With the change in seasons now fully upon us, days are getting shorter, and the risk of seasonal affective disorder is turning into very real suffering for literally millions of Americans.  Most of this suffering can be prevented, if people recognize the cause of their symptoms and get help.

Seasonal affective disorder (SAD) most often visits patients during the fall or early winter.  It has also been called “winter depression” or “winter blues,” but its symptoms mimic major depression of any other kind—the distinguishing characteristic in this case being its connection to less sunlight.   Those symptoms can include sadness, tearfulness, decreased concentration, decreased self-esteem, low energy, alterations in sleep patterns and appetite, loss of interest in hobbies and work and, in severe cases, thoughts of suicide.

If you have struggled with repeated bouts of depression in the past, it’s very important to figure out if you can identify this kind of seasonal pattern.  But SAD doesn’t necessarily manifest itself with serious symptoms every year, so all of us need to be alert this year to whether we’re burdened by it.

SAD costs the economy dearly in lost productivity from employees, employers and entrepreneurs fighting its symptoms.  But it will also inflict an additional and very substantial financial burden on the millions of families directly affected, at a time when so many families are struggling already.  That’s one reason why SAD may be a bigger threat this year than the H1N1 flu, even though SAD gets a lot less attention.

SAD responds to the same treatments used to fight non-seasonal depression.  Psychotherapy is tremendously helpful, as is exercise and, when indicated, medication.  Another promising and safe treatment is transcranial magnetic stimulation (rTMS), which involves repeatedly stimulating a particular area of the brain using magnetic waves. 

I have seen many, many of my patients also benefit tremendously from the use of bright light therapy, which involves sitting for a short time each day in front of specially designed portable lights (which are relatively inexpensive and widely available) that replicate sunlight (without exposing the user to any damaging “tanning” light).   One of these devices is called the goLite, but just Googling “bright light therapy for depression” will bring up lots of choices.  If fall and winter and “down” times for you, then get one of these lights and use it.  It could change your life—for about $150.

It’s time we took SAD very seriously, given the fact that it causes so much damage to so many lives and is so responsive to treatment.  It’s the psychiatric epidemic that comes every year—and one we already know how to defeat.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

The key to balancing school and social life seems to be the Holy Grail of parenthood. Parents often cite a conflict between each. Put your child in too many activities, and see a decline in academic performance. Focus solely on academics, and you sacrifice a well-rounded child. With colleges looking at factors beyond a solid grade point average, parents have been working to support a child with a strong academic background as well as other skills and talents. Balancing school and a social life is one key to supporting such a child without having to forgo one for the other.

Sleep!
This is easier said than done. Keep in mind that you and your child can only accomplish so much in one day. Be proud of all that you did in a day and get your family to bed at an early time. You know how much sleep your child needs to operate at his best. Also remember that the more tired your child is, the harder it is for him to concentrate. Assignments will take longer to complete the later he stays up. It may be to his benefit to go to bed at his normal time and get up a few minutes early to complete his assignment. A good night’s sleep should never be sacrificed.

Stick to the routine…then change it
Many families establish routines in the beginning of the school year with the good intentions of maintaining them through June. The key to establishing successful routines is to recognize when your families’ needs have changed and when the routine needs to change. Stop banging your head against the wall if the schedule is not working. For example, Dad may have helped with homework but now is going to run the carpool to soccer because he gets home later from work. Changing your routine doesn’t mean you have failed- it means you are in tune with how best to manage your family. Make sure that you have a family meeting to notify everyone of the changes and to troubleshoot any possible conflicts. Also, be sure not to change routines too often. Your children will get confused with frequent changes, which defeats the purpose of having a routine.

First work, then play
Staying on top of long term projects and upcoming tests will help you and your child structure his time. Getting work done early allows free time at the end of the week. Sometimes doing work at the last minute makes us feel busier than we actually are. Working on a long-term assignment for even 10 minutes a day is better than leaving it until Sunday, when you should be spending quality time with your family. Set a goal for your child in regards to homework and studying. Tell him if he finished a certain percentage or piece of his assignment he can have a playdate or sleepover on the weekend. Help him make the correlation between “First work, then play.” This will benefit him now as a student and later as an adult.

