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The winter months are not only host to some common physical ailments – mental health can become more challenging to manage due to factors such as reduced sunlight, colder weather, and increased social isolation.
A SAD state of affairs
Seasonal affective disorder (SAD) is directly linked to the lack of sunlight in winter disrupting the body’s internal clock and leading to symptoms such as low energy, sleeping too much or too little, changes in appetite, depressed mood, and even suicidal feelings.
Kerry McLeod, head of information content at mental health charity Mind, says there is plenty of advice that pharmacy teams can give customers about avoiding or managing seasonal affective disorder, but stresses that it is important that pharmacy staff understand that “SAD is a legitimate and real form of depression” and isn’t just people feeling a bit low in the wintertime. “SAD can have a significant impact on someone’s day-to-day life,” says Kerry. “So, if a customer is concerned about how their mood is affecting them, you can recommend that they speak to a GP to discuss mental health support and treatment.”
For those looking for self care tips to manage SAD, Kerry says there are a few things to recommend: “For those of us with winter SAD, making the most of natural light – such as spending time in parks or gardens, or simply sitting near a window – might help. Planning ahead for winter can also help – for example, making meals in advance and freezing them if you know you may lack energy to do this during a difficult period. People might find it helps them to keep a note of their symptoms, including when they start and if particular things seem to trigger them, like changes in the weather, to notice any patterns and explain how they are feeling to a GP.”
Depression and anxiety
Depression and anxiety can also intensify for some people during winter as reduced physical activity, darker days and isolation increase stress and worry.
However, Kerry says that it is important to not make assumptions about how certain weather or seasons will impact someone: “Some people might be more impacted by the summer months, or some people might not find the seasons impact them much at all, but it is okay to check in with people to see how they are feeling if you notice a change in their mood or behaviour.”
As people may turn to pharmacy teams for advice, it is important to know the best way to communicate on the topic. “Asking supportive, open questions about how they feel will lead to a better conversation,” Kerry says. “Based on how they respond, you may be able to signpost them to services you are aware of. This could be their GP or a local mental health charity if they feel they need specific mental health treatments and support, or if they are feeling isolated, you may have services or programmes in your local area you could signpost them to.”
There might be practical concerns that are impacting customers’ mental health, such as financial pressures of higher energy bills in the winter, so knowing local services to signpost people to for support in their area can also help.
Boosting nutrient intake
Millions of adults and children could also be at increased risk of infections this winter unless they tackle their persistent low nutrient intakes, according to the latest scientific review entitled ‘British Dietary Habits and Declining Nutrient Intakes’ from the Health and Food Supplement Service (HSIS).
“Our in-depth analysis revealed sizeable shortfalls in intakes of essential micronutrients across the UK,” says nutritionist and review co-author Pamela Mason. “Besides the worrying findings on folic acid, a range of other nutrients were affected, many of which are key in helping to protect us from common illnesses, especially winter bugs. Notable examples are vitamin D, iron, zinc and selenium. As it takes time and effort to get our diets back on track, we suggest that people top up with a daily multivitamin and multimineral supplement.”
Indeed, while the winter months are notorious for coughs, colds and sore throats, Cara Shaw, nutritionist and spokesperson for liquid iron supplement BlueIron, says: “It’s important to note that it is common to see people with low iron experience frequent infections and poor recovery from things like the common cold, so if someone is noticing recurrent illness and/or poor recovery, it's time to get iron levels checked.”
“Winter can worsen conditions like loneliness-related depression or anxiety”
‘Tis the season
The festive holidays are definitely something to look forward to during the darker months, but the overindulgence these can encourage could leave customers looking for over-the-counter (OTC) treatments and self care advice.
Feeling the burn
Indigestion – or dyspepsia – is one of the most common results of dietary overindulgence and happens when stomach acid breaks down the protective lining of the digestive system as a result of incomplete digestion or delayed emptying of the stomach, causing irritation and swelling.
Most indigestion and heartburn can be treated with lifestyle changes and OTC medicines. Cutting down on rich, fatty foods, alcohol, and caffeinated or fizzy drinks is a good place to start. Being overweight or a smoker is also something to address, and pharmacies running weight management or smoking cessation services can tactfully signpost customers to these.
Pharmacies are also well-stocked with OTC products that can help. Simple antacids work to neutralise excess stomach acid following short periods of overindulgence, but customers experiencing more persistent indigestion may benefit from a referral to the pharmacist or their GP, as many of the medicines to tackle this need a prescription. Customers should also talk to the pharmacist if they want to use indigestion remedies but have liver or kidney problems, are pregnant or breastfeeding, are on a low-salt diet or are lactose intolerant.
Hangover helpers
UK alcohol education charity Drinkaware claims almost two thirds (61 per cent) of drinkers in the UK over-indulge with alcohol over the festive season, while one in five (18 per cent) say they typically suffer more hangovers during this period.
Top tips for avoiding a festive hangover include choosing a smaller glass size and alternating alcoholic drinks with soft ones. If a hangover hits, rehydration can help ease symptoms, alongside paracetamol to help reduce headaches, and antacid to settle an upset stomach.
Stomach summersaults
There are plenty of reasons why people can feel – or be – sick. For example:
- Diarrhoea or vomiting from norovirus or food poisoning
- Headache and a high temperature from an infection such as flu
- Headache and sensitivity to light or sound could be caused by migraine
- Morning sickness from pregnancy.
Eating foods and drinks containing ginger or peppermint can help to settle the stomach as well as helping with flatulence and cramps. Choosing smaller meals of bland foods can also help, until the nausea passes.
