Ep. 187 Stacey MaGee Podcast Transcript

Steve Martorano 
The Behavioral Corner is produced in partnership with Retreat Behavioral Health -- where healing happens

The Behavioral Corner 
Hi, and welcome. I'm Steve Martorano, and this is the Behavioral Corner; you're invited to hang with us as we've discussed the ways we live today, the choices we make, the things we do, and how they affect our health and well-being. So you're on the corner, the Behavioral Corner. Please hang around awhile.

Steve Martorano 
Hi, everybody, welcome again to the Behavioral Corner where it's me, Steve Martorano. I hope you have found us by now and are making us a regular part of, your podcasting life. We talk about everything, because that's what affects our behavioral health, everything. It is brought to us by the financial cooperation of our underwriter and partner Retreat Behavioral Health. And once again, we dip into their pool of very expert and talented people when we have a topic that needs some precision brought to it and that we have here today. You know, it's the irony of this time of the year, where the songs tell us "tis the season to be jolly." That many, many people find that difficult. Some find it impossible. And there's a term for what goes on regarding this time of the year, and a kind of depression about the change of the season. And you may know it as SAD. S-A-D, which just stands for Seasonal Affective Disorder and that's our topic today. As I said, we get expert advice from our pals at Retreat from their mental health division. We have again with this, Stacey MaGee, Stacy has been with us before here on the Corner. Stacey is a clinical supervisor with Synergy. Stacey, thanks for your time, we appreciate it.

Stacey MaGee 
Thank you.

Steve Martorano 
You know, before we get into SAD, I know it's just talking about being, you know, the Grinch here. You and I got to talk about being miserable at this time of the year. It's, unfortunately, reality. Before we get to that, though, tell us a bit about Synergy and, what programs you guys offer.

Stacey MaGee 
Yeah, we have the are Synergy as our mental health program. You know, our substance use program on one side of the building, we had the sub-mental health. But if you talked about the substance abuse, I mean, they can be, you know, the primary diagnosis is substance abuse but can be co-occurring disorders with their substance abuse side. But the same for Synergy. The primary diagnosis is surrounding mental health. But we do have some mental health patients that do have some substance abuse-related disorders. So they can also be kind of CO-occurring but most of our patients come in like more the mental health side, whether it's schizoaffective disorder, schizophrenia, depression, or anxiety, but they might have like PTSD, so, so, or borderline personality. So all those disorders that they're in our diagnostic manual. So yeah, we provide a lot of the services. You know, it's some difference on the substance use side and the mental health side, but they can be up here to 30 days in our treatment program. We provide them...they have our primary therapist, we provide them a person with the aftercare to work on their aftercare, what happens when they come out of treatment. So it's a lot of the same components but...but different components. I mean, they get immediately they get a psychiatrist they see within 24 hours to get reevaluated because some of our patients come in with, you know, already diagnosed someone with no diagnosis, but they follow up with the psychiatrists weekly. Sometimes that follow up more than just weekly, you know, and, and so our, our program is just geared a little bit different towards mental health, like our track groups are bigger educational groups to get, of course, we have psychotherapy groups and stuff like that, and they get individual therapy to dislike or other side but it's just geared more for the mental health side.

Steve Martorano 
Just to put a finer point on it. So I make sure people are clear. While there are, as you point out, CO-occurring disorders that have to do with mental health, that are associated with substance abuse, and must be treated as mental health issues. For the first time now, Synergy has been developed as a distinct set of programs. You can seek help through Synergy without to be associated with any addiction or abuse problems.

Stacey MaGee 
Yes, most definitely. Some of our clients just they don't have any addiction problems. They do have distrait mental health issues, such as depression, anxiety, you know that those types of disorders.

