winter blues

4 Proven Methods For Fighting The Winter Blues

Seasonal Depressive Disorder, also known as Seasonal Affective Disorder (SAD), occurs in parts of the world where we experience lower sunlight levels at certain times of the year. It typically occurs in the late fall and winter, but it is possible to see it in the spring and summer as well.

Symptoms include:

  • Inattentiveness
  • Hopelessness
  • Depression
  • Social withdrawal
  • Fatigue

You may have experienced this at one time or another in your life, depending on where you live and seasonal changes, but in order for you to have the “disorder” the symptoms must occur in succession each season over at least two years. There must also be a period after when the symptoms lift for a long period of time related to the increase in sunlight you experience from seasonal changes. It is literally a depression due to climate and seasonal weather changes!  

There are several theories as to how this occurs, including sunlight deficiency and hormonal changes. One theory is that the large change in sunlight reduces the amount of serotonin that we naturally produce, and also increases the amount of melatonin levels in our bodies. This changes our circadian rhythm.

Increase Your Vitamin D Levels

Vitamin D is also essential for serotonin levels in the blood. Serotonin is a neurotransmitter that helps with mood and sleep. Adequate dietary vitamin D as well as exposure to sunlight which converts vitamin D into the active form “calciferol”, help to keep up those serotonin levels. If you aren’t sure if your Vitamin D level is adequate, a blood test can be ordered from your doctor to determine the level. Although above 30 ng/ml is generally considered adequate, but optimal ranges for an individual can be between 40-80ng/ml. There are vitamin D receptors on most cells in the body, it’s involved it lots of processes from depression as we already mentioned, but also bone and teeth health, cognition, immune system regulation, and more! So why just be adequate, when you can aim for optimal.  

Take Melatonin 

Melatonin, which is a hormone involved in circadian rhythm, is increased as a response to lack of light. This happens in the winter months with shorter daylight hours available, as well as those grey days that happen in many places like the Midwest. Less bright light allows higher production of melatonin, leading to feeling sleepy or lethargic. Some studies show that taking a low dose of melatonin like 0.5-3mg in the evening helped to correct the “sleep phase delay” that happens as a result of the higher production of melatonin left over during the day. This in other words, helps to reset the clock.  

Light Therapy Can Augment The Lack Of Sunlight

Another important factor in resetting that circadian clock and reducing the naturally higher levels of melatonin produced in the darker winter day is the use of a therapeutic light box. Using a therapeutic light box of 10,000 lux immediately upon waking has been studied and used over and over again with good effect (up to 75%). It also avoids the use of medications or supplements. To use a light box, it should be 10,000 lux, although some users find the brightness uncomfortable, and use a lower intensity for longer periods of time. There are some light boxes that offer different intensities to use, as well as automatic timers. Keep the light box 12-14 inches away from your face and keep it off to the side. You aren’t looking directly into the light box (just like you don’t look directly at the sun!). You can start with lower times as you adjust to sitting with it on and can use up to 1 hour. 

Light Therapy

WARNING! If you have bipolar disorder, light boxes can induce mania and hypomania, but you can still use them, just use for shorter intervals, and monitor your mood. 

Get Off The Couch And Start Exercising

Exercise is another important intervention for Seasonal Depressive Disorder. While exercise alone is a known intervention for depression, for seasonal depression, pairing it with light therapy works best. Choosing exercise that has positive social aspects is also shown to boost mood even more. This could be anything from having a gym buddy, to taking exercise classes with a group of people. Exercises that are aerobic, high intensity interval training, weightlifting, yoga and tai chi all count! So, you can choose what suits you best. The average amount of exercise to benefit in one Harvard study was 35 minutes a day (about 4 hours each week). For each additional 35 minutes a day, you can further decrease your chances of depression. You don’t have to start out at 35 minutes a day. Start small, and increase your exercise as tolerated. You want this to be a positive addition to your life, not a punishing one.  

Exercise is just one of the many things that our product MindScout suggests to help our customers live better lives.

Exercise Buddy

If you feel like you are fighting the winter blues each season, try some of the tools above! If you still notice some lack of motivation, focus, drive. Remember, humans have evolved to stay in and conserve in the winter! Show yourself some kindness, take time for self-care, reflection and adequate rest and recovery. Spring is right around the corner. 

