the past week Points Per Answer A. zero B. one C. two D. three E. four

A. I don’t have a partner B. Almost all of my social activity C. A moderate amount D. Very little to none 9. Picture your closest family member.

By JANCEE

A. No B. Yes, a couple of times a year C. Yes, monthly D. Yes, weekly 7. Think of your closest friend (someone who does not live with you). How many hours did you have contact with each other last month?

A. None B. One hour or less C. Two to four hours D. Five hours or more

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A. No B. Yes

What the Scores Mean 0-12: You are self-sufficient, maybe more than is beneficial for your health and happiness. You have some meaningful social ties, but your score suggests that you may not have many people to turn to for emotional support and a sense of belonging. You may simply be more introverted or have lost touch with some of the people you care about. You may feel intimidated by the idea of making more friends. This challenge will help you begin.

13-21: You have the outline of a healthy social network. You have a number of people in your life who make you feel connected — a good balance of friends and family, close ties and those in your community whose faces you might know, if not their names. You have people who will show up for you and lend a hand if you need it, and you will do the same for them.

22 or more: You are in tiptop social shape.

You thrive being around others and are comfortable in most social environments. You have found community in different realms of your life, whether it’s at work, with old or new friends, or around your neighborhood.

Your strong ties help you cope with life’s ups and downs.

6. Do you participate in any group activities, either in person or virtually?

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If you could never talk to each other again, would that person know how you felt about him or her?

8. Do you have a partner? If so, how much of your social activity includes that person?

DUNN © 2022 The New York Times

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Dry Eyes Afflict Many of Us. Here’s What to Do About It. J��� E. B���� NEW YORK TIMES

I didn’t have to wait until my ninth decade to appreciate how annoying dry eyes can be. And I was flummoxed by the plethora of products on pharmacy shelves that promise relief for a problem that affects about 1 in 5 adults. Perhaps you, like me, are among the many who have tried various over-thecounter remedies that did not help or sometimes made matters worse.

Dry eye problems become increasingly prevalent with age. But since my mid-30s, I have been coping with a mild form of this condition and, despite intermittent visits to health professionals, have gotten only limited relief. With all the “extra” time I had to read for pleasure during the pandemic, the gritty feeling in my chronically dry eyes rendered this diversion anything but pleasant. Other common complaints linked to dry eyes include itching and undue sensitivity to sun and bright lights, all of which I suffer from.

In an online survey published in January, two-thirds of respondents reported having symptoms of dry eye, and of those, more than onequarter said their symptoms were made worse by wearing a face mask.

But Dr. Ira Udell, a professor of ophthalmology at the Zucker School of Medicine at Hofstra/Northwell, said that while masks may indeed cause ocular discomfort, an association between mask-wearing and dry eye per se is unlikely, given that exhaled moisture when wearing a mask fogs glasses and, if anything, the increased humidity would raise moisture levels around the eyes.

A more likely explanation of those findings is an association between dry eyes and pandemicrelated stress. In two studies of veterans, researchers found strong links between dry eye syndrome, post-traumatic stress disorder and depression.

What causes dry eyes?

I have recently learned just how complicated it can be to keep my eyes moist and free of irritating dryness, a need made more challenging by an ever-greater reliance on

screens for work and play. When people stare at computer screens for hours on end, they blink less often, resulting in tired, distressed and dry eyes.

Inadequate lubrication of the ocular surface can also result in blurry vision, a symptom that has repeatedly prompted me to get my vision checked, only to find that my current prescription hasn’t changed even though words on a page are less clear.

Although dry eye problems are most common in people older than 50, they are also increasing among young adults, which experts attribute to the ubiquity of smartphones and computers. Younger people are also more likely to wear contact lenses, the prolonged wearing of which may also cause dry eyes.

Dry eye is a hallmark symptom of Sjögren’s syndrome and other autoimmune disorders that impair the body’s lubricating tissues. Dry eye also commonly occurs temporarily following cataract surgery; Lasik eye surgery, which reshapes the cornea to improve vision; and blepharoplasty, an operation to correct drooping eyelids.

Some people develop chronically dry eyes because their lids don’t close completely during sleep. If you suspect this may be your problem and you live alone, you might invite a visitor to check your eyes when you are asleep, Udell suggested. A cell phone photo would be useful to show to your doctor.

How does the eye stay lubricated?

Think of the tear film that coats and lubricates the eye as a threelayer sandwich, with each layer produced by different glands. The meibomian glands in the upper and lower eyelids create an oily outer layer that stabilizes the film. If the film breaks up too quickly, blurry vision is the likely result. Next are two sets of lacrimal glands that supply the watery tears. Innermost is the mucin layer that attracts water and helps to spread the tear film over the surface of the cornea. Even if the tear supply is adequate, a mucin deficiency can impede wetting of the cornea and damage its surface.