Schedule unscheduled time!
Set aside time where you have absolutely nothing scheduled! This doesn’t mean you have to stay home. It could mean that you wake up every Sunday morning and see what your family is in the mood to do that day. Leaving free time is so important for your family- emotionally and physically. Children have lots of energy and you may worry about hearing “I’m bored” but everyone needs some time to just relax. This is very important as your child becomes more involved in extra-curricular activities and sports.

You may set boundaries for your family but other parents can ambush your plans. Most parents have been caught off guard when a child’s friend asks for a sleepover. Your child inevitably begs and pleads and promises to get up on time for softball practice the next day. Sometimes being proactive and setting an example will let people know what you are comfortable with. For example, if your child asks for a friend to come over for a playdate, approach the parent alone. Say “Kate is going to ask Danielle if she wants to come over tomorrow. I wanted to give you a heads up- I know I don’t like surprises!” If you are comfortable speaking directly to the parent, let them know that you would appreciate a call ahead of time so that you can check your schedule and work something out. It is also perfectly acceptable for your child to hear “No” sometimes so if you feel a sleepover will wreak havoc on your weekend plans, be confident in scheduling it for another time. Be prepared for the whining and protesting that may ensue and stick to your decision!

Don’t feel bad about saying “Next time” to friends and family. You know when your family has reached its max and absolutely cannot survive another birthday party, movie night, or barbeque.

Pay attention to your child’s signs of stress. Some children become withdrawn while others become irritable. Make sure you keep an eye for your child’s signs and act accordingly. You may need to cancel an event or just schedule a fun activity to balance out others. The key to balancing school and social life is being flexible and always keeping your child’s physical and emotional health as the top proiority.

Jennifer Cerbasi teaches at a public school for children on the autism spectrum in New Jersey. As a coordinator of Applied Behavioral Analysis programs in the home, she works with parents to create and implement behavioral plans for their children in an environment that fosters both academic and social growth. In addition to her work both in the classroom and at home, she is also a member of the National Association of Special Education Teachers and the Association for Supervision and Curriculum Development.

For many parents across the country, this fall will be their first time sending a child to school. Early childhood education has evolved, and educators and researchers are looking at this first introduction to formalized education as a crucial time for students.

There is more direct instruction in math, reading and writing, with schools utilizing a detailed curriculum to address skills. Story time now accompanies formal reading instruction. In some schools, play time may now even accompany formal social skills lessons. Although September seems far away, now is the time to start preparing your child for his or her first school experience.

Here are some simple and fun ways to get your child ready for preschool and kindergarten:

Preschool

Reading
Read to your child every day. Exposing your child to a variety of age-appropriate books will foster a natural love of reading and curiosity about words. Don’t worry about teaching phonics or decoding skills — the ABC song will suffice for now. Children will often ask what a word or sentence says. Feel free to tell him, but do not press him to repeat or try to sound out words. Keep in mind that at this age your child should have a natural excitement about words and should not feel he is being “tested’ when enjoying a good book!  

Teach your child to recognize her name. You can make a special sign for her bedroom door or write her name in the cover of her books. Learning names and common words (such as store names) is a first step in recognizing and pronouncing letters and sounds.

Math
Count objects while playing with your child. Use his blocks, books, or other toys and model one-to-one correspondence. Counting “one, two, three blocks!” naturally introduces this important math skill to your child.

Expose your child to basic shapes. When reading or watching a TV show, point out circles, squares, or triangles. Many TV shows targeting the preschool-age child highlight these shapes as well as rectangles, hearts, and diamonds. It is very easy to find these shapes in the environment and you can create a scavenger hunt with your child to locate these common shapes in the environment.