We would love to help you with your next your next digital health product. Contact us for a free consultation!

Psychiatric Nurse Practitioners

Nurse Practitioner Week – The Importance and History of Nurse Practitioners 

The inception of the Nurse Practitioner started in 1965 by a nurse and physician duo, but nurses have been serving in expanded roles, much longer than that.  

In 1893 in the Lower East Side of Manhattan, where rapid industrialization and immigration created a huge need for medical and nursing care. Lillian Wald, a young graduate from the New York Training School, started the Henry Street Settlement (HHS). These visiting nurses would carry black bags with medications, home remedies, sterilized milk, ice, and other needs for the families they served. HHS also provided a savings bank, a library, vocational training, and social activities.

Nurse Practitioners in snow
Nurses in the HHS trudging through the snow for a home visit 

In 1903, nurses dispensing practices as well as what constituted practicing medicine were questioned after the passage of the Nursing Registration Act.  “Nothing contained in this act shall be considered, as conferring any authority to practice medicine, or to undertake the treatment or cure of disease” (Article XII, 1903). At the turn of the twentieth century, the FDA required disclosure of certain ingredients such as alcohol, cocaine, chloroform, marijuana, and more. With the creation of new treatments and interventions, and federal and state legislative acts being created and changed almost daily, nursing, medicine, and pharmacy practice boundaries were constantly shifting.  

Other nurses were creating similar public health services in other major cities like Boston, Philadelphia, and Chicago.  There was the creation of the Frontier Nursing Service (FNS) in 1925 by Mary Breckinridge, a nurse midwife from a prominent Kentucky family. The FNS served the population in the Appalachian Mountains which was considered one of the most remote and difficult to reach populations. Nurses covered over 700 square miles of terrain by 1930, on horseback, and for the most part worked alone without any physician supervision.  

The FNS as well as the Henry Street Settlement created committees to help navigate the changing legislative landscape to continue to be able to deliver treatment to their patients. By creating advisory committees and standing medical orders and guidelines for the nurses, they were able to oversee the welfare of the patients. These nurses were working to the fullest extent of their training.  

Around 1950, most nurses were in hospitals where medical and nursing boundaries were more clearly defined.  This was in great contradiction to those lone rangers of the Frontier Nursing Service, and other similar rural working nurses. In 1955 the American Nurses Association developed a model of nursing that would constrain nursing practice and lead to interprofessional conflict among nurses and physicians for the next several decades.  

“The practice of professional nursing means the performance for compensation of any act in the observation, care and counsel of the ill . . . or in the maintenance of health or prevention of illness . . . or the administration of medications and treatments as prescribed by a licensed physician . . . The foregoing shall not be deemed to include acts of diagnosis or prescription of therapeutic or corrective measures.” (ANA, 1955, p. 1474) 

Then, in 1965, nurse Loretta Ford, Ph.D. and Henry Silver, MD saw the need to bridge the gap in the health care needs of children and families in rural Colorado communities. Dr. Ford and Dr. Silver created a training program for nurses to give them advanced practice skills to be able to go into rural communities where most physicians would not go, and care for the communities there. This became the first Nurse Practitioner program.  


Pictured above. Loretta Ford, Ph.D., who served as a nurse in the U.S. Army after her fiancé was killed in World War II. She was also honored this year during a ceremony for National Nurse Practitioners week, Dr. Ford, who will turn 103 years old this December is considered “the Mother of Nurse Practitioners”.  

Despite the considerable resistance and criticism by some in the medical community, Dr. Ford and Dr. Silver successfully launched their Pediatric Nurse Practitioner program, which was then followed by Nurse Practitioner programs in Boston a few years later. By the 1970s there were more than 65 Nurse Practitioner programs in the United States. The American Nurses Association then starts to create a council on Nurse Practitioners to help legitimize the role, in part reversing its stance from the 1950s. In the 1985 the American Academy of Nurse Practitioners, which later became the American Association of Nurse Practitioners was established, creating more standards for credentialing, research, and advocacy. By 2023 there are more than 255,000 Nurse Practitioners in the United States! Dr. Loretta Ford was honored this year by the American Association for Nurse Practitioners.   