Steve Martorano 
If anybody familiar with substance abuse treatment understands it, the mental health piece goes hand in hand with trying to get the addiction under control. So it's surprising actually, it's more pure substance abuse facilities, who were probably very good at that. Having also done what Retreat did, which go, which sort of separating the two, so that you weren't tied to one diagnosis to get the kind of help you need. And the things you guys at Synergy are now dealing with talking about an epidemic. And we are in a real crisis in terms of mental health in this country. And the effects of that are obvious. Alright, so let's begin with the time of the year, I will use my favorite quote, at the risk of sounding even more Grinchy here. But I remember somebody saying a very long time ago, at this time of the year, "Well, the holidays have this by the throat again." And I've always thought, "Yeah, it does. It's exactly what it feels like." feels like yeah, here we come. Get ready, be happy. And so there's a whole set of circumstances that make that difficult for a lot of people. But we're talking about something specific at the outset here, and that's a Seasonal Affective Disorder, SAD. What is that? describe it for us.

Stacey MaGee 
Yeah, that's amazing. Now, this, this subject is not really talked about a lot, you know, but a lot of people experience it, you know, but, you know, SAD is just what it is, it's, but it's still with people that have short periods, mood changes over seasons, especially the with the fall and winter seasons, you know, you know, when the days get shorter, you know, and, you know, the time change comes along. My wife hates time change. I mean, she just absolutely hates it, you know...

Steve Martorano 
Do we know anyone who doesn't like that?

Stacey MaGee 
But some people call it "The Winter Blues." You know, that's...that's...that's another thing, you know, because you have, you know, you feel better in the spring, but you just...the longer daylight, you know, the better the spring, but the shorter daylight hours are just worse, you know, so, so SAD is a part of a type of depression. And, and the symptoms usually start late in the fall or early winter. And but we have seen some episodes in the springtime and summer, but it's it's much less common.

Steve Martorano 
Yeah, well, I mean, when reading before we got together for this, I was surprised to find out about the seasonal disorders that can occur in the spring and summer, which is interesting. Before we get into some of the symptoms of this, how it manifests itself, and people have a problem. It just strikes me as, like your opinion, there seems to be it wouldn't surprise me I should say if this onset in the fall and winter of gloom and sadness might be the residue of kind of an evolutionary period when it was harder to hunt. It was difficult to be sheltered you had to go inside you couldn't live outside and so I think that would seem to be logical that over the Millennium as we progress those slots are still there somewhere. Right?

Stacey MaGee 
Right. Because they you know, it affects our activities affects everything we do when we come to a different season. You know, when you're in spring and summer you can go waterskiing and go do all this other stuff. When winter comes along you can't do some of those same activities. So that's a change.

Steve Martorano 
Yeah, and in the natural world, the difference is star. Ine season is associated with, at best, hibernation, but certainly not growth. And the other one is with, you know, growth obviously spring. 

Stacey MaGee 
Yes, most definitely. 

Steve Martorano 
So let's talk about the symptoms that take something like this that we've all experienced on some level and turn it into you know, a pathology -- a disorder. What are some of the symptoms that people who really have a problem with SAD exhibit?

Stacey MaGee 
Usually the onset or the start of it, it can last about four to five months. I'm gonna start with that. So like depression, you know, I mean, you have symptoms for depression to save you have depression may include feeling depressed most of the day, most every day, loss of interest in activities or, you know, having problems sleeping feeling sluggish, feeling agitated, you know, low energy hopelessness, worthlessness and difficult to concentrate and, you know, even for some people suicide, you know,. Now, for the winter pattern of SAD, the specific symptoms usually include like oversleeping or hypersomnia. Stuff like that are overeating particularly craving for high carbohydrates and weight gain, you know, you know, you gain all this weight because you're less active, you know, and, and you kind of feel like you just kind of start social withdrawal but like you said hibernating, that is kind of the main symptoms of SAD as what usually people that experience. Now for the summer months, like we said, we have some people in my be, some of those types of trouble sleeping, insomnia, poor appetite, weight loss, restlessness, you know, anxiety and, and episodes of some people, I've heard of episodes of like, violent behavior. So, aggression that that happens, so, and then you, you know, some of that same kind of symptomology of a bipolar disorder. So...

Steve Martorano 
How long has Seasonal Affective Disorder have been recognized? You know, as a...it is in the diagnostic manual, correct?

Stacey MaGee 
Yeah, the DSM five, but I think it goes back to the DSM three if you don't quote me on that, but I've been around...I've been in this field for 35 years. And, you know, and I heard it early on, then when I started in this field, so...

