The Nights are Longer and SAD is Here

By Aimee Sterk, LMSW, MATP Staff

I can feel the change in the seasons and I’m not enjoying it. Shorter days and longer nights start the cycle of Seasonal Affective Disorder (SAD) for me. This time of year I start feeling the energy drain and the pull of my bed increase. According to the Mayo Clinic, the causes of SAD aren’t entirely known but there is felt to be a genetic component and a chemical component the chemical components are related to reduction in sunlight and a corresponding reduction in serotonin and melatonin. Lower serotonin can trigger depression and melatonin helps with sleep.

The risk factors for SAD include living in places like Michigan—the further you live from the equator, the more common SAD is which is likely due to the decreased sunlight during winter.

Luckily for me, there are some treatment options involving assistive technology (AT) and lifestyle changes that really help me:

Light Therapy

light therapy boxA couple of years ago, when I was complaining about the dark falls and winters in Michigan and my belief that I had SAD, my coworker told me about light boxes. Each morning I start the day with 45 minutes in front of my lightbox. In fact, I’m writing this blog with it on. The bright light mimics outdoor light and appears to cause a change in brain chemicals linked to mood, most likely increasing serotonin. Studies have found that light therapy is effective for SAD and may be effective for nonseasonal depression.

I position myself 12-24 inches from the lightbox and have it off to the side of my computer monitor. I use it in the morning almost every day.  My box has bright white full spectrum light and produces 10,000 lumens. In the past, many SAD light therapy boxes were using blue light wavelengths, but recently research has indicated that broad spectrum light is more effective. For the past several years, my lightbox has helped make my SAD much more manageable.

I want people to know about possible side effects of light therapy and contraindications so I’ve copied some warnings below to be very aware of:

Are there any side effects or conditions where light therapy should be avoided?

“Individuals whose skin is especially sensitive to light, such as those with lupus (systemic lupus erythematosus) should consult a physician before attempting light therapy for any condition. You may be advised to avoid light therapy if you have a history of skin cancer or if your eyes are sensitive to light because of conditions such as glaucoma, cataracts, retinal detachment and retinopathy. In addition, light therapy has been reported to lead to mania in some patients with bipolar disorder (manic depression) and to cause suicidal thoughts. For these reasons, patients using light therapy boxes should report any mood changes or disturbing thoughts to their health care practitioners.
Certain drugs can increase sensitivity to sunlight and may cause skin reactions as a result of light therapy. These include antibiotics, anti-inflammatory drugs, some anti-histamines, lithium, the supplement melatonin and the herbal remedy St. John’s wort. If you’re taking any drug or supplement on a regular basis, check to make sure it won’t cause a reaction to light therapy.

Some ophthalmologists have warned that blue light, part of the full spectrum of light used in light therapy, could damage the retina and increase the risk of age-related macular degeneration, a progressive eye disorder that is the leading cause of blindness in people over the age of 55. So far, however, no research has confirmed that risk.

If you’re bothered by the glare from your light box, the blue light is probably responsible. You can screen it out by wearing special eyeglass lenses or clip-ons during treatment. There are also light boxes available that filter out the wavelengths believed to be most harmful.

Other side effects of light therapy are minimal. Some patients report headaches, eyestrain or eye irritation or nausea when they begin treatment, but these effects usually are mild and disappear after a few days.

Exercising

In this case, my DVD player and online streaming device are AT. My therapist informed me that exercise boosts serotonin and I find it helps me feel better about myself while reducing anxiety and stress. I regularly start my day with an exercise DVD or a streaming program when it’s too cold, dark, wet, or snowy outside to exercise out of doors.

Getting outside

There were brief periods of sunlight this past weekend and I made sure to get outside and hike and work in the yard. The Mayo Clinic suggests that getting outside within two hours of waking in the morning is most effective and that even on cold and cloudy days, getting outside is helpful.

Brightening my home and office

I make sure to open my drapes and have installed solar tubes in darker areas of my home (our hallway). I have painted the walls in our darkest rooms bright, light colors. When I’m up before the sun, I turn on all the lights in the area of the house that I am in.

Taking a vacation someplace warm and sunny

Florida-Mangrove-forests-in-the-south-of-the-peninsula-of-florida
One of my favorite vacations was to Florida. I especially loved paddling the mangroves with my husband in the bright sunshine and warmth in the middle of winter.

I know that I hit my limit of coping with Michigan weather every February so I save up all year to go someplace warm and sunny many years. If only I could find a way to bill that to my health insurance. Funny thing is, the article from the Mayo Clinic even recommends taking a trip as a way to manage SAD, Take a trip. If possible, take winter vacations in sunny, warm locations if you have winter seasonal affective disorder .”

