Be Well with Crossover Health

Shining a Light on Seasonal Depression (with Dr. Nicole Thalheimer)

• Crossover Health • Season 1 • Episode 23

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As the temperature drops and the daylight hours shorten, it’s common to feel the emotional effects of the dark days of winter. Seasonal Affective Disorder ( SAD) is more than just “winter blues.” Dr. Nicole Thalheimer, Crossover Clinical Psychologist, joins the podcast to discuss how SAD is diagnosed and how she has helped many cope with the disorder.  Listen in to learn how the sun and the weather impacts how we function on a daily basis. She has the expertise and a tool kit for her patients to feel better.

Stick to the end to hear Nikki’s favorite podcasts (when she’s not listening to Be Well), her favorite guilty pleasure (plus, a plea to Ben and Jerry’s), and her (furry) healthy habit.

Connect with us!

Nicole Thalheimer:

We actually are very much so impacted by the sun and weather and that can actually impact our ability to function.

Crossover Health:

happiness, success, freedom, energy, fun, balance, strength, peace. It all stems from our physical and emotional wellbeing. You're in the right place for a healthy discussion with experts to show you the way. This is be well, a podcast from crossover health. Not sick is not enough. Being Well is a movement to get the most we want out of life. In each of our episodes, we pick a health or lifestyle topic, bring in one of our doctors from the frontlines and have a real conversation. Be well do good. Enjoy life. What's up everyone? This is Dan Lord, Program Director for crossover health. You're in the right place for a healthy discussion. Just a reminder, the following presentation is for informational purposes only and is not intended or implied to be a substitute for professional medical advice. Please do not apply any of this information without first speaking with your doctor. Today, our guest is Dr. Nicole fell Heimer. She is a licensed clinical psychologist working on the crossover virtual care team, a generalist by training Nikki specialty research and lifelong passion center around sexuality, gender diversity and sexual orientation all over the country. And for the past decade, Nikki has been working with individuals, couples and families across a variety of settings, including community mental health and college counseling. Most recently, she worked as a gender specialist supporting trans and non binary folks in a large private practice in the Chicagoland area. Nikki, welcome to the show, please tell us a little bit about your practice that crossover.

Nicole Thalheimer:

Thank you so much. I appreciate being Welcome to the show. It's an honor to be here. And I love crossover. My practice at crossover is quite diverse, working with folks from all over presenting with concerns around depression, anxiety, and I'm also one of the gender specialists on staff. So when we have trans or non binary folks who are looking for support in different ways, I am one of the staff members who will help support them in that journey in that process.

Crossover Health:

Perfect, perfect. Thank you what we were just chatting about before we went on, is it's a thing. It's a real, it's a real diagnoseable issue. It has a real name seasonal affective disorder. Let's start there.

Nicole Thalheimer:

Yeah, you're completely correct. It is a thing. And I think that folks who may feel, you know, more down in winter months, might not realize that there's biochemical things happening that are contributing to that. So you know, seasonal affective disorder has some similarities to things like depression, right? I like to call it the depressive umbrella. And this kind of falls underneath that. So you can have some similar symptoms, which can be lack of motivation, fatigue, irritability, not enjoying previously enjoyed activities, excessive guilt, which are all depressive symptoms. Right. Right. But they look a little different, because they come on more seasonally.

Crossover Health:

That makes sense. Now, do you see a big difference depending on where you live? Because obviously, seasons happen more in the Northeast or in the Midwest versus the West Coast? Is that follow the same kind of prevalence see there?

Nicole Thalheimer:

It's a great question. So you do tend to see it more in places that are more northern kind of latitudes. So you do have, as you said, the Midwest, the northeast, you know, Scandinavian countries be going up to like Alaska, where you literally may not see the sun, you oftentimes will see more prevalence rates up in those regions, but there can still be impact in Southern California, it might be a little more nuanced. It might not be quite so intense, but we do and are impacted by the sun and weather. And that has a you know, an impact on our mood for sure.