Steve Martorano 
Yeah, so it's, it's nothing that they cooked up the other day. It's been with us and identified as a problem for a long time. Do we know whether it affects men or women differently or greater numbers?

Stacey MaGee 
It affects women in greater numbers. So I don't know all the science behind that. You know why it affects women more than then men, but it does affect women more than men. So...

Steve Martorano 
Do you guys in your field when you treat patients see any tendency towards self-medicating in order to overcome those feelings associated with SAD?

Stacey MaGee 
Most definitely, it's just like any other mental health disorder, whether you are depressed, you know, and you feel like you want to do a bunch of energy drinks to get to go on, you know, are you willing to do some type more type of drug, methamphetamine or something like that? I mean, yeah, we're, we're always trying to compensate with our moods, and what the changes in everything, whether it's stress, or trauma, or was seasonal, you know, darkness, you know, no, light, no, so, yeah, we're always on it. So...

Steve Martorano 
You know, most people are gonna say, "Oh, really seriously, I feel the same way you do. The days are shorter, it gets darker early, it's cold, and it's a pain in the neck. I like the spring much better and on and on. How is this a problem?" How does it I mean, you've mentioned a couple of the symptoms: loss of sleep and lowering of interest in activities. When should somebody go? "Well, my behavior is normal that what, when should I get help?" What are the warning signs that you probably need help?

Stacey MaGee 
Well, if you're seeing any of these warning signs that we have kind of mentioned like hypersomnia, or just overeating or weight gain, or you just feeling down and depressed. I mean, it never hurts to seek a mental health provider just asked questions, you know, and they have like these questionnaires. I mean, there's I think there are questionnaires on Google that you can kind of do that to kind of answer the questionnaire that kind of make you think well maybe I do have this Seasonal Affective Disorder this SAD so and to be diagnosed with it you know, you just have to like I mentioned meet some of that criteria. That was mentioned, and I think it has to happen if I can remember right. It has to happen within two consecutive years. So feeling this way, you know, so are you just every year I experienced this thing, you know, I'm okay in the summer, but when the winter comes I start feeling these symptoms, you know, gaining weight or I feel like I'm social withdrawal, and I'm not going out as much I'm isolated I'm hibernating. So that's the time when you might want to seek a mental health provider and just or ask your regular doctor you know, and say, Hey, this is what's happening. What do you suggest you know?

Steve Martorano 
Is SAD something that's typically treated with drugs? 

Stacey MaGee 
It can be and they can, and they can be just like a temporary thing with SSR you know, uptake you know, because when you get into that winter season you know, it's like regular depression you have a depleted level of serotonin a call it a hormone, and that can happen with SAD, you know, just during those months, you have to stay low motivation or just feel like you just can't get out of bed or something like that. So...

Steve Martorano 
Do children suffer from this? 

Stacey MaGee 
I have not heard of children suffering from this. You know? That's a good question. I've never really studied that out. So you know, I not going to answer something I do not know. So...

Steve Martorano 
Good. Good for you. More people in general, should be saying they don't know.

Stacey MaGee 
I know one thing. If I had to live in Alaska or New England, I'd probably have SAD.

Steve Martorano 
I didn't live in New England. And I love my time in New England. But...I did notice that winter gets there early, and is no hurry to leave. I grew up in Philadelphia, which is semi-tropical compared to Boston. What about people who live in areas where there are six months...of semi-light? How does this affect them?

Stacey MaGee 
I think we have seen a higher rate of SAD, but I think we've also seen they're just adaptation, anything else where they're more able to adapt to it, then someone who lives in California or something like that? Or, you know...

Steve Martorano 
Yeah, it's interesting that we should be baffled about our environment. Would affect us so profoundly when...when, you know, you can look at a number of different pieces of evidence to go, yeah, you know,

Stacey MaGee 
People with SAD can be more adaptable to that that have already had like, prior depressive disorders or prior some type of mental health. So they're at higher risk. So they're in high risk.

Steve Martorano 
Yeah, let's get back to the treatment thing in a second. But Can someone have SAD that CO occurs with some other mental you mentioned depression, but I'm thinking specifically about bipolar diagnoses? Can SAD trigger manic episodes and a bipolar person?

