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HOUSE CALL WITH DR. SANJAY GUPTA

Winter Woes

Aired December 4, 2004 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


BETTY NGUYEN, CNN ANCHOR: "Now in the News": A bloody day in Iraq. Smoke clouds the streets of Baghdad after twin bombings. Two car bombs went off near the coalition-run green zone, killing at least 16 people.
The agenda is a long one for talks today between President Bush and Pakistan's President Pervez Musharraf. The Pakistani leader, Mr. Bush's main Muslim ally in the war on terror, arrived in Washington last night. Among the issues, Pakistan's army downgrading the hunt for Osama bin Laden.

In Ukraine, street protests continue in Kiev as parliament works on legislation to hold another presidential election. Ukraine supreme court ruled last month's election null and void. The court says Ukraine's next move must be held -- next vote I should say -- must be held on December 26. And we'll be watching.

I'm Betty Nguyen. HOUSECALL WITH DR. SANJAY GUPTA begins right now.

SANJAY GUPTA, HOST: Good morning and welcome to HOUSECALL. Checking medical headlines first.

Well, we know stress is bad for you, but a new study says extreme mental stress can actually affect your immune system. The study showed immune cells age fastener in women who are under pressure. Researchers found it wasn't the actual stress that mattered most, but perceived stress was a major factor in cell aging.

And a yet to be approved testosterone patch is under scrutiny by the FDA. Critics say the patch, made to boost sexual desire in women, may have more risks than rewards. Supporters argue studies have shown to have problems with the drug.

And a new online survey. 74 percent of people admit to gaining more than 10 pounds around the holidays. More than a third said they had a hard time getting back on track once those festivities ended.

"Winter Woes," from diet and exercise to cold and flus. That's our top story today.

Well, this is the season of giving, spending time with family, but it's also the season of getting stressed out, getting sick, maybe getting a little depressed. The long nights and colder days don't help many people's moods.

And as Elizabeth Cohen reports in some cases, they can cause a form of depression.

(BEGIN VIDEOTAPE)

LU ANN HUGHES, SAD PATIENT: You love that shirt.

ELIZABETH COHEN, CNN CORRESPONDENT (voice-over): In the winter, Lu Ann Hughes dresses her three children before the sun comes up. She eats breakfast before the sun comes out.

HUGHES: And you get out of the shower and it's still dark. And you have your cup of coffee and it's still dark.

COHEN: In winters past, all that darkness made her feel depressed and irritable with her children.

HUGHES: Mostly, those are the things that really cause me trouble in the winter is not being able to be the effective parent that I wanted to be. Those months were tough.

COHEN: At first, Hughes tried an antidepressant drug, which she says doesn't didn't work very well. And then she tried light, fake light for about half an hour a day in the winter.

HUGHES: It took only about two weeks until I really started noticing something's different.

COHEN: Hughes has seasonal affective disorder or winter depression. Her doctor explained to her that the light outside affects so many things inside the body, such as hormone levels, which in turn, affect mood.

MICHAEL TERMAN, DR., NY STATE PSYCHIATRIC INST.: The clock in our head depends on seeing sunrise every day to keep in sync with local time.

COHEN: Dr. Michael Terman, director of the Winter Depression Program at the New York State Psychiatric Institute says 80 percent of the time light therapy helps patients with winter depression feel better.

TERMAN: It's a rapid turnaround. It's a faster effect than you get with antidepressant drugs.

COHEN: Fake light and getting as much real light as she can has been the answer for Hughes.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: And as many as 26 percent of us suffer to some degree from SAD, Seasonal Affective Disorder. The majority are them are women and people in the northern regions, where little sun and long nights can take their toll.

So the question is this, how do you know if you have SAD or you just have the winter blues? Well our guest today can help answer that. He's Dr. Norman Rosenthal, a psychiatrist and the man who first described Seasonal Affective Disorder. He's also author of the book "Winter Blues."