Social Skills
Schedule play dates or spend time playing at the park. Sharing, turn-taking, and waiting are all skills your child will need to enjoy a positive social experience in preschool and may be practiced when engaging with peers.

Develop a daily schedule and stick with it. Keep in mind your soon-to-be preschooler likely needs 10-12 hours of sleep a night, so get him to bed on time at night. Wake him in the morning, have breakfast, and get dressed even if you are not planning to leave the house right away. These morning activities are clear ways to signify the start of the day for your child.

Check with your child’s preschool in regards to its rules on potty training Many schools require children to be potty-trained before starting in September. If your child is not yet fully trained, you have plenty of time this summer to work on it!

Kindergarten

Reading
Help your child practice writing his name, especially if he has shown an interest in it. Have him write the first letter then you can write the other letters. You can also write his name first then have him trace it. Keep in mind constant practice or repetitions may discourage your child and frustrate him, ultimately delaying his acquisition of this skill. Make it fun and only practice if your child shows interest.

Point out words that start with the letter of her first name. Although she may not be aware of it, she knows the sound that letter makes and it will be easier for her to associate items with a sound she already knows. Say “Grace, do you want grapes for snack? Grapes sounds like Grace!” See if your child can think of another word that starts with the same sound. If she has trouble, provide an example so she does not get discouraged and the game continues to be fun!

Math
Ask your child to retrieve various quantities of items for you. Have him help you set the table for dinner and ask “Please get four napkins.” This is a fun and easy way to practice counting, a skill that will be targeted throughout Kindergarten.

Model sorting items for your child then ask her to practice. While playing, say “I’m putting all the cows over here and the pigs over here.” Then ask your child to put all the chickens together, and so on. Grouping or sorting is an important pre-math skill for your child to attain.

Social Skills
Maintain a schedule. If your child just finished preschool, he is likely used to a routine that involves getting up in the morning and getting ready for school. Maintain a similar schedule this summer so back-to-school time doesn’t involve early morning chaos!

Give your child orally-presented directions. For example, tell your child “Get the blue block and give it to Daddy.” Having your child follow one and two step directions prepares her to process language as well as comply with known instructions, skills necessary for kindergarten.

When playing with peers or siblings, ensure your child is taking turns with toys and games. Your child could be in a class of 20 children come September and will have to take turns with materials and toys every day. Preparing him to wait will make it easier for him in his class in the fall.

The most important thing you can do to prepare your child for school is to make learning a fun and natural family activity. Drills and repetitious practice of skills at this age may develop stress and fear of school in your child. Introducing simple math, reading, and social skills to your child will get him started on the path to success!

Jennifer Cerbasi teaches at a public school for children on the autism spectrum in New Jersey. As a coordinator of Applied Behavioral Analysis programs in the home, she works with parents to create and implement behavioral plans for their children in an environment that fosters both academic and social growth. In addition to her work both in the classroom and at home, she is also a member of the National Association of Special Education Teachers and the Association for Supervision and Curriculum Development.

Having the occasional late-night snack won’t pack on the pounds, but according to many studies, if nighttime noshing becomes a habit, it might. Yet, when the clock strikes twelve and you’re still wide awake, it’s often unfeasible to resist raiding your kitchen from top to bottom. Although a box of donuts or a pint of ice cream might seem like your only hope to get you through the night, don’t succumb!

Foods high in sugar can prevent you from getting a good night’s sleep because they can wreak havoc on your blood sugar levels and your waistline. Foods which release serotonin in the brain through an amino acid known as tryptophan are associated with a calming, anxiety-reducing effect and even drowsiness, helping you to fall asleep.  Simply put, serotonin helps to alleviate stress, sending you off to a peaceful night’s sleep. Replacing those sugar-laden snacks with healthy alternatives will allow you to drift off to dream land guilt free.

The Fix:
Whole grains are a low-fat way to trigger some insulin production which will induce sleep without weight gain. Dairy products and lean protein contain the magic tryptophan, an amino acid that also helps the brain produce serotonin and melatonin.