Both the meibomian and lacrimal glands have receptors for

the sex hormones, androgen and estrogen, and a decrease in hormone levels likely explains why dry eye problems increase in women at menopause and in men who are treated with anti-androgen therapy for prostate cancer. Indeed, the most common cause of dry eye is evaporation of moisture from the eyes from dysfunction of the meibomian glands that results in instability of the tear film.

Sometimes the attempted solution, like using multiple-use eye drops that contain preservatives, can actually make eye irritation worse.

I ended up with chronically red eyes after using such drops, and the problem soon resolved when I switched to single-use lubricants that were preservative-free. While single-dose eye drops are only approved for a one-time use, Udell said that it’s usually safe to use them for up to two days if you want to cut down on cost and waste, as long as the tip isn’t touched and is covered after each use.

Medications that treat other conditions can interfere with adequate

Continued on Page 14

PAGE 12 | JANUARY 12 - 18, 2023

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As COVID-19 Continues to Spread, So Does Misinformation About It T������ H�� NEW YORK TIMES

Nearly three years into the pandemic, Covid-19 remains stubbornly persistent. So, too, does misinformation about the virus.

As Covid cases, hospitalizations and deaths rise in parts of the country, myths and misleading narratives continue to evolve and spread, exasperating overburdened doctors and evading content moderators.

What began in 2020 as rumors that cast doubt on the existence or seriousness of COVID quickly evolved into often outlandish claims about dangerous technology lurking in masks and the supposed miracle cures from unproven drugs, like ivermectin. 2020’s vaccine rollout fueled another wave of unfounded alarm. Now, in addition to all the claims still being bandied about, there are conspiracy theories about the long-term effects of the treatments, researchers say.

The ideas still thrive on social media platforms, and the constant barrage, now a years long accumulation, has made it increasingly difficult for accurate advice to break through, misinformation researchers say.

That leaves people already suffering from pandemic fatigue to become further injured to Covid’s continuing dangers and susceptible to other harmful medical content.

“It’s easy to forget that health misinformation, including about Covid, can still contribute to people not getting vaccinated or creating stigmas,” said Megan Marrelli, editorial director of Meedan, a nonprofit focused on digital literacy and information access. “We know for a fact that health misinformation contributes to the spread of real-world disease.”

Twitter is of particular concern for researchers. The company recently gutted the teams responsible for keeping dangerous or inaccurate material in check on the platform, stopped enforcing its Covid misinfor-

mation policy and began basing some content moderation decisions on public polls posted by its new owner and chief executive, billionaire Elon Musk.

From Nov. 1 to Dec. 5, Australian researchers collected more than half a million conspiratorial and misleading English-language tweets about Covid, using terms such as “deep state,” “hoax” and “bioweapon.” The tweets drew more than 1.6 million likes and 580,000 retweets.

The researchers said the volume of toxic material surged in late November with the release of a film that included baseless claims that Covid vaccines set off “the greatest orchestrated die-off in the history of the world.”

Naomi Smith, a sociologist at Federation University Australia who helped conduct the research with Timothy Graham, a digital media expert at Queensland University of Technology, said Twitter’s misinformation policies helped tamp down antivaccination content that had

been common on the platform in 2015 and 2016. From January 2020 to September 2022, Twitter suspended more than 11,000 accounts over violations of its Covid misinformation policy.

Now, Smith said, the protective barriers are “falling over in real time, which is both interesting as an academic and absolutely terrifying.”

“Pre-Covid, people who believed in medical misinformation were generally just talking to each other, contained within their own little bubble, and you had to go and do a bit of work to find that bubble,” she said. “But now, you don’t have to do any work to find that information — it is presented in your feed with any other types of information.”

Several prominent Twitter accounts that had been suspended for spreading unfounded claims about Covid were reinstated in recent weeks, including those of Rep. Marjorie Taylor Greene, R-Ga., and Robert Malone, a vaccine skeptic.

Musk himself has used

Twitter to weigh in on the pandemic, predicting in March 2020 that the United States was likely to have “close to zero new cases” by the end of that April. (More than 100,000 positive tests were reported to the Centers for Disease Control and Prevention in the last week of the month.) In December, he took aim at Dr. Anthony Fauci, who stepped down Saturday as President Joe Biden’s top medical adviser and the longtime director of the National Institute of Allergy and Infectious Diseases. Musk said Fauci should be prosecuted.

Twitter did not respond to a request for comment. Other major social platforms, including TikTok and YouTube, said in recent weeks that they remained committed to combating Covid misinformation.

YouTube prohibits content — including videos, comments and links — about vaccines and Covid-19 that contradicts recommendations from

Continued on Page 30

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JANUARY 12 - 18, 2023 | PAGE 13

LGBTQ+ Health: New Year, New You

by Brian Reach

Falls Church News-Press

The New Year often comes paired with myriad resolutions to improve ourselves: quitting smoking, losing a few pounds, learning a language, etc. Whether one believes in resolutions or not, a new year typically brings with it feelings of a fresh start, and is often a time of self-reflection and self-improvement.