Doctor, thank you very much for joining us

NORMAN ROSENTHAL, DR., AUTHOR: Good to be here, Sanjay.

GUPTA: Listen, you know, many people get down around the holidays and during the gloomy weather. How do you know when it's not just the blues? And I should add as well that you were the first person to describe this, but you also suffered from this as well. So you're the perfect person to ask this question.

ROSENTHAL: Yes, I've experienced it and I've treated it and I've studied it. So I pretty much know about the blues.

GUPTA: And the good news, of course, is that there's a ton of things that we can do to help people who get the blues, whether it's a mild case or whether it's all the way to Seasonal Affective Disorder.

ROSENTHAL: Yes, that's good. And we're going to hear about some of those solutions. In fact, we already did. Some of them in Elizabeth's piece, let's get to some questions about those though.

GUPTA: Jill in Indianapolis wants to know more. "I've heard of the winter blues where people get the blues due to lack of sunlight. Is there anything you can do until the days get longer again?

So what do you say to someone like Jill, doctor?

ROSENTHAL: Oh, I'd say there are lots of things to do, starting with getting more light. Now there are lots of ways to get more light. You can go out and take a walk in the morning or at lunch time, if it's a bright, sunny winter day. Or you can bring a lot of lamps into your house

But if you've really got a serious case of SAD Seasonal Affective Disorder. And we should really talk about what that really means. If you've got a real bad case, then you need the kind of light that you saw in the piece, a special kind of light fixture that's been researched and that puts out a tremendous amount of light, maybe 20 times as much as you'd get in an indoor environment. And that can turn the blues around or the SAD around, as you saw, within even a few days.

GUPTA: And I want to talk more about those lamps in a second again, but I'm still trying to clarify. How do you know if you're actually suffering from Seasonal Affective Disorder, versus you know, just being a little down like so many people get with the shorter days and the colder weather?

ROSENTHAL: I think you need to look back over the last several years and ask yourself, how do you feel when Thanksgiving comes, when Christmas comes? Do you slow down? Do you need more sleep? Do you have less energy, less vitality? Do you enjoy things less? A lot of these people have to increase their eating of sweets and starches and gain weight just to kind of keep going. They don't concentrate. They withdraw from friends and family. And they feel really depressed.

And this can last several months. You see, we're talking about the holiday blues. Maybe it's just a couple days here or there, but this is really something that comes every year. It's quite bad. It gets in the way of your functioning. It gets in the way of your fun. And it lasts a long time. Then you know you've got a case of SAD.

GUPTA: I think it's interesting. So it actually sometimes persists beyond the holiday season, even when the weather starts to get a little nicer. That's a good point.

Another question now Richard from Chicago writing, "My doctor suggested Zoloft for my SAD. However, I do not feel depressed. I just feel tired and lacking in vitality. What can provide me with energy?"

That seems like an interesting -- a common occurrence as well, doctor.

ROSENTHAL: Yes, it's true, because lots of times, people just have less energy and they need more sleep. And they can't get things done. and they may not actually feel sad or down, but it's still a variation of the same kind of problem.

And an antidepressant may be helpful. Certainly I would recommend following a doctor's instructions. But also, it's good to know that there are a lot of other things as well. And I would definitely bring to the doctor's attention the question of light therapy, the question of exercise, see whether there are other things to do. Although there are many different antidepressants. And they really do work in a lot of cases

GUPTA: And they -- but sometimes other options before you get to the medication route?

ROSENTHAL: That would be my way of going about things.

GUPTA: We're definitely in the holiday season, and therefore seeing a lot of family. But family problems can bring on stress and sadness this time a year as well.

Erin in New York, she writes this question. "This year the holiday season is a painful one for me. My parents are separated and recently my family had to put our cat to sleep. I'm taking an antidepressant, but it's not helping me. What can I do to feel better?"