The Food:
2 whole-grain crackers with low-fat cheese
½ whole-wheat pita with 2 slices of lean turkey breast
1 packet instant oatmeal or ½ cup high-fiber cereal with ½ cup warm skim milk

The Fix:
These nutty snacks are full of magnesium and B vitamins, both of which help promote serotonin — the relaxing neurotransmitter. Natural sugars in apricots boost blood-glucose levels, which sag while you sleep. The most “serotonized” fruit is the banana. Bananas are high in vitamin B6, melatonin and serotonin which help us feel drowsy.

The Food:
1 oz of pistachios and 8 dried apricots
1 oz almonds and an apple
½ Banana with 1 tablespoon of peanut butter

*Chamomile Tea: Okay, so this isn’t a snack. Chamomile has a mild sedative effect and is well known among the sleeping problems crowd. The oatmeal cookie triggers insulin but has some other good side effects.

Tanya Zuckerbrot, MS, RD is a nutritionist and founder of Skinnyandthecity.com.    She is also the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.

Dear Yvonne,
I am a 50-year-old-man who has lost all interest in — and avoided — sex with my partner since she has gained weight. Watching her gobble a double pie a la mode for a nighttime snack was like an anti-Viagra for me. When I met her 3 years ago, she was perhaps 30 pounds thinner. I noticed an older photo of her and she appeared to be perhaps 50 pounds heavier. Do women lose weight to meet a man and seek commitment as if crossing a finish line to find the food again?
—JK 

Dear JK,
Both men and women often seek to be physically fit in order to attract a potential partner. Many do “let themselves go” once they have the commitment since they feel that the woo’ing phase of the relationship no longer requires work. However, it’s hard to say, if your partner intentionally lost weight to “nab” you, and then didn’t have a care in the world when she put the weight back on.

The reasons why people put on weight are very complicated and numerous. Factors that lead to weight gain include:

          o Diets high in calories (sodas), saturated fat (fried foods), and/or sugar (candy)
          o A lack of exercise
          o Not getting enough sleep
          o Stress
          o Health problems, for example, hypothyroidism
          o Medications
          o Menopause

In order to reclaim your sex life, try to spend quality time with your lover in ways that keep both of you active and eating healthy meals. Instead of being critical, try to be compassionate by expressing concern for her health, and offer to be of assistance in any way possible. Feeling sorry for yourself won’t do you or her any good.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

Today I want to comment on a news piece from the New York Post about Dr. Malcolm Lloyd, a physician who seems to be recommending daily alcohol consumption as a preventative for a variety of ailments from the common cold to Alzheimer’s and certain cancers. He also seems to be indicating that people who drink regularly in moderation seem to live longer than those who don’t. Give me a break!

I know that there have been numerous publications exploring the correlation between alcohol consumption and heart health. For example, we all know that a chemical compound found in wine called resvesterol, is a potent antioxidant that has been shown to complement the stability of a healthy heart.

However, there have been many other studies that have clearly demonstrated increased cancer rates ― especially breast cancer ― in women who consume moderate amounts of alcohol.

Now trust me, I am not, by a long shot, a person who doesn’t enjoy a good drink once in a while. And I do acknowledge that there are cultures in various parts of the world where alcohol is an integral part of the local cuisine. However, these are also the cultures where healthy servings of vital nutrients, vegetables and proteins play a key role in their daily eating habits. They tend to be more physically active, and place a lot of importance on maintaining healthy sleep patterns.

But here in the U.S., we are a “fast-food nation.” For the last 3-5 years, we’ve been hearing about how the obesity rate has reached epidemic proportions – affecting both adults and our children.