Dr. Ford notes that Nurse Practitioners were intended to work independently. “A lot of them were doing it anyway. Now this has legitimized it,” Ford said. “We were the ‘Lone Rangers.’ We had to make decisions”. However, as it stands today, Nurse Practitioners are not able to work autonomously, in every state.  

US Map

AANPs State of Practice Map: Shows which states are fully independent practice, reduced, or restricted practice states. No matter which state nurse practitioners live in, their educational standards, and credentialing remain standard. This means that in many states, Nurse Practitioners can’t practice to the level of their training and education. States that don’t have full practice tend to have larger costs associated with health care, larger discrepancies in healthcare in rural areas, and larger shortages of primary and mental health care. 

Nurse Practitioners are educated, trained, and certified to work autonomously. Professional licensure already manages professions where there is overlap. Think of Osteopathic medicine, physical therapy, massage therapists, podiatrists, etc… All those professions have different educational pathways, and all have some overlap, but also offer distinct therapies to offer patients. None of those professions have oversight over each other. An osteopathic doctor doesn’t oversee a chiropractor, a podiatrist, or a massage therapist. Each profession has undergone training, certification and licensure in their area of expertise, none of them are practicing out of their own scope, but there are some overlaps in practice.  

We still have significant healthcare shortages in many areas of the country. Nurse Practitioners are part of the healthcare team. Nurse Practitioners have been in the trenches, reservations, ghettos, mountains, on horseback in the snow to serve and care for people. Nurse Practitioners (and Registered Nurses) were also the ones still in the hospitals during COVID-19, when many physicians were at home.  

Nurse Practitioners advocate for patients, advocate for quality care, accessible care, and affordable care. Celebrate this Nurse Practitioner week by advocating for those you advocate for you, your family, your friends. Advocate for Nurse Practitioners in your state to practice to the extent of their education, training and licensure. Contact your state representative, and state nurse practitioner professional advocacy centers. When you advocate for Nurse Practitioners, you are advocating for citizens to choose their healthcare.  

Jaime Bristow, MSN, RN, BA, PMHNP-BC

LFT Health discusses self care with anxiety

Anxiety – Normal Or Not? 6 Ways To Cope With Either

We all have anxiety. Anxiety serves an essential function in humans. Without anxiety, we would be extinct. Three elements of anxiety are: 

  • psychological – what we experience in our minds, 
  • physiological – how our bodies respond 
  • behavioral – what actions we take.

In this blog, I will review normal anxiety that we have all felt compared to pathological anxiety. Pathological anxiety is the unhealthy and life-impacting anxiety type. We will review responses in the body, some general mental health care, and finally 6 tools to deal with anxiety, which help with both normal anxieties, as well as pathological anxiety.  

Words that describe anxiety
What words do you use to describe anxiety?

Why Do We Have Anxiety?

We humans need to be able to respond to our environment and to respond to challenges. Have you ever been walking down the street and come across a tiger? Well, likely not if you live in an urban/suburban area. But you may come across an angry customer or gotten into a car accident. Anxiety is part of our survival system. We feel anxious when our brains and bodies perceive threats. These perceived threats, that we may not be consciously aware of, start a cascade of processes in our mind and body. Our brain through our senses, emotions, and memory (both conscious and unconscious) will engage our stress response system. This is part of our survival mechanism. To survive, we need to quickly engage our bodies to react – without thought. During emergency situations we may not be aware of anxiety at all, and just act.  

What sensations and experiences might be activated when this happens? Let’s talk about if you have had any of these sensations.

Normal Anxiety And Pathological Anxiety

Anxiety is part of our NORMAL experience as humans. Having anxiety in reaction to perceived threat, deadlines, a test, starting a new job – all normal responses. But there is anxiety that is unhealthy also known as pathological anxiety. What makes anxiety pathological or unhealthy? In general, pathological anxiety is different from normal anxiety in that:   

  • It persists over time or does not go away even when the stressful event or time has passed.  

Example: You were in an auto accident 6 months ago, but you still feel your heart racing every time you need to drive to the store. 

  • The anxiety is uncontrollable and excessive to the point where it is affecting your quality of life. Excessive means it is out of proportion to the situation or is not age appropriate.

Example: The teenager who freaks out when mom or dad goes to work or out of town. It’s age appropriate to have separation anxiety between 6-12 months even up to 3 years old. If a teenager still has this, it would be pathological anxiety. 