And doctor, I know you see patients still. You take care of patients in clinical trials as well. What sort of advice do you give to someone dealing with loss or family issues, especially around the holidays?

ROSENTHAL: Yes. I would really say that antidepressants are not the answer to everything. I think the holidays can be a very painful time, just as we've heard. It brings back a lot of memories. It brings back a lot of associations. And I think it's really important to reach out to friends, to reach out to family. And in some cases a counselor can be very helpful or a therapist just to help you look at things in a slightly different way. And that can make all the difference.

GUPTA: Don't isolate yourself. We're getting good advice from Dr. Norman Rosenthal. Listen, the season of peace can turn into a season of stress and piling on the pounds. Some keys to survival coming up on HOUSECALL.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: 'Tis the season.

UNIDENTIFIED MALE: I've very stressed out.

UNIDENTIFIED FEMALE: Just being in the store. There's one of something left.

UNIDENTIFIED FEMALE: Stress and the holidays, tips for staying sane are straight ahead.

And then there's the food.

UNIDENTIFIED MALE: I enjoy eating on the holidays. And I let it get out of hand sometimes.

UNIDENTIFIED FEMALE: How to keep a holly, jolly Christmas from turning into a roly-poly New Year.

First, take today's daily dose quiz. Is taking aspirin or acetaminophen to prevent a hangover a good idea? The answer when we come back.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Checking the daily dose quiz, we asked is taking aspirin or acetaminophen to prevent a hangover a good idea? The answer is, no. According to experts, while it may help with the hangover, it can damage your liver or stomach lining.

(END VIDEO CLIP)

GUPTA: Looking for some holiday harmony this year? Well, between travel, high expectations of a joyous family reunion, and that frenzied gift buying, the holidays can be anything but harmonious.

Talking with us about ways to stay chill this winner is Dr. Norman Rosenthal. He's a psychiatrist and he's the medical director of Capital Clinical Research Associates in Bethesda, Maryland.

I should add as well that he suffered from SAD and was the first to describe it.

Doctor, the holidays can be especially hard if you're dealing with a lot of family tensions. I think just about everyone can relate to that. What advice do you have for people looking for a peaceful season?

ROSENTHAL: I think to focus on the specifics, to focus on the center of gravity of the season, which is one of peace, of happiness, of reaching out, of giving. I think too often we use it as a time to settle scores or take up issues with people we haven't seen in a while.

I'd say back off of anything controversial. This is not the time. If your mother-in-law tells you that you're looking like you've gained a little weight, just kind of back off. Don't get into it with her, because I think that that's the kind of thing that really can bring people down.

GUPTA: And you know, the thing is, doctor, everyone seems to imagine the TV movie version of the holiday season. But it really turns into that frenzy, that sort of panic attack in the last few days. What do you suggest people do to avoid that?

ROSENTHAL: Yes, I think let's keep our expectations realistic. These TV images of Christmas or Hanukkah, they're not the reality. The reality is -- often falls short. So I think if we keep our expectations realistic, we're less likely to get disappointed and hurt and angry.

GUPTA: All right, let's keep going on another important topic. Another big stresser every holiday season is weight gain. An online poll found 85 percent of respondents admitted their eating habits got worse during the holidays. And 74 percent reported gaining as much as ten pounds around the holidays.

Let's get to an e-mail now about this. Asu from New Jersey writes, "I gained a lot of weight during Thanksgiving. How do I prevent from gaining more through the holidays?"

And I -- let me just add one thing here. Weight loss experts will tell Asu, I think, the key to avoiding more weight gain is to plan ahead. Never go to a party hungry. Eat slowly and savor your food. Also, limit alcohol consumption, an important point. It can actually increase your appetite. And lastly, exercise. You can't forget the exercise, right, doctor? How important is that?

ROSENTHAL: That -- all that you said is really important, but I would add something. And that is many of us who have winter difficulties are also carbohydrate junkies.

GUPTA: Good point.