Crossover Health:

Well, you know, our timing is really good right now, because we're changing seasons. And, you know, we also just had daylight savings. And that was a factor too, right?

Nicole Thalheimer:

Absolutely. That totally can I know that? Yes. It's nice to now wake up and have the sun be out. But most of us, you know, are wrapping up work and the sun is gone. And I think that that's a hard adjustment, especially when the clocks change.

Crossover Health:

Yeah, sure. So you're mentioning people can experience the same types of feelings as depression. How would you diagnose this differently? How do you kind of take somebody through and understand if they actually have this issue?

Nicole Thalheimer:

As you said, it does look pretty similar. Some of the big things that are different, and how you get to this diagnosis are around timing. So it's not that this just happened once this past fall, but it needs to have happened at least for two years, and not be necessarily tied to other things like the holidays, right? For some folks, the holidays, the best time of year. And for others, you know, it can be rough. Yeah. And so it's maybe, you know, families kind of loaded for you. And so, you know, there's some grief that comes around the holiday time, right, that's a bit different than what we're talking about in terms of seasonal affective disorder.

Crossover Health:

That makes sense, that makes sense. So, maybe dive a little bit deeper, what do people need to know who might be experiencing this? And when would you seek professional help?

Nicole Thalheimer:

Also, great questions. So the other nugget that I didn't mention is that this gets better when it gets warmer, right? When the spring comes, get a little more sunlight, that gets better. So it can be something that you could start tracking a little bit, right, if you've noticed, you know, I get home, I start to feel really bummed out as it gets dark. And I noticed like the first you know, nice day, in the spring, all of a sudden, my mood feels really good. And, you know, keep track of that, whether it's journaling or talking to your, you know, primary care physician being able to recognize that, hey, there might be something else going on here. You know, I think that when we're talking about really anything under the depressive umbrella, it doesn't hurt to talk to professionals in general. Right. Right. I think that it's one of those things where it's certainly my hope is wouldn't harm but could potentially be helpful. So if you recognize like, calm winter, you're not functioning,

Crossover Health:

it's gonna make a significant significant for someone.

Nicole Thalheimer:

Absolutely. And it can impact lots of different aspects of life. Right, and maybe for some folks, they can still get out of bed. But, you know, it takes so much more energy to do their basic everyday things. It's worth checking out. Yeah. And that's where, you know, some of the theories of how this happens. There's some different perspectives. But in terms of things like, you know, melatonin disruption, which, you know, helps us sleep, circadian rhythm, disruption, serotonin changes, all these things, we actually are very much so impacted by the sun and weather, and that can actually impact our ability to function.

Crossover Health:

Makes sense? So if I'm listening to this as a member, and I think, Hey, I might have some seasonal depression, or a loved one might have have some of some of these symptoms, what are some tools that they can, or some strategies they can kind of try right away? What are some things that you would would recommend?

Nicole Thalheimer:

I think we can look at it in two different ways. There are very tangible things you can do, such as getting a lightbox. So you can literally go online and find there's several different kinds, some get real expensive, some are much more affordable, but it's literally simulated sunlight. And that doing that I want to say it something like 15 minutes, it doesn't have to be an excessive amount of time. So good points

Crossover Health:

make right or even if you're busy, and you only have 15 minutes, during lunchtime to see the sun better than not doing it at all right? Like it's better to do a little bit

Nicole Thalheimer:

100% That is my general life mantra, something is better than nothing. Yeah. So if you're able to get outside during lunch, 15 minutes, five minutes, even, that can make a huge difference. If your schedule your logistics, don't allow it, being able to do something like getting a light box can be really helpful in terms of just some of that stimulated son, being able to I mean, if you can take breaks, even not at lunch and just go outside, walk around the block for five minutes. Even if it's cloudy out the fact that you're outside in daytime can make a difference.