Diagnoses which are considered pathological types of anxiety:  

  • Separation anxiety disorders
  • Social anxiety disorders
  • Panic disorder
  • Generalized anxiety disorder
  • Agoraphobia
  • Other specific phobias.

There are also other mental health disorders that involve anxiety as a symptom. Even though they are not classified as an anxiety disorder. These include: 

  • Obsessive-compulsive disorder
  • Post-traumatic stress 
  • Acute stress disorder 
  • Depression  

With these types of disorders, you can experience anxiety as one of the symptoms. But how and why they occur is a factor in how the American Psychiatric Association categorizes them differently, even though anxiety is a core symptom.

Anxiety affects both sexes equally. I highly recommend you listen to Adam Scroggin’s story of having a panic attack and how it can feel like you are dying.

Consequences Of Pathological Anxiety

If you think you have pathological anxiety. It is important to speak with a professional in the mental health field to explore further. Why? Because this prolonged pathological response to anxiety which is a disorder has real life impact on your health and functioning. Although it is not always the cause, anxiety disorders are associated with heart disease, high blood pressure, stroke, arthritis, asthma, gastrointestinal problems like peptic ulcers and irritable bowel disease, and chronic pain. Having a medical condition can also make you more likely to develop an anxiety disorder as well. So, make sure that you have a discussion with your health care provider. 

Body Responses to Anxiety Disorder

Some of our bodies responses to continued, prolonged, pathological anxiety.

What To Do If You Have Anxiety – The Basics

So, you have anxiety, what now? There are some great first steps to take for your general mental health, which can help you and your body be better prepared to handle anxiety, whether it is normal anxiety or a disorder.  

Basic mental health self-care:  

  • Get regular physical activity. Activity adds up. It does not have to be all at once. 30 minutes total 5 times a week is the goal, but it does not have to start there. Start slow and progress to that goal.  

  • Eat healthy, regular meals and stay hydrated. A balanced diet with protein, carbohydrates, and fat. The emphasis should be on whole foods. Also drink plenty of water, which can improve your energy and focus throughout the day. Also, limit caffeinated beverages such as soft drinks or coffee. 

  • Make sleep a priority. Stick to a schedule, and make sure you’re getting enough sleep. Blue light from devices and screens makes it harder to fall asleep, so reduce blue light exposure for 30min to 1 hour from your phone or computer before bedtime. 

  • Try a relaxing activity. Explore relaxation or wellness programs or apps, which may incorporate meditation, muscle relaxation, or breathing exercises. Try journaling, taking a hot bath, or listening to music.  

  • Set goals and priorities. Decide what must get done now and what can wait. Practice saying “no” to new tasks if you start to feel like you are taking on too much. Give yourself praise for what you DO accomplish each day! 

  • Practice gratitude. Remind yourself daily of three things you are grateful for. Be specific.  

  • Focus on positivity. Identify and challenge your negative and unhelpful thoughts. Do not ignore the negative thoughts, challenge them, and only allow them so much time in your mental life.  

  • Stay connected. Reach out to your friends or family members who can and DO provide emotional support and practical help.  


General Mental Health Care LFT Health

Remember, you do not need to do 100% of the healthy things above 100% of the time. Do them most of the time. For you it might be 70% of the time, or 95% of the time to achieve general mental health. Every individual is different.

The 6 Interventions Specific For Anxiety

Now that we have gotten down the basics of general mental health, which are foundational, we will look at 6 ways you can care for your anxiety.  

  1. Learn about anxiety! You have already started but click on some of the links. Learning about what anxiety is, and its symptoms, can help you to better identify anxiety and know how it may be affecting YOU.  

  1. Mindfulness. Mindfulness takes practice and training. It comes easy for some and can be challenging for others. Different from other meditation, it’s a focus on the present moment noticing sensations and emotions without judgement or trying to figure them out. Start with Youtube for something that is less than 5 min at first.  

  1. Practice breathing exercises for anxiety. To de-activate the anxiety systems in the brain/body, we need to activate the relaxation system. A good start is to breathe in for 3 counts (count in your head 1… 2… 3…), then hold for 2 counts (count in your head 1… 2…), then exhale for 4 counts (count in your head 1… 2… 3… 4…). Do this three times and then allow your breath to go back to its natural rhythm. Repeat this exercise 3 more times. 