ROSENTHAL: And I remember, this is the great pumpkin pie that a cousin of mine makes on Thanksgiving. I couldn't just have one piece. I would have to have, like three pieces. I had no way of limiting my carbohydrate intake, the sugars, starches, etcetera. So I've really gone on one of these diets where you limit your carbohydrates. And I would rather have no pie at all than try to limit myself to one piece, because that's hopeless. I'm just like -- I'll eat everything that isn't nailed down.

GUPTA: Must have been pretty good pie. We're going to talk more about that.

Coming up on HOUSECALL, determined not to get a cold this year? We'll show you how your job could be making your sick.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: The sneezing, coughing, runny nose.

UNIDENTIFIED MALE: Can't go out and do anything. Just sitting at home being sick.

UNIDENTIFIED FEMALE: Tips to keep cold and flu-free this winter season.

Plus, a great indoor exercise that's not just for kids.

But first, more of this week's medical headlines in "the pulse."

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Concerts and rallies took place Wednesday around the globe to mark World AIDS Day. World leaders, rock stars, and millions of other people came together to call for a renewed fight against the disease.

Close to 40 million people worldwide have HIV-AIDS, roughly equal to the entire population of Spain.

The Supreme Court heard arguments this week about whether patients like Angel Rache can use home-grown marijuana to alleviate pain. Rache suffers from several ailments. And her doctors recommended using marijuana as a last resort.

The U.S. government argued that a court ruling for medical marijuana use limits the government's ability to regulate interstate commerce. The Supreme Court is expected to make a decision on this case by next summer.

Christy Feig, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: So when you sneeze, you sneeze 200 miles an hour. Never knew that.

Between now and springtime allergy season, as many of half of us will pick up some kind of respiratory illness. And a third of those illnesses will be flu. And what's the difference? Fever, muscle aches and exhaustion are rare in colds, common in flu. Runny nose, sneezing and sore throats are hallmarks of a cold, but show up only occasionally with the flu.

So how does a person stay in that 50 percent or more of the population that gets through the winter germ-free?

Elizabeth Cohen shows how your work could be the key.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN CORRESPONDENT (voice-over): In the old days, coming into work when you were sick was a badge of honor. But these days, it's kind of a badge of stupidity, because one sick worker can infect many others. And then...

ROSLYN STONE, CDC WORKPLACE REPORT: You go outside of your office and get others sick. They get -- they may get sick. Their children may get sick. Their children go to school and may get your children sick. And it becomes a visual cycle.

COHEN: And this year especially, companies are trying to get the word out to stay home if you have the flu. That's because in years past, about 60 percent of businesses offered flu shots to their employees. But this year's shortage of shots forced companies to cancel their vaccination programs, leaving workplaces more vulnerable than usual.

It may sound obvious to stay home when you're sick, but one study shows 90 percent of workers come in when they don't feel well. Roslyn Stone is the chairwoman of the Center for Disease Controls Workplace Flu Prevention Group.

STONE: ...gone three days. And they feel the pressure to come back to work. They know their work is piling up. They know other people are handling parts of their workload. They think that other people might, you know, be thinking poorly of them.

COHEN: According to one online workplace poll, 27 percent of workers said they had too much work to stay home when they're sick. 24 percent came in to work sick because they didn't want to seem disloyal to their employee. And 17 percent said they were saving their sick days for an emergency.

And even when people do stay home, sometimes they don't stay home long enough.

STONE: So they come back to work, when in fact, maybe they should be out for a week to two weeks because they are still contagious. They are still not at nearly 100 percent.

COHEN: So next time you feel a cold or the flu coming on, think about leaving work. Your boss may thank you for it.

Elizabeth Cohen, CNN, Atlanta. (END VIDEOTAPE)

GUPTA: Thanks a lot, Elizabeth. She's trying to get us some days off of work, it seems.