Crossover Health:

Good to know, good to know when other ones you have. So

Nicole Thalheimer:

being able to be aware of the possibility of the seasonal affective disorder and kind of reflect and say, is me not wanting to go outside because I didn't sleep well last night? Or is that more of a seasonal affective disorder talking? And if it is a seasonal affective disorder talking, do the opposite. So if my sad as we call it is telling me not to go outside means I probably should go outside and it will probably be good for me. Again, not for an hour, it can be for five minutes, and that can make a difference.

Crossover Health:

Yep. That's a really, really good to remember. Thank you for that.

Nicole Thalheimer:

Absolutely. And I think being more if possible. Obviously the current time being social can be kind of difficult, but if you can be a little bit more social if you're able to move more. Again, it doesn't it could be Going into the gym and getting a hard workout in, it could also be, you know, walking the dog or playing fetch or riding a bike with your kid for, you know, 10 minutes that all of those things build up. And they can have some really positive impact,

Crossover Health:

right, having those regular activities that you're moving your body, one of the ingredients, right,

Nicole Thalheimer:

on a present and, and taking care of the daily stuff. I like to also say, right, when, when winter comes, or when you're feeling some of these symptoms, like, let's go back to basics, am I eating? Am I hydrating? Am I sleeping, and if you're not doing any of those with regularity, start there, you know, maybe the first week you're noticing this, it's really hard to do anything but drink more water. Okay, that's something, again, something is better than nothing. So starting there can be helpful.

Crossover Health:

So circling back to how you work with patients and what you would recommend, if I'm a member, or if I'm listening here and believe that I'm working on my seasonal depression or something close to it, when it when is the right time to reach out for help? When When do you think you recommend, hey, you know, you've tried all these things, you've tried these different tactics, but now it's time to get some professional help.

Nicole Thalheimer:

Yeah, I would say if you're noticing basic functioning isn't happening. If you're noticing that the things that you typically do, like maybe you're a runner, and you're doing your running, and it's still not, you're not feeling what you're used to feeling in terms of some improvement, you know, reaching out to whether it be crossover or another mental health provider to check in. Right part of the power of therapy is having both an expert but somebody outside your day to day to be able to kind of problem solve and gameplan and talk through. And I think if you're thinking, hey, this might be the time, chances are it is, right, because if you're recognizing like this, this may be it. I'm gonna go on a limb and say, go talk to someone.

Crossover Health:

Yep. Yeah, that's good to know. And good for everybody to think about. Sometimes that's hard. But we want to be there for you. Right?

Nicole Thalheimer:

100%. And again, being able to how we notice how we know ourselves, which sounds kind of funny, but if you are an animal person, and you know, playing with your dog is not bringing you the joy that it typically does. That's information. Yeah, right. Clearly, I'm a dog person. Clearly, I love playing with my dog. I think I brought up dogs three times now. Because I know she brings me a lot of joy. Yeah. And if I'm not, you know, laughing at her ball obsession, she loves more than anything in the world. It's a good indicator of like, Hey, what's up with me? Like, I'm not laughing at her being ridiculous right now. And so that's, that's data for me to be able to say, hey, what's happening with me reflect on what that looks like and feels like,

Crossover Health:

I love that. I'd love to shift gears just slightly. And talk about your delivery of mental health care. And, you know, you said you were a virtual list, and a lot of mental health, whether you're going to see somebody from crossover or someone, someone from somewhere else, a lot of mental health is shifting to online. Could you maybe speak to how that has changed your practice or impacted it? Good or bad? Because I think for for a very long time you'd go in in person and speak to your therapist, but that's really changed. And I'm wondering, you know, what your experience is? But,

Nicole Thalheimer:

you know, I think there's been a lot of pros, and there's definitely been some cons. So I think that by being virtual health, particularly mental health care is a lot more accessible. Right, working with folks who maybe have very tight schedules where they can they have a lunch hour, but they can't drive to my office during that lunch hour, but they can pop on a call during my lunch hour or during their lunch hour. Folks who have kids where it's like, well, I can have maybe my co parent, watch the kids for an hour while I'm talking to my therapist, but again, can't leave necessarily to you know, add commuting time on and things like that. Yeah. I think that we talked about building rapport. Right? How do you build the therapeutic relationship? Yeah, it is still very possible virtually, but it's a little bit different, because we're not in a shared space. And so sometimes building rapport can take a little bit longer in a virtual setting, but it's still it's still very, very possible.