Do you have SAD as well? What AT or strategies have worked for you?

 

Butterflies, Bracelets, and Rocks

By Aimee Sterk, LMSW, MATP Staff

My Facebook memories have been showing me that October is often a very hard month for me with many anniversaries of stressful events. I want to share a blog post I wrote two years ago as it came up in my Facebook memories as well and sparked a lot of discussion on my wall.

So here it is–how I was doing two years ago, and what AT got me through (and I’m still using these tools and techniques):

I have PTSD and have been triggered a lot lately. I can sense it happening. Something reminds me of a traumatic event and I start reliving it in my head. I started seeing a new therapist for EMDR (Eye Movement Desensitization and Reprocessing) after my old therapist left her practice and no longer takes my insurance. I dreaded having to start over—and having to share with her what has happened to me. Talking about past traumas re-traumatizes people and exacerbates PTSD. Luckily, my new therapist knew this and didn’t want to dig in—just wanted some generalizations, but as we were getting started, she could tell that I was going back to the experiences—and she had some great new techniques that helped me self-soothe enough so that I could interact with her. I’m now adding the Butterfly Technique and a large egg-shaped rock to my Calming Techniques and Items Toolbox in addition to the bracelet and weighted blanket that were already in there.

The Butterfly Hug Technique involves crossing your arms over your chest and linking

Butterfly Hug
A webcam shot of me holding my hands in the position I use for the Butterfly Hug.

your thumbs at your sternum. Your fingers are pointed up towards your collarbones, not towards your arms, and the finger tips rest just below or on your collarbones, palms facing down against your chest. You then pat yourself in this position for 1-3 minutes. This bilateral stimulation provides a sense of calm. It helps ground you and keep you in the present moment. It was originally used in Mexico helping survivors of a hurricane and has been used with inmates, many of whom have a trauma history, and others with PTSD. I put an image of a butterfly on my phone to remind me that I can do this technique any time. There is a great youtube video on the butterfly hug technique created by Debbie Augenthaler.

Rock
This snowflake obsidian rock fits well in my hand and offers enough weight and size to register strongly with my brain as I pass it back and forth between my hands. It helps with mindfulness.

The other technique she taught me uses a super low-tech piece of AT (assistive technology), a 3-4 inch egg shaped rock that fills the palm of your hand. She instructed me to take this rock (hers was polished marble) and pass it back and forth between my hands. I felt stupid at first, but then realized it was helping and did it for my entire appointment. I asked her what the technique was called and if the size of the rock/weight were important. She said it was a type of Brain Gym technique that also promotes bilateral brain stimulation. The size and weight are somewhat important—the rock needs to be big and heavy enough to register in your hands.  I found a large enough egg at a local store that carries crystals and meditation supplies. I find it helpful to use this technique to reconnect and calm—it allows me to return to mindfulness, being in the present moment and noticing my thoughts without judging them. Mindfulness is universally beneficial and helps with chronic pain, depression, anxiety, and stress and promotes well-being. There is now a free online course for Mindfulness Based Stress Reduction (other courses in person and online are $350-$450). I’m going to give it a try.

metta-bracelet.jpg
The different colored stones in this bracelet help me remember the different pieces of the lovingkindess or metta meditation.

While I wrote about my weighted blanket before, I haven’t shared about my loving kindness bracelet. I originally learned about loving kindness meditation as a mindfulness practice—a way to become present, decrease stress, and increase positive emotions and well-being. There are dozens of studies on the benefits of a loving kindness practice. I had been practicing it irregularly, especially when I was experiencing insomnia, and then more regularly after attending a workshop by Kristin Neff, an expert in self compassion. The loving-kindness meditation is a way to tap into the calming practice of sending love to yourself and to others and the world. I had trouble remembering to stop and do the loving kindness meditation and make it a part of my daily routine until I added my loving kindness/metta bracelet I got from Jan Lundy, an author, speaker, and spiritual director. Jan co-designed a bracelet with four different kinds of stones to represent each of the phrases you repeat in a loving kindness meditation. I can sit and meditate and use the stones as keys to remember:

May I be safe

May I be strong

May I be happy

May I live with peace and ease

I work my way around the bracelet first a couple times for myself, then for others. Jan has full instructions on her website. When I am anxious and overwhelmed, I need a visual cue to help me reset. Having a reminder on my wrist does just that, and then guides me in my practice. Jan’s bracelet is beautiful, but if cost is a barrier, you could go to a craft store or raid your closets and jewelry boxes and pick out beads with meanings for you and string your own.

