Author Archives: Zuzanna Walter

Seasonal Depression Risk at All-Time High During Pandemic Winter

November 5, 2020

As many studies have already reported, rates of mental illness symptoms in the population have been rising throughout 2020 due to social distancing measures, increased isolation, and a general upheaval of normal life due to the COVID-19 pandemic. For this reason, the prevalence of seasonal affective disorder (SAD) is also projected to reach an all-time high in the forthcoming months as surges in virus cases coincide with declining options for activities as colder weather encroaches. Alongside the widespread, multi-faceted devastation caused by the pandemic, political concerns and social unrest leave the American population increasingly vulnerable to SAD this fall/winter season.

Seasonal Affective Disorder 

According to current estimates, approximately 5% of Americans experience seasonal depression which usually begins during transitions from the summer to fall and fall to winter.

The onset of colder weather and decreased sunlight exposure contribute to a biochemical imbalance in the brain characterized by lowered serotonin levels and altered circadian rhythms. Common symptoms include sadness, loss of interest in activities, changes in appetite or eating patterns, changes in sleep, and loss of energy. The condition typically lasts for approximately 40% of the year although, in some patients it can last even longer.

Seasonal affective disorder is more common among women, young adults, those living further from the equator, as well as those with a personal or family history of depression. Nonetheless, the current environment is not conducive to overall wellbeing, putting more individuals at risk for depression even if they have never experienced mental health concerns before.

SAD Amid COVID-19 Restrictions

The symptoms of seasonal depression are likely to be exacerbated by pandemic conditions across the world as the number of activities decreases and feelings of isolation, compounded by stress and anxiety, increase across populations and age groups. Protective measures against COVID-19, including the closure of many business and limited social contact, contribute not only to declining in-person interactions but also growing financial burden. The lack of physical mobility, reduction in activities, and persisting threat of the novel coronavirus greatly heighten the risk for mental health symptoms in the population.

“There’s less activity, there’s less socialization, there are less mastery activities, there are less pleasurable activities, so in general there is an increase in depression, not to mention job losses and losses of people,” Dr. Lata McGinn, co-founder of Cognitive and Behavioral Consultants told USA Today in a recent article.

Therapeutic Options

It is paramount to find safe ways to socialize and remain active throughout the coming fall/winter season. Individuals are encouraged to maintain a strong support system of family and friends with frequent video and phone calls, socially-distanced visits, and other safe interactions. Experts recommend keeping a consistent exercise routine, which can greatly benefit mental health while also increasing overall emotional and physical wellbeing. Despite the cold, it is important to continue spending time outdoors for sunlight and fresh air exposure in a safe way.

Another potential therapeutic option recommended by psychologists is light therapy, which can be used indoors to mimic sunlight exposure. Daily treatment involves approximately 20 minutes of exposure to the light throughout the winter months with improvements seen between 1-2 weeks after initiating treatment.

In addition, experts recommend pursuing an “activity diet” focused on learning and building new skills – such as studying a new language – in order to derive a sense of accomplishment. CNN outlines several other helpful options and ideas for combating seasonal depression symptoms during this time, including journaling and other meditative practices. 

However, some patients may need to undertake more aggressive treatment measures to improve their seasonal depression symptoms. Talk therapy and cognitive behavioral therapy can effectively treat SAD as can antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs). With the rise of telemedicine, there has also been an increase in available options for virtual psychologist and psychiatrist visits bringing mental health support to patients in the comfort of their own home.

Although the National Institute of Health does not recommend diagnosing seasonal affective disorder until symptoms are experienced for two or more consecutive years, if symptoms begin to negatively affect daily functioning individuals are urged to seek professional support. As per the American Psychiatric Association, “anyone feeling severe symptoms of depression or suicidal thoughts to contact a doctor immediately or seek help at the closest emergency room. The National Suicide Prevention Lifeline can be reached at 800-273-TALK (8255) or via online chat.“

October Partner of the Month: Finding Genius Podcast

October 29, 2020

Finding Geniuses, Feeding Curiosity

Weeding out the mediocre to reach the extraordinary—the top 0.1% of experts in research, academia, industry, and business. That’s step number one. Second, ask challenging questions that evoke compelling answers—the type of answers you don’t hear often, the type that could trigger whole paradigm shifts. Third, deliver it to you, whether you’re an expert yourself or a layperson who loves to learn.

October 2020 marks Richard Jacobs’s fourth anniversary of following these three seemingly simple steps. Initially, Jacobs focused on ‘round-the-corner’ technologies, including cryptocurrency, artificial intelligence, 3D bioprinting, and more. How can cryptocurrency lead to a more transparent form of governance? Are swarm-based predictive insights being implemented in new entertainment products? Is life extension possible with bioengineered organs? These questions are just a snippet of the wide range of tech-based topics explored by Jacobs and his guests, in what was then titled Future Tech Podcast.