People who are vomiting may become dehydrated, so pharmacy staff should advise them to sip water little and often. Pharmacy teams should also recommend customers call 111 or see their GP if their nausea continues, and anyone who suddenly feels sick and has chest pain that feels tight or heavy; pain that spreads to their arms, back, neck or jaw; and shortness of breath should call 999 immediately, as these can be signs of a heart attack.
Susceptibility and self care
Some people with bipolar disorder may find themselves more susceptible to depressive episodes during the winter, but offering advice and support can empower customers to take proactive steps and improve their overall stability during difficult times.
“By providing proactive, compassionate interventions, pharmacy staff can play an important role in helping individuals with bipolar disorder reduce the impact of seasonal depressive episodes,” says Reshma Malde, pharmacist at John Bell & Croyden, London.
Reshma suggests pharmacy teams can offer advice and support such as: “Emphasising the importance of sticking to prescribed medication schedules, as even minor inconsistencies can impact mood stability, and offer a repeat prescription service, if your pharmacy has one, to ensure their medications are ordered and ready in time.”
Self care advice can also be useful, with Reshma adding the importance of a balanced diet. She suggets “a balanced diet rich in nutrients like omega-3 fatty acids, magnesium, and vitamin D, which may support mood stability, as well as light, regular physical activity such as walks or gentle stretching and simple relaxation methods such as deep breathing, meditation or mindfulness to help manage stress and reduce the risk of mood swings.”
“Two thirds of drinkers in the UK over-indulge with alcohol over the festive season”
Lonesome lows
Winter can worsen conditions like loneliness-related depression or anxiety as the colder weather and longer nights lead people to stay indoors, reducing social interaction and physical activity, both of which are beneficial for mental health.
“For many of us, feeling lonely is linked to low self-esteem or self-confidence, or in the winter it might be harder to meet up with people due to the weather and darker days,” says Kerry. She recommends signposting people to accessible and supportive in-person and online groups such as book clubs, classes or volunteering, or free online communities such as Mind’s Side by Side (sidebyside.mind.org.uk).
Reshma says pharmacy staff can also support customers who may be experiencing loneliness and social isolation by “ensuring the pharmacy feels like a welcoming space where customers feel comfortable stopping by for a chat or support”. Checking in with regular customers to ask how they are getting on with the change of season can help teams recognise early signs of mood shifts and recommend proactive steps to help customers protect their mental health all winter long.
Throats and noses
Soothing sore throats
Around half of the population will have at least one sore throat a year – usually caused by a viral or bacterial infection – according to charity The Selfcare Forum. Most throat infections clear up by themselves after a week or so with no need for antibiotics, but in the meantime, there is plenty pharmacy staff can recommend that might help relived the symptoms.
Jacquie Lee, Numark medication safety officer and information pharmacist, says some of the most important self care advice tips to pass onto customers for treating sore throat at home include:
- Drink plenty of water
- Eat cool or soft foods
- Take pain relief such as paracetamol or ibuprofen
- Use local anaesthetics sprays or lozenges, to help with pain relief by numbing the area – but for no longer than five days
- Suck local antiseptic throat lozenges
- Demulcents such as glycerin, honey and lemon are useful for children, pregnant and breastfeeding women
- Use a humidifier in dry rooms or take a warm shower to add moisture, which can relieve throat dryness and irritation
- Stay away from smoke, pollution and harsh cleaning agents, which can worsen irritation
- Get plenty of rest and sleep to boost the immune system and speed up recovery.
Some customers may prefer traditional herbal remedies such as echinacea or pelargonium products. In an era where antibiotic resistance looms large, echinacea is now under the scientific spotlight, with a growing body of evidence showing its potential in not only preventing respiratory tract infections (RTIs) but also significantly reducing the need for antibiotics.
A recent study titled ‘Echinacea Reduces Antibiotics by Preventing Respiratory Infections: A Meta-Analysis (ERA-PRIMA)’ published in 2024 Antibiotics (bit.ly/3DhYSE7) claims that alcoholic extracts from freshly harvested Echinacea purpurea were among the strongest in the fight against viral infections and offered a wide spectrum of activity against enveloped respiratory viruses, including influenza viruses.
“One of the key findings was a 32 per cent reduction in the likelihood of contracting an RTI when using echinacea,” explains immunologist, Jenna Macciochi. “People using echinacea were about 40 per cent less likely to experience another infection compared to those who did not use it.” But perhaps the most striking finding was echinacea's impact on reducing antibiotic therapy needs. “People using echinacea were 40 per cent less likely to require antibiotics for their infections,” adds Jenna. “The total number of days people needed to take antibiotics was reduced by 70 per cent, showing a significant decrease in dependency on these drugs.”
Congestion concerns
When temperatures drop, the body tries to arm itself the best it can and this can lead to unwanted symptoms such as nasal congestion.
The sinuses are connecting cavities in the skull that sit behind the nose, cheeks and forehead. The combination of cold, dry winter air and the warm air indoors can leave the sinuses feeling dry. This can lead to an overproduction of mucus, congestion and create pain and pressure in the sinuses.
When the nasal passages become congested with mucus, it creates a blocked feeling in the nose and sinuses which normally lasts for a few days, or for longer – depending on the cause. A cold, flu or sinusitis can be common causes of nasal congestion in the winter months. Though most instances of congestion will improve on their own, pharmacy teams can be on hand with self care advice and over-the-counter (OTC) solutions to help tackle symptoms. This includes:
- Steam inhalation
- Decongestant drops, sprays or tablets
- Salt water (saline) solutions
- Steroid sprays.
Customers experiencing nasal congestion for two weeks or more should be referred to their GP.
Resources
- Mind: mind.org.uk/SAD
- The Health and Food Supplements and Information Service: hsis.org
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