What AT, techniques, and resources do you tap into for stress, anxiety, depression, and self-soothing?

Tasty Tools: Assistive Technology in the Kitchen (Part 6)

Kitchenaid stand mixer

By Jen Gosett, BS, CTRS, MATP Staff

Welcome back to our Assistive Technology in the Kitchen series, Part 6 :-)!  Today we are talking about using a stand mixer (or standing mixer) as an Assistive Technology support in the kitchen!  

Graphic of a handheld mixer with beatersMixing by hand can require precision, endurance, and fine motor control.  Handheld, electric beaters can be difficult to use; holding the power button down can take a lot of grip/pinch strength and holding the device itself takes a fair amount of upper body strength. Knowing I can set the stand mixer to do its job makes cooking and baking seem less daunting and more accessible to me. 

When you think of a stand mixer what comes to mind?  Having a lot of time available to “play” in the kitchen?  That’s what I thought at first too and I couldn’t justify spending a larger sum of money on something I’d maybe use once a week.  But then I searched “uses for kitchenaid stand mixers” on Pinterest and found that (along with other surprising uses), I could shred cooked chicken breast using a stand mixer!  

2 forks shredding cooked chickenI have been making bbq chicken in my slow cooker for years, but there’s a step in the recipe where I need to shred the cooked chicken with 2 folks.  Using 2 forks to shred up a protein (even if tender) can require upper body strength, fine motor control, and muscle endurance.  Not to mention that your hands are really close/touching hot meat and that can be painful.  By using the stand mixer to shred the chicken, I now just use tongs to place the hot, cooked chicken into the mixer, mix for 30 seconds on low with the paddle attachment, and all my chicken is all shredded and ready for bbq sauce & bun (maybe a little coleslaw too)!  😉

Shredded BBQ chicken sandwich, topped with coleslaw

I use my mixer with the whisk attachment whenever I want something really thoroughly mixed: Jello, instant pudding, ranch dressing/dip, fluffy eggs for scrambled eggs & omelets, box cake mix, meat for meatballs & meatloaf, etc.  

Tray of soft pretzelsStand mixers often come with that paddle attachment I mentioned with the shredded chicken, the whisk attachment, and a dough hook attachment.  You can make lots of great, yeasty dough’s for soft pretzels, breads, rolls, etc. using the dough hook.  I especially love using the dough hook to make quick breads; the dough hook attachment doesn’t over mix and ends up giving them the best texture!

  • Pro tip 1: When I bought my mixer, I purchased a second bowl & paddle attachment so that when I was making a recipe that required 2 different batters or preparations, I didn’t have to stop to wash my one bowl & paddle.  The bowls I have are the lighter, stainless steel ones.  Kitchenaid has some pretty ceramic and glass bowls available, but they are heavy and therefore can be cumbersome to use, wash, scrape batter out of, etc.  In addition to the food weight inside of the bowl, the glass & ceramic bowls add 3 additional pounds!  

Stand mixer with ceramic mixing bowl

  • Pro tip 2: Stand mixers are heavy and can be difficult to lift (even just to scooch over a bit).  Mine lives on my counter so I don’t have to deal with moving it to store it after I’m done using it (besides, it’s pretty and I like looking it lol).  I’ve found that by putting small, furniture felt pads on the bottom of the stand, the mixer scooches around on the counter a lot more easily.  And if the pads get dirty they are easily replaceable.

3 stand mixersStand mixers in general are relatively expensive and if you’re going for the bright, colorful, and popular models (ahem, Kitchenaid), be prepared to pay $300-$400.  I saved for a few years before I purchased mine and during that time did a lot of research to find out which model would be best for me.  After visiting stores (Williams Sonoma and Sur La Table tend to have various models in their stores) to physically touch the mixer controls & watching the America’s Test Kitchen equipment review of stand mixers, I purchased an Artisan Kitchenaid Stand mixer (in the green apple color) with the “head tilt”.  I got mine from Kohl’s when it was on sale.  At that time, I had a 30% off coupon and they offered a rebate (saved me about $100).  I bet you could get the same deal if you checked their site (I think they list sales on Saturday’s) and keep your Kohl’s coupons/look up Kohl’s coupon codes.  Note: I wouldn’t recommend the Kitchenaid mini because I’ve seen that it doesn’t mix as well as the other models.

Do you have a stand mixer?  What do you use it for most?

If you missed them, check out Part 1Part 2Part 3Part 4, & Part 5 of this AT in the Kitchen series!