Impelled by a major personal health crisis in 2017, Jacobs began gearing the episodes toward topics in health, medicine, and bioscience. This led him to interview nearly 100 experts on sleep science and related issues, such as the connection between dentistry and snoring, and how the bacteria in your gut could be keeping you up at night. He’s heard from countless authoritative voices on the latest in cancer research, genetics and epigenetics, the microbiome, oral and systemic health, thyroid health, and how the mind affects the body—especially when it comes to stress and anxiety.

A new title seemed fitting; not only did the old one too narrowly capture the breadth of information discoverable through the podcast, but it failed to underscore what Jacobs was really doing: searching for information from the best and the brightest in the world, and finding geniuses. Finding Genius Podcast emerged in mid-2019.

Jacobs’s most recent endeavor on the podcast has been to dig deeply into the topic of viruses, far beyond the definitions you’ll find in a Google search. He’s interviewing 30+ researchers, academics, and clinicians to get their take on a set of provocative questions. Are viruses alive, and if so, does that necessitate self-awareness? Do viruses communicate and coordinate with one other to invade and replicate within host cells? How have viruses played a role in evolution, adaptation, and speciation? Are viruses actually responsible for building host immunity, as opposed to only breaking it down? The answers to these questions and more will be used to create a uniquely informative and palatable compendium of perspectives and data about viruses.

Good questions lead to good answers, which in turn lead to even better questions; it’s this positive feedback loop of curiosity and knowledge that fuels Finding Genius Podcast, and appeals to a growing number of listeners. Don’t wait for the next episode; visit Finding Genius Podcast and type a word or three in the search bar. Diet. Robots with muscles. History and COVID-19. Meditation. Microbiome and cancer. Whatever you choose, it’s a near guarantee that you’ll learn something new.

Open Notes: Patient Transparency and the New Federal Mandate

October 28, 2020

Alongside a surge in telemedicine adoption and increasing reliance on technology, the growing shift to digital healthcare delivery has prompted a cultural shift in medicine forcing many clinicians to abandon the traditional model in favor of a more modern approach. An elemental component of the modern medical care model is patient transparency, which has been at the forefront of discussions in recent weeks due to the forthcoming implementation of a new federal mandate.

To support universal patient transparency, beginning November 2, 2020 all patients in the United States will have immediate access to clinical notes and thus, will be able to read and review clinician’s writings, test results, and other health reports. Per the 21st Century Cures Act systems need to “support patients’ access to their EHI in a form convenient for patients, such as making a patient’s EHI more electronically accessible through the adoption of standards and certification criteria and the implementation of information blocking policies that support patient electronic access to their health information at no cost.”

Open Notes Policy 

Referred to commonly as “open notes”, the new federal mandate requires the release of all inpatient and outpatient notes for immediate patient access, including test results with potentially sensitive information. The information now made available to patients immediately includes consultation notes, discharge summaries, medical history, physical examination findings, imaging narratives, laboratory and pathology report narratives, and procedure and progress notes. Unsurprisingly, the plan has been widely contested by healthcare professionals who fear it will result in increased workloads and adverse patients reactions. However, there has been a growing adoption of the new protocols with time as evidenced by several institutions which have already implemented the policy.

Those supporting the new law believe it has the potential to strengthen patient-provider communication and relationships. Certain healthcare institutions are ahead of the curve; UC Davis Health voluntarily implemented open notes a year ago although only two dozen of 1,000 staff physicians opted into the program. Nonetheless, those that did reported positive results and support for the initiative. Similarly, at the University of Colorado Cancer Center, open access to oncology notes has been granted to patients for the past 5 years with no reported issues and highly appreciated by patients.

Sensitive Health Information 

Sensitive information may present more of an issue in certain specialties, such as oncology, psychiatry, genetics, and adolescent medicine. For instance, when reading pathology or imaging notes, patients may learn they have been diagnosed with cancer without a physician’s explanation or contextualization. In oncology specifically, patients may struggle to understand their prognosis and treatment plan leaving them stressed, frightened, and/or confused. In certain cases, the importance of physician contact and empathy may be much needed and more valuable than previously thought.

Medical professionals highlight the importance of clear, open, and honest communication with their patients to better accommodate the forthcoming open notes protocols. “When I order imaging or send pathology specimens, I have already discussed with the patient the possibilities, including cancer, and what we will do next. Patients deeply appreciate these discussions, before they see the results,” Dr. Robert Breeze, vice-chair of neurosurgery at UCHealth in Anschutz, Colorado told Medscape in an interview.

As clinicians tend to write notes in medical lexicon, they may now need to write things out in lay terms for the benefit of their patients which may potentially generate more work. Although the new mandate does not require a change in writing style, many clinicians may find they will need to alter their notes to make them more readable for patients, potentially making them less useful for utilization review, billing, and other internal purposes.

Clinicians in favor believe that the open notes policy will help serve overworked physicians by empowering their patients, allowing them to better understand their treatment plan and medication which can ultimately minimize the physician’s workload. Although the federal mandate may seem daunting, the benefits may outweigh the risks if notes are compiled in a patient-focused manner in line with a patient-centered care model. Access to clinical notes, results, and other important health information may promote patient engagement and treatment adherence, as well as deepen the patient-provider relationship.