  1. Physical activity… yes, again! This can be in addition to the physical activity mentioned above, or part of the routine that is our goal for general mental health. Yoga can be helpful for depression; high intensity workouts can be effective for anxiety.  

  1. Find a support group. Not only does this provide social support but can help with problem solving and learning new ways of managing your anxiety.  

  1. Grounding techniques. Grounding is a term used to bring your awareness back into your body and present moment. Different from mindfulness. These are used to help manage powerful emotions like anxiety but can also be used for other strong distressing emotions. Try one of the following.  

  • Pick a color at random. Now look around the room, making sure to move your head around to do so finding all the objects in the room that are that color. Name them aloud or in your head.  

  • Play the “alphabet game”. Pick a subject like animals, or sports teams, or cities, etc… For example, using animals, start naming animals using each letter of the alphabet in order. A… aardvark, B… baboon, C… camel…. etc… Make it challenging enough that you need to think about it a bit!  

Anxiety Care LFT Health

Anxiety is complex, but with some tools, learning and awareness, you can manage it! There are lots of other ways to manage, and even change our anxiety. If simple tools do not seem to help, continue to explore other options. There are hundreds!  

Seek help from one of the many experts out there as well. Mental health professionals all have many tools to help. They can also help with exploring the origins and types of anxiety you might be experiencing and help to tailor your treatment to make it more effective. Lastly, it does take time. Especially if you have an anxiety disorder, it takes time, retraining, coaching, and sometimes several types of therapy to care for your anxiety. But you are worth it! 

Nyjah Houston skateboarding and mental health

How Skateboarding Helps My Mental Health

COVID-19 was tough on a lot of us. I have several family members and friends who almost lost their businesses during the pandemic. Now that things COVID is under control for most of us, I am glad to hear that a lot of local businesses are doing better. This summer has been great for me. I finally feel like I can get out and do things again that I really enjoy.

Like a lot of you, I really struggled during COVID. I had a very tough time working alone at my home in the basement. It was dark and Zoom Fatigue is a really thing (especially for older people like me). I grew up working in an office and meeting with people face to face. I find it to be the most valuable way to communicate. On the flip side, I do love how hybrid is providing flexibility to working parents, people how had a far commute and those who truly want the work-life balance. I get the value proposition: you save gas, you have time to do a load of laundry, you can exercise in the middle of the day between meetings, etc.

To get out of the house, I decided to start skateboarding (aka skating) for my mental and physical health. It helped a ton. On top of that, everyone was isolated at home so I had the whole city of Carmel to myself. The Carmel Police were super cool to me. They didn’t try to kick me off public property or anything. In fact, a lot of them came up and talked to me and told me stories about how they used to skate as a kid. Some Police Officers still skate today, which is totally cool. The University of Southern California did groundbreaking research that shows that skateboarding helps people with communication and building relationships with people from diverse backgrounds. One of my idols growing up is Tony Hawk. He has done so much for the skateboarding community and to help those in need. Here is one of my favorite quotes from Tony:

Tony Hawk and LFT Health

I am doing significantly better since I started skateboarding regularly. It has allowed me to find a tribe of like minded individuals who care about me.

From my research on mental health, here are the clear benefits I received:

  • It gave me a mental break from working 10-12 hours a day.
  • It reduced my exposure to artificial light from indoor lighting and computers.
  • I got vitamin D from all of the sunshine. Studies show that natural sunlight improve mood.
  • The physical activity helps keep my body strong. The mind/body connection is a real thing.
  • I built confidence doing tricks again that I was doing in my teens and twenties.

Even Avril Lavigne is getting in on the skateboarding action. In her TikTok debut, she takes lessons from legendary skater Tony Hawk. Well done Avril!

MindScout Mental Health Platform

Press Release – LFT Health Receives First Found Of Funding To Build MindScout

For Immediate Release

LFT Health has received its first round of funding to build a mental health platform called MindScout. The funds will allow LFT Health to continue to do user research, build the first minimum viable product (MVP) of the iOS and Android app and have a working Healthcare Portal.