Tasty Tools: Assistive Technology in the Kitchen (Part 5)

Food processor containing cucumber slices

By Jen Gosett, BS, CTRS, MATP Staff

In Part 4 of this series, we had gotten back from grocery shopping, put our goods away and were starting to prep food for the week (remember those oven eggs?).  When I do my food prep for the week, it’s not typically right after I put all my food away (I’m usually tired & hungry and can get frustrated more easily.  Anyone else feel that way?) 😉  When I start prepping, it’s helpful and less overwhelming for me if I start with a clean(ish!) kitchen: my sink is usually clear, random things on my counters are put away, etc. I’ve found that this helps me keep my motivation/keeps me on task because I’m solely focusing on food prep (rather than also cleaning & putting random things away).  

Clean sink and counter top

A few years ago, I started looking into purchasing a food processor.  “A food processor is a kitchen appliance used to facilitate repetitive tasks in the preparation of food. Today, the term almost always refers to an electric-motor-driven appliance, although there are some manual devices also referred to as ‘food processors’.”

Food processor with attachments“Food processors are similar to blenders in many forms. The primary difference is that food processors use interchangeable blades and disks (attachments) rather than a fixed blade. Also, their bowls are wider and shorter, a more proper shape for the solid or semi-solid foods usually worked in a food processor. Usually, little or no liquid is required in the operation of the food processor, unlike a blender, which requires a certain amount of liquid for the particles to move around the blade.”

Food processors can be helpful for individuals who have support needs centered around fine motor use in their hands/arms: instead of holding a knife, cutting board, & the food item while trying to cut it, with a food processor one can “feed” food through the “feed tube” and the machine slices it for them.  I find my food processor specifically helpful because it can chop my veggies, fruit, and cheeses up for me via the slicing discs that came with my model.

Food processor blending solid food into liquidFood processors can also blend food to a puree/liquid consistency for salsas, soups, and for those who may need a liquid form of solid foods.

  • Pro tip: my food processor has “a specially designed locking system with leak-resistant [red] ring that allows you to fill the work bowl to capacity with ingredients.”  I really like this feature, but the ring is made of a rubbery material and makes it difficult to open and close.  An easy fix I’ve found is to rub a little vegetable oil on the seal & inside of the lid before I use my food processor (the lubrication from the oil doesn’t impact the seal’s ability to keep in liquids).

Loaves of french breadIn addition to chopping & grating food for me, I use my processor to make bread dough (it has a special blade for this).  Kneading bread dough the traditional way can take a lot of continuous upper body strength.  With a food processor, one can put the ingredients into the machine, push the button, and in a few minutes have bread dough ready.  

Hand cutting butter into flour using 2 butter knivesOne of my favorite uses for my food processor cutting butter into flour.  As I’ve said before in this series, I love baking!  For scones, biscuits, & pie crusts I need to use very cold bits of butter (the butter melts in the oven and produces steam which makes the flaky layers many of us love!)  Traditionally, a pastry cutter or two knives are used to cut the butter into the flour.  This process requires a lot of fine motor control and continuous upper body strength.  With my food processor, I measure in my flour, place my stick of butter in, and turn on the machine.  After a minute or less I have what I need to bake some up some deliciousness!

Big food processors can be expensive and it took me a while to make the decision to buy one.  I did a lot of research!  While I was deciding, I purchased a smaller one to see if I would really use it.  Though this smaller one does not slice food for me, it does chop it.  I use it to chop peppers, onions, and cheeses for quiches & omelets and to chop nuts & dried fruit for cookies & breads.  And the first pie crust I ever made was with this little processor.  

Mini Kitchenaid food processor

Do you have a food processor?  What do you use it for? 🙂

If you missed them, check out Part 1Part 2, and Part 3 of this AT in the Kitchen series!

Point Louder!

hand with finger pointing rightWhile facilitating a training session with a group, I was told to “point louder”, a humorous way to let me my pointing was not effective communication, since some members of the group were blind.

Audio description is the auditory narration of visual representations such as television programs, films and live performances. During gaps in dialogue, it describes visual elements such as scenes, settings, actions and costumes. Audio description is also called “video description” and “descriptive narration”. It is particularly beneficial to people who are blind and vision impaired and can help people with other print, learning and physical disabilities.

Here’s an example of a video with audio description on YouTube: The Hunger Games with audio description Katniss hunting, from Media Access Australia.

symbol for audio description "AD"

Ideally, audio description would be a separate audio track, which can be accessed by assistive devices and/or toggled on or off as needed.  On YouTube now, you can turn on and off closed captions, but you can’t turn audio description on and off. If you want to provide an accessible video on YouTube, you’d have to produce two versions, one with audio description and one without.

Finding described television shows has become much easier. As part of the Twenty-first Century Communications and Video Accessibility Act of 2010, several of the most popular television networks have made certain prime-time and children’s programs accessible to viewers with vision loss by adding audio description.

