Part of the Get Through the Winter series from Silver Hill Hospital
When people feel more depressed in the winter they often toss it off as a simple case of “winter blues.” And that may well be the case. After all, it’s cold, dark, and by default, we spend a lot of time indoors.
But if the steps we discussed in “,” don’t help, you may also be experiencing Seasonal Affective Disorder or SAD, and you would not be alone. The American Academy of Family Physicians reports that four to six of every 100 people may have winter depression, or SAD. Another 10% to 20% may have a mild case.
What is Seasonal Affective Disorder?
According to the National Institute of Mental health, most symptoms of SAD begin when daily body rhythms go out-of-sync with the sun. There are cases of SAD in the summer months, but in general, it occurs in the winter.
Dawn comes late and dusk is early. We end up waking up in the dark and then it’s dark well before we are ready for sleep. For many of us, our mood becomes negatively affected. For some, the change in the light cycle can even cause depression. SAD is more prevalent in northern latitudes and is four times more common in women than men. Symptoms can appear as early as August and last until April.
Onset of SAD often begins in the early twenties, but school children and adolescents can also fall victim. In this case, it is usually parents and teachers who suspect something is amiss and will need to take action.
Check with a clinician if you experience a prolonged depression with a change of the seasons, you find yourself sleeping at all the wrong times, or you have any of these conditions:
- Increased appetite with weight gain (weight loss is more common with other forms of depression)
- Less energy and ability to concentrate in the afternoon
- Loss of interest in work or other activities
- Slow, sluggish, lethargic movement
- Social withdrawal
- Unhappiness and irritability
The main treatments for SAD are light therapy, medications, and psychotherapy, and it usually responds quite well.
Light therapy, also called phototherapy, involves sitting a few feet from a specialized light therapy box so that you can be exposed to bright light. An ordinary light bulb will not suffice. The light box must produce the artificial equivalent of early morning light, or 2500 to 10,000 lux, to be effective. It can then be adjusted downward if necessary.
This type of therapy mimics the light outdoors and seems to cause a positive change in brain chemicals linked to mood. It also helps reset biorhythms to their more natural state. Nausea, eyestrain, irritability or headaches are side effects, but are uncommon. Speak to your doctor and mental health professionals before starting light therapy. Patients with Bipolar Disorder, or anyone on a mood-stabilizing drug, must first check with their psychiatrist before beginning light therapy.
Often people with SAD benefit from certain antidepressants, especially when their SAD is seriously impacting their ability to function on a daily basis. Keep in mind that it may take a couple of weeks for the benefits of the medications to be felt. Your doctor may need to try different medications in order to find the one that works best with the least side effects as well.
Some patients also find that taking melatonin in the afternoon in addition to morning light therapy is effective. Check with your physician. Melatonin can also make you sleepy, and the last thing you need is to further alter your sleep schedule.
Addressing mood and behavioral issues in psychotherapy can increase the effectiveness of light therapy and/or medications. Psychotherapy can help to identify negative thinking patterns that increase feelings of depression. There is also evidence that identifying feelings and talking about them in a supportive environment actually changes the way the amygdala portion of the brain functions. This is the part of the brain that handles strong emotions. Psychotherapy can help mediate the response in this basic brain circuit and decrease feelings of sadness.
Seasonal Affective Disorder is a real mental illness. Let no one tell you otherwise. By using a combination of light therapy, medications, and/or psychotherapy, the symptoms of SAD can be alleviated. In conjunction with these, eating right, exercising and getting outside for the winter sun are also important. There is absolutely no reason to suffer with SAD through the winter without help.
-- Bradley W. Bloom
Licensed Clinical Social Worker
Silver Hill Hospital
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Silver Hill Hospital’s blog is intended only to provide information; it is not intended to provide diagnosis or treatment. If this is an emergency, please call 911.