CEO Jaime Bristow says “the funds are critical to completing our mission to find new and novel ways of treating mental health issues using tech. It allows our development team to move quicker and validate that we are building the right product”.

Adam Scroggin and Jaime Bristow

CTO Adam Scroggin says “this allows us to work on our proprietary Machine Learning prediction algorithm and demonstrate to Healthcare Professionals a working web portal. We will be able to help with reducing costs, digitizing the intake process and assist people with living their best lives”.

The Indiana Public Health Commission estimates that $885M is lost each year due to productivity losses caused by mental health issues. MindScout will radically reduce these costs by using novel ways to approach mental health treatment.

For more information, contact jaime.bristow @

Mental Health Awareness Nurses Week

Mental Health Month during Nursing Week

Although it is mental health month, this is something that I reflect on daily in my work as a psychiatric nurse practitioner. It’s also the driving factor for me when spending time with clients and starting LFT Health where we work on creating digital solutions for healthcare. There is not health without mental health.  

We are conducting research to make sure we are building the right thing for our customers. If you have 3 minutes, please help us by completing our survey.

Mental health needs are growing

The World Health Organization notes 13% of the world’s population has a mental health disorder, and calls it, “a mental health crisis”, and that was before the Covid-19 pandemic hit. That’s an estimated 970 million people globally living with a mental health disorder. In the United States, there is around 52.9 million people who suffer from mental health disorder, that’s about 21% of our population according to NAMI. In my home state of Indiana, there are about 1,125,000 adults with a mental health disorder, ranking a meager 43 out of 50 in Mental Health America’s  ranking of adults with a mental health disorder and their ability to access care.  

This was a real lottery winning. It is also the number of individual living globally with a mental health disorder.


This was a real lottery winning. It is also the number of individual living globally with a mental health disorder.

In the United States we have 1.2 million mental health providers. For our 52.9 million people with mental health disorders. Doesn’t seem like much of a gap? Well, it is. 150 million people in America live in what is called a federally designated mental health shortage area. These areas are often rural but include urban and suburban areas as well. It can take 7-11 years for someone to initiate contact with a mental health provider. Often, primary care is the first and only contact for someone who is having mental health issues.

Solving the mental health gap

What’s the solution? Well, like pretty much everything in life, it’s complex, and there is no simple solution. Just as every individual is unique, the solutions to help every individual reach mental health access are also unique to their situation. However, we can start by addressing some of the issues with the tools we have and enhancing them with the technology at our disposal.  

Just like so many other areas of our modern life, technology has opened opportunities to address mental health care as well. The National Institute of Mental Health notes that the public, health care practitioners, and researchers have new access via smartphones, tablets, computers, and phones for help that was never available before. Many are now familiar with telemedicine since COVID.  76% of people in advanced economies and 45% in emerging economies have smartphone access. Even 70% of individuals with serious mental illness own smartphones.

All tech is not good tech

There are a lot of technological resources now to support mental health and like anything else, some are good, and some are not. Websites, tiktok, social media, youtube, and mobile apps are all teaming with mental health resources. Just like with anything else, it’s important to look at the source and content.  


    • Who is providing the content and/or application?

    • Are they credible? Meaning, do they have the education, background and experience to say or provide the content and/or application?

    • Who is funding them?

    • What is their motivation?

    • How much does it cost to access?

    • What are the safety, security and privacy issues at stake for the end user?

    • Does it fit your needs as an individual?

Need more guidance?

Finally, if you are struggling. Go to an expert. This may mean starting with your primary care, or using an EAP if your workplace has one. There are community mental health centers that provide mental health assistance, as well as charity-based therapy services, look at local universities or colleges that have psychology/social work or other mental health services. They often have programs for their students to do clinical work while they learn on a free or sliding scale basis. The students are fresh and eager and have experienced clinicians backing them up. If you know the kind of therapy you want, search on databases like  

If you have suicidal thoughts, or know someone who does, don’t wait. Call 988

Advocate, be part of the solution

As our mental health needs grow throughout the world, don’t give up. Advocate! Advocate for yourself, your loved ones, and humanity. We have tools now to help, both digital and personal, and more are coming. Hope is a powerful intervention for mental health.  

What have your experiences been with mental health digital technology? If you would like to share, take this brief survey to share your experiences. Click here!