Actually in all seriousness, that's one way to stay cold and flu- free this season. And we're discussing the woes of winter with Dr. Norman Rosenthal. He's a psychiatrist and he's also author of the book "Winter Blues".

Doctor, colds cause more visits to doctor's offices than any other condition. I guess it's between sitting shoulder to shoulder at holiday recitals and practically nose to nose when you're doing that holiday shopping. Getting sick seems almost inevitable.

Lots of questions coming in on this topic. Let's get to an e- mail now from Sandra in New York, who's looking for some help. "What are the options for people who can't get a flu shot because they're not considered "high risk?"

And doctor, I'm sure you get this question all the time, but there are some basic precautions that we can all take to prevent colds and the flu. Is that right?

ROSENTHAL: Oh, definitely. You know, let's remember to wash our hands after we've shaken hands with people or come in contact with somebody who might have the flu.

And also, for those who think they're coming down with the cold or the flu, be considerate, you know, don't go hugging and kissing people, and shaking their hands.

I -- when I've got a cold or the flu, I tell my patients or my friends I won't shake your hand, I don't want to pass the germs on to you. I think that's considerate.

But I think given that there isn't enough flu vaccine around, people should remember that there are options beyond just basic hygiene and care. And that is there is the flu mist, which is of course, the nasal vaccine for people between ages 5 and 49, who are in good health. And that's quite effective.

Also, there is the drug Tamiflu out there, but you have to catch the flu within the first 48 hours in order for it to be effective. So if you think you're coming down with the flu, be sure and catch your doctor quickly, because if you start it very quickly or even when you've been exposed to a serious case of the flu, you can actually prevent it or prevent the symptoms from getting too bad.

GUPTA: Dr. Norman Rosenthal, keeping us safe and healthy.

Listen, we're not done yet. Coming up, a new take on an old exercise. Stay tuned.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Portable, cheap, and a calorie blaster. Jumping rope isn't just for kids anymore.

Plus, Web sites that'll help you keep feeling cheerful all winter long. Grab a pen. More HOUSECALL coming up.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEOTAPE)

HOLLY FIRFER, CNN CORRESPONDENT (voice-over): Think skipping with jump rope is just for kids? Well, think again. This activity is much more than child's play. In just ten minutes, you can blast calories and tone your whole body in a high energy cardio workout. Affordable, convenient and best of all, inexpensive.

The jump rope is considered by most the single best piece of exercise equipment you can own. So to get started, ensure the rope is the right length for your height. Start simple. Jump with both feet together. Jump just high enough to clear the rope. Use complete arm motion to turn your rope.

The faster you jump, the more calories you'll burn. Skipping sculpts legs, improves agility and coordination. And it also strengthens your bones, lowering your overall risk of osteoporosis because it's a weight bearing activity. Though it looks easy enough, don't be surprised if you get winded after just a few minutes on your first try.

(END VIDEOTAPE)

GUPTA: Maybe next time we'll see Holly Firfer actually jumping some rope. Thanks, Holly.

Listen, if you're looking for ways to keep fit and healthy this winter, click on to the Mayo Clinic's Web site at Mayoclinic.com. You're going to find information on Seasonal Affective Disorder and how to avoid stressing out this holiday season.

Plus, test yourself on the differences between the cold and the flu.

Well, Dr. Rosenthal, been a very interesting show. Lots of good advice. Do you have a final thought for our viewers today?

ROSENTHAL: I'd say get more light, get more exercise, get more rest, and have a wonderful winter.

GUPTA: I think that's the best advice I've heard in a long time. Dr. Norman Rosenthal, thank you so much. We're out of time for today. Again, thanks to Dr. Norman Rosenthal. Thank you as well at home for all of your e-mails. Next week, we're going to be talking about healthy holiday meals with the folks at "Cooking Light" magazine. Plus, we've got some fun healthy gift ideas for you as well. All that's next weekend HOUSECALL, 8:30 Eastern. Make sure to tune in.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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