Crossover Health:

Thank you for that. I just, you know, it's nice to hear how easy it is to get help.

Nicole Thalheimer:

And the other thing when it comes I bring up building rapport before because research shows that one of the the most in Important things in therapy and therapeutic change, regardless of orientation of your clinician, or even sometimes what you're doing is, how do you build that therapeutic relationship? Right? The trust that you build in therapy, that can be the biggest catalyst of change. And so that's important to remember that a therapeutic relationship is like any other relationship, you may meet with somebody you don't totally click with. And that's okay. That doesn't mean therapy isn't for you, it just might mean that provider is not for you. So I always tell folks, you're not going to hurt my feelings if you're not feeling like we've clicked and can do this work, because it's about you building that therapeutic relationship to make change.

Crossover Health:

Awesome. So Nikki, any last recommendations that you would have for those who are working on or dealing with seasonal depression?

Nicole Thalheimer:

Absolutely, I think being mindful, noticing if you've noticed that this is becoming a pattern, being able to maybe take some of the steps that we've talked about, or reach out for support, that, you know, you are not failing, if you're reaching out for help in this way, you're not somehow less than if you can't manage or what you've done to manage isn't working. And when you can, you know, enjoy the little things. It was five minutes outside where the sun actually came out that it's okay, that that makes your day.

Crossover Health:

Absolutely. 100% 100%. Well, thank you so much. So we'd like to get to know you a little bit better. I hope it'd be okay, if we did some rapid fire questions. Bring it up. Here we go. Here we go. What's your favorite podcast at the moment?

Nicole Thalheimer:

I go back and forth between Marc Maron podcast that's been on for a long Yeah, he's funny. He's got some great guests. I've seen him live before. I'm a big fan. And Dan Savage savage lovecast have been around for a long time as well. I appreciate that. He brings on subject matter experts. Yeah, because he says right he's not a trained clinician himself, but he'll bring on experts which I appreciate.

Crossover Health:

Very cool. Awesome. Well, then what is your guilty pleasure?

Nicole Thalheimer:

Ben Jerry's easy. That

Crossover Health:

was easy. Which flavor? I like to cookies and cream so good.

Nicole Thalheimer:

I love a flavor that was a special flavor that they don't actually had was called One Love. It was Bob Marley flavor it had like it was banana ice cream and like chocolate pieces. Yeah, it's my favorite. And they it's not there anymore. So it's a little sad, but it's okay.

Crossover Health:

Ben and Jerry's. You heard it here. Bring back one love. What's one thing you do every day to stay healthy?

Nicole Thalheimer:

Combination of hydration and again playing with my dog? Yeah. Animals are really great for mindfulness you know touching sometimes smell things like that. So I like to ground with my dog and, and drink lots of water.

Crossover Health:

Thanks so much for coming on the show. Nikki.

Nicole Thalheimer:

Absolutely. Thanks so much for having me.

Crossover Health:

Anyone 18 are over in the United States can be a crossover health member. At crossover. You stay connected to a care team that works together and gets to know you over time. A doctor, a nurse, a mental health expert, a physical therapist, a chiropractor, a health coach, a fitness coach and a care navigator. Go to crossover health.com to join the healthcare revolution. If you like our podcast, please follow or subscribe and leave a review. If you have a topic you want us to explore. Let us know on Facebook or Instagram at crossover health. Until next time, be well