Obesity significantly raises the risk for many diseases and conditions like:
          o          Coronary heart disease

          o          Type 2 diabetes

          o          Cancers (endometrial, breast, and colon)

          o          Hypertension (high blood pressure)

          o          Dyslipidemia (high total cholesterol or high levels of triglycerides)

          o          Stroke

          o          Liver and Gallbladder disease

          o          Sleep apnea and respiratory problems

          o          Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)

          o          Gynecological problems

 
Americans also deal with high rates of depression — another disease that when coupled with the effects of alcohol can have disastrous results.

We also have to remember that alcohol has addictive properties that for some folks can completely ruin the chances of future health and longevity.

I know that everyone is looking for an excuse to justify their daily cocktail, but I find it irresponsible for one physician to give us a free pass to drink myself to “an everlasting life.”

Dr. Bassett

Allergy season in many areas of the US has had a big impact on all of allergy sufferers, particularly on children.  As children often spend a larger amount of time outdoors during the summertime they may be more so affected by the onslaught of daytime seasonal pollens and mold spores.  

 If one parent has allergies there is at least a 25 to 33 percent chance of the child developing allergies and the risk goes up over 50 to 75 percent if both parents are allergic sufferers.  So family history is a key factor in whether or not your children will develop seasonal allergies, indoor allergies and/or asthma.

 Recent studies have looked at impaired sleep as a result of poor breathing due to congested nasal and sinus passages during the night.  This may have a direct impact on daytime behavior and performance in the classroom.  Fatigue and daytime drowsiness may also be a sign of sleep disturbances that occur due to poorly controlled allergies.

Some suggestions I typically discuss with the parents of children suffering from seasonal allergies are:

  * Change clothes after spending time in the park where pollens are plentiful

  * Washing hair and taking a bath later in the day after being outside on a “high pollen day

  * Pre-treat to prevent daily symptoms during peak seasonal pollen periods

  * Vacation at peak allergy times by a body of water such as a lake, river or by the beach, where pollen levels are typically lower

* Ask your pediatrician or allergist if your child should be on “anti-inflammatory” nasal sprays to reduce congestion from seasonal allergies that may assist in better quality sleep at night

Be proactive and develop a sensible allergy management program for your child to successfully combat seasonal allergy triggers!  Learn more at www.acaai.org and www.aaaai.org.

 Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended to diagnose or treat any condition.

With as many as 70 million Americans suffering from insomnia, according to a 2007 report by the Institute of Medicine, the need for ZZZs has led to a booming market for a new class of non-narcotic sleep drugs, like Ambien, Lunesta and Sonata.

Americans spent almost $1.8 billion filling more than 16 million prescriptions for Ambien and Ambien CR last year, and almost $713 million on over 6 million prescriptions of Lunesta, according to Drug Topics digital magazine.

The new sleep aids fall into two classes — selective gamma-aminobutyric acid medications and sleep-wake cycle modifiers — and they have been billed as safer than the older class of sleep drugs, known as benzodiazepine drugs. The older drugs, which include Halcion, have been shown to be both habit-forming and addictive.

Still, the new drugs carry side effects that users should be aware of.

Addiction, sleep driving, sleep eating, and sleep sex are a few of the serious side effects reported by some patients who take the new medications.

But many doctors believe the most harmful aspect of these newer drugs is a potential overdose. Mixing them with other substances or taking doses exceeding a physician’s recommendation can result in over-sedation and death.

A three-year-old Rhett Lamb boy has fallen asleep for the first time in his life.  This after, doctors performed an experimental surgery to fix his rare brain condition called chiari malformation.

The condition puts pressure on his brain stem.  The surgery allowed doctors to remove pieces of bone from the Florida boy’s skull and spine to relieve the pressure off his brain stem.

The surgery appeared to have worked, Rhett’s father, David said Thursday.

“Last night, we didn’t wake up,” David Lamb said. “It was amazing.”

Working long hours or worried about losing your job? No problem.

Stressed about the conflicts between your boss and co-workers? That’s more likely to make adults lose sleep, according to a study.

Even those working the graveyard shift are sleeping better than those who are stressing over interpersonal relationships at work, the study said.

What do you think?