A number of on-line streaming video services, like Amazon and Netflix now offer audio description. A good way to learn about these and new services as they become available is through updates from the The Audio Description Project: An Initiative of the American Council of the Blind.

Audio description is a bit of an art. I’ve attempted it. It can be difficult to determine what descriptions will be adequate for understanding, yet still flow nicely in the gaps in dialogue in a video.

In video and in person, it’s important to remember to point louder in order to achieve effective communication!

Resources

What’s Cooking?

Logo Disability Network Capital AreaBy Guest Blogger: Kellie Blackwell, Disability Network Capital Area

When it comes to cooking, I have often shied away from trying many things. I have a gas stove and this can present some challenges with low vision, another reason is that I like being able to follow a recipe. It was not until I began pairing the All Recipes skill from my Echo with other types of AT, that I began thinking more and more was possible. Even though the skill has been changed and does not offer quite as much in the way of hands-free step-by-step verbal instruction, it is still very useful when you need quick, easy access to recipes, the ingredients, and the cooking instructions.

A rice cooker with inner pan and lidI find now, I am using the skill more so for the list of ingredients. Why you might ask? I have recently been introduced to using a rice cooker, yes, I said rice cooker, for a creative and simple way to make a variety of dishes. So far, I have made a turkey meat loaf, scrambled eggs, and taco meat in my rice cooker! The rice cooker has provided a way to cook smaller, healthier options with the touch of one button! I am loving it! I also have had the chance to use my talking digital cooking thermometer to ensure the proper temperature of the meat. It has been a game changer in the kitchen!

three sets of bump dotsOther types of useful AT for low vision I have used in the kitchen include; the double-sided spatula and bump dots for my microwave. I have also purchased a Keurig for an easier way to enjoy my cup of coffee in the morning. The K-Cups are pre-measured and there is no longer a concern of pouring the hot liquid from the pot into a cup!

If you are interested in trying out some of these items, visit the Assistive Technology tab on the Disability Network Capital Area website to set up a demonstration of low vision and a variety of other devices!

Sleep with Me

Night scene with a tree, crescent moon, and figure in the moon reaching for a star

By MATP Staff Member Laura Hall

I have always had trouble sleeping.  Even as a little girl, I’d lie awake thinking that I was the only one in the world awake. I’d wake up my sister, who would not be happy and certainly not comforting.  Now I’m an adult, and thankfully understand the concept of people awake in different time zones, shift workers, etc.  However, the bedtime anxiety has never gone away.  I can’t seem to slow down my thoughts, and it seems like all I do is keep myself awake by worrying that I’ll never fall asleep.

A figure reading a book from behind. Headphones surround the figureWatching TV or using my phone keeps me awake because of the blue light.  My Cerebral Palsy makes it difficult to hold books, so I sometimes listen to books through the National Library Services‘ free service for people who have print disabilities, BARD.  I have started getting myself into a bedtime routine, often using the Amazon Echo’s skills to play Jeopardy and then relaxation music as I prepare to wind down.  I’m finding this is helping, but my heart still races when I lay down and turn the lights off.

Sleep with Me Podcast LogoDuring a random conversation at lunch, my colleagues on the Michigan Assistive Technology Program were discussing which podcasts were their favorites.   Someone mentioned a podcast called “Sleep with Me“.  I laughed at first but she explained that it was a podcast meant to help you fall asleep.  I thought it was going to be more relaxation music, but I gave it a try.   The podcast host, “Scooter”, explained that he was going to help me sleep by telling me a bedtime story.  Odd, I thought, but I kept listening.  Some gentle music started, and Scooter began talking.  Several minutes went by and I realized  that I had no idea what he was talking about.  I laid there trying to make sense of it, and, ironically, fell asleep.  I tried it a few more times, and always fell asleep.  Soon, it dawned on me that the podcast isn’t supposed to make sense!  The genius of this podcast is that it is supposed to distract you from your racing thoughts and bore you to sleep. Even if you don’t sleep, (and I have yet to stay awake for an entire podcast) Scooter is there to keep you company.

Listeners have also created their own facebook page dedicated to the podcast.  Posts range from tips on sleep hygiene, funny animations, or just posts from people who can’t sleep during the night.  The best part is that someone is always awake and online to chat with so you never feel alone.  Several people, called “Noderators” monitor the page and are available no matter what time it is.  I finally don’t feel like I’m the only one in the world awake!  The Sleep with Me podcast is an unusual, but free and effective form of assistive technology that helps me with my anxiety and insomnia.  Are there other tactics you use?