Stacey MaGee 
I mean, we've talked about mental health and, their triggers and all of them. So in some flow together. So like with bipolar, you got bipolar two is more of a depressive disorder. So that can kind of trigger more that down area or depressive disorder, and that bipolar two, they might have some hypomania and some manic, but it's more than a depressive disorder. So it kind of feels more like bipolar two. So that's why, you know, a good psychiatrist, you know, you got to continue to work with a psychiatrist to really get a good diagnosis on something like that. But, you know, the main thing is anything is possible. So you can have like, you know, that hypomanic and a hypo, you know, the summer months compared to what you feel in the winter months.

Steve Martorano 
So we've mentioned medicine employed, often in this case, psychiatry. What sort of psychiatric techniques would be helpful with SAD?

Stacey MaGee 
Well, some of the techniques have been it's like therapy. They are they have these light bulbs that are the luminance, and they release more luminance I think that was what they do. And because you know, you don't get sunlight, so they gave me the sunlight without giving I can't the, I think they're about 10,000. Lux is more than a regular light bulb, and you'd sit under those for 30 to 45 minutes. And, you know, they're basically they're just about 20 times brighter things. Really. Yeah, but they don't have UV light. Okay, so you can't get a tan.

Steve Martorano 
You can't get a tan Oh, well, I just thought did a lot of tanning places could also be giving psychiatric help. So light treatment is a well-established treatment for SAD. And that's fascinating because we began this way, both lamenting the fact that they change the clocks every year, and it just drives people nuts. Would is the medical establishment have a position on whether it's healthier if they stopped doing that or not?

Stacey MaGee 
No, I don't. I don't know. You know, I mean, we all know this was like change was created for the farmers, you know, but I don't think we have enough education. We're not really looking at that, you know, so but

Steve Martorano 
Well, you know, I've heard that since I was a kid, and I know you have as well, well, but farmers need this, and I don't know, I know I live in Philadelphia. I don't run into farmers a lot. But I think they're doing ok farming. No matter what time of the year their clock says. Yeah, never. I've never run this. I don't even I don't I can't begin to understand why that is because, as you said at the beginning, almost nobody likes the idea of it. You know, it may be just one more graphic reminder for some people that, Oh, Winter's coming with their blue right here, and then it's a holiday. It's let's go. Let's take a moment here, hit a one-hour thing. Absolutely. Now, the light therapy, you know, you got to think about combination thing. We can also have psychotherapy, or as you said, the antidepressant medications along with that. So you just start looking at one thing.

Steve Martorano 
It also ought not to be thought of as something that someone can just shrug off. You know, "snap out of it" is probably the worst thing you can say to somebody in a situation like this, correct?

Stacey MaGee 
Yeah, most definitely. And you know, and also probably some therapies like CBT, cognitive behavioral therapy, how to change your thought patterns. Sometimes its just straight-up talk therapy that helps.

Steve Martorano 
Yeah. Let's, let's swing this over into the final area. I wanted to talk to you about this. And that is, all of this coincides. The season coincides with, of course, the holidays. It's quite apart from SAD, which is basically about the change in seasons. There is the approach of the holidays, and the imperative, that you are happy and joyful. This is very difficult for a lot of people. What advice do clinicians like yourself give people who dread the idea of the holidays?

Stacey MaGee 
I'd say talk and get support for one thing. And don't make and don't just think you feel like you're the only person because the holidays are stressful. Let's just be honest, all the shopping, all the traffic, all the stuff and stuff, it's just stressful. I think we sometimes we stigmatize ourselves and think that, you know, I'm the only one feeling this way. And I know a bunch of people millions is feeling this way. You know, and we think we have to get in the holiday season, you know, we got to do all this stuff. It's just like, you know, some people thank God for Amazon, I don't even have to go out, you know, but that could be a bad thing for people with seasonal depression disorder that hibernate, and they don't get out. They don't get in the festivities, and they don't do stuff. So I would just treat it like, you know, self-care, you know, we have to self-care for ourselves. We have to do things, exercise, and different types of things to get ourselves motivated. And just recognizing the education of recognizing that we have these symptoms. And because you sometimes you feel like God, I'm not normal. What's wrong with me?

Steve Martorano 
And in the holidays? I've always thought because I'm, I can be accused of being one of these people who doesn't fall down with joy during the holidays. 