For LGBTQ+ individuals, navigating the health care system in search of competent care can be daunting. “We want to see everyone in our community taking care of their physical and mental health.” says Dr. Jorge Ramallo, lead physician at the Inova Pride Clinic, “That means seeing providers you trust, taking advantage of prevention resources like PrEP to prevent illness, and getting tested for HIV, STDs, and other health conditions.” The Inova Pride Clinic opened in June 2022 on N. Washington St. in Falls Church and serves patients age 12 and over.

NovaSalud (2946 Sleepy Hollow Rd., Falls Church) is an organization that provides free, confidential, and rapid HIV testing, sexually transmitted infection (STI) testing, prevention and education services, and free condoms, with a particular focus on Latinx men and trans women. Ignacio Aguirre, Senior Manager of Prevention Programs at NovaSalud, says the most important thing LGBTQ+ folks can do to be healthy in 2023 is to “have safe sex — including taking PrEP.” Pre-Exposure Prophylaxis, or PrEP, is a once-daily pill that prevents HIV transmission by up to 99 percent when taken regularly. There are two primary versions of PrEP; Truvada and Descovy, both of which are manufactured by Gilead. Though not typically covered by insurance and extremely expensive (a one-month supply can cost over $1,000, even with health insurance),

Pre-Exposure Prophylaxis, PrEP, a once-daily pill, is up to 99 percent effective in protecting individuals from contracting HIV

a co-pay card making either medication entirely free is offered by Gilead online at gileadadvancingaccess.com.

While sexual health is often the primary focus when discussing LGBTQ+ health, Aguirre stressed the need to be proactive about one’s overall health, get insurance, find a primary care doctor, and ask questions. “Ask about your overall health” Aguirre said, “from digestive system to heart and lung function to testing for chronic disease,” When it comes to requesting STI testing, it is important that patients be assertive, and request the tests they need.

“Some STIs present no symptoms, but can be affecting our system without [us] even knowing it.” mentioned Aguirre. When it comes to getting tested, “swab what you use,” because a blood test won’t provide comprehensive screening for many STIs, so be persistent, specific, and detailed.

When discussing one’s health with a provider, modesty can be dangerous.

Asked about the monkeypox (MPX) vaccine, Aguirre advised people to take advantage even with the urgency having subsided. “We should sheild our immune system against anything that might cause deterioration of our health.”

NovaSalud provides MPX vaccine clinics the second Thursday of every month.

For trans individuals, both Inova Pride Clinic and NovaSalud offer a variety of care. “Gender-affirming care is also a key part of LGBTQ+ health care for gender-diverse patients.” said Ramallo, “The Pride Clinic is able to provide comprehensive gender evaluations and treatment tailored to each patient’s needs.”

NovaSalud also provides a number of mental health support services to Northern Virginia’s LGBTQ+ community.

The organization’s RISE retreat helps queer men of color explore their experiences of homophobia, distrimination, and overcome the impact those experiences can have on their utilization of health care resources. TSISTA is their life skills group for Latinx transgender women based on gender- and culturallyrelevant discussions aimed at reducing risky sexual behavior, increasing condom use, and other training. CLEAR is their program offering one-on-one, evidence-based counseling for adults living with HIV/AIDS. Readers are encouraged to visit NovaSaludInc.org, Inova.org/PrideClinic, or schedule an appointment with their primary care provider to discuss their 2023 wellness goals.

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Dry Eyes Can Be Caused by Environmental Conditions and More Continued from Page 11

tear production. Common culprits include antihistamines, beta blockers, oral contraceptives, diuretics and drugs used to treat Parkinson’s disease, anxiety disorders, asthma, chronic obstructive pulmonary disease (COPD) and abnormal heart rhythms.

What can you do to relieve dry eyes?

Environmental conditions that can exacerbate dry eye problems include smoky or excessively dry air, which can result from indoor heating and air conditioning. Long before the pandemic, I began wearing eyeglasses when outdoors, especially on windy days and always when riding my bicycle, to protect my eyes from dryness and grit. A variety of glasses are available to block out wind, glare and airborne irritants.

If you swim, be sure to wear goggles to prevent salty or chemically treated water from irritating your eyes.

Another practical measure that Udell emphasized is applying warm compresses to the eyelids

morning and night to assist meibomian gland function. I gently wash my eyelids from the nose outward with a warm washcloth every night. Repeat the washcloth cleanse if you wake up in the morning with “sleep in your eyes,” then apply artificial tears.

Use of artificial tears several times a day is essential for most cases of dry eye. Although no product precisely mimics the composition of natural tears, many are helpful if used regularly, Udell said. He suggested trying various products one at a time to find one that is most effective for you. You could start with a low-cost generic product and, if that doesn’t help, try the brand name version, he said.

However, if over-the-counter remedies and the practical measures described above fail to bring adequate relief, consult an eye specialist. There are prescription products and special glasses that create a high-humidity moisture chamber around the eyes, among other remedies, for severe cases of dry eye.

By J ane E. B rody © 2022 The New York Times