Stacey MaGee 
Oh, you're Mr. Scrooge, huh?

Steve Martorano 
Do you know what it is? I took your advice before you gave it. I accept the way I am. But I think the deal has to be if the people around me are willing to recognize it. I have that about me and not, you know, cheer. What up? Come on, sing along. If they don't do that, then I won't bring them down with my curmudgeonly attitude. And we'll all just start...and we'll just sort of get through this together. Yeah, I think that's the deal that my family has made with me at least. That's what they tell me in front of me. I'm sure my behind my back. They're going don't tell your father Merry Christmas one more time. Just one real quick point. My wife's grandmother lived to be 107. Wow. And I to healthy, up to a very short time, she passed away. But I remember that they would stress to the rest of the family what are we getting Gram for Christmas. And no matter what it was, she would generally be upset by the gift or not excited about it,. And I finally said to my wife. You can't give somebody 200 sweaters before they start to hate the sight of sweaters. She doesn't want any when she's said enough to the family. Just leave it alone. She doesn't want to open any more presents. I think it helps people who feel a kind of SAD this time of the year if the people around them went a little lighter, a little easier on them. And maybe we'll get through together. Finally, I'll get you out here because I know you're very busy. We appreciate your time. I'm sure that the pandemic didn't have a good effect on the seasonal affective disorder. But I wonder whether because...because, you know, the season, it's been three years now. And during that period of time, in retrospect, it seems as though there was a suspension of the natural order of nature. In other words, we didn't have summer, winter, or fall. We had COVID. Did it exacerbate the problem of depression and seasonal disorder, or was it just long...one long, miserable stretch?

Stacey MaGee 
I think have affected it. I think that we saw uptakes and more people depressed uptakes and people with anxiety uptakes and suicide, you know, I mean, you had where you couldn't go to a family member's funeral at that time, you know, there. And so, I mean, how stressful is that? You can't even say goodbye to your loved one. And I think...I think society in life does ask, you know, it does affect in all these disorders. And, as a therapist in this, I would be if it didn't affect me. I mean, I feel sad sometimes during the winter. You know, I'm from Louisiana up from, like, I'm not used to all this stuff. I've lived here 10 years, but I'm just like, I wish winter would just go away. It's just too long. I find myself getting irritable and kind of restless and, you know, feeling those same things, but I definitely it has exasperated the SAD and the depression and all these other months

Steve Martorano 
Well, you know, in terms of the weather, as I say, No one moves to the northeast for the climate. Yeah, because he because it's rough, you know, different seasons altogether. I want to thank you, Stacey MaGee, from Synergy Health Programs. We leave people with nothing. We're not trying to rain all over your holiday parade here. But if you do have trouble with this, you're not alone. Don't feel alone. And there's help out there if you need it. Go get it.

Stacey MaGee 
Yeah, there's help out there. And you know, I know us as Retreat we have an admission process with you know, even if this just...on a website, you can just ask questions, you can send in questions that question you'll get a response. So if you don't have a direction to go, you know, we definitely will. We're not here just to you know, to meet you every time we will be. We'd like to help the community and we speak to the community. We talk about these things, and any advice that we can give you, we'd love to help you.

Steve Martorano 
I can attest to that. I mean, Retreat has always made a point of making sure you're going to talk to somebody. You will talk to a person very early on in your contact with him. Stacey, thanks so much. You're our go-to guy on these issues. We're going to have you we get if we can back in the spring or early summer when of course, hope springs eternal. We can have a lighter conversation.

Stacey MaGee 
Yeah, we'll all be happy in the summer.

Steve Martorano 
Hey Stacy, have a great holiday.

Stacey MaGee 
Y'all have a great holiday, and I wish everybody else a great holiday.

Steve Martorano 
And you all as well. Don't forget to subscribe, which is the button on there. Subscribe to the Behavioral Corner, and we will rendezvous next time. Take care.

Synergy Health Programs 
Millions of Americans are negatively affected daily by their mental health. Retreat has served the community for over ten years, offering comprehensive mental health programming through our mental health division, Synergy Health Programs. To learn more about Synergy, please reach out today at 855-802-6600.

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