Cold weather and less daylight can make anyone feel down. The reduced light and warmth may leave you feeling melancholy, irritable, or tired. If these feelings recur each year and make it difficult to function during the winter months, you may be suffering from seasonal affective disorder, otherwise known as SAD. This form of depression can affect your health, relationships, and everyday activities.

Evy Smith talks to us about what SAD is and how to prevent or treat it. Smith is a counselor with the Employee and Family Assistance Program at the University of Vermont Medical Center.

What is seasonal affective disorder?

Evy Smith: Seasonal affective disorder is a type of depression that recurs each year at the same time, with onset during the fall and winter months. It can run throughout the winter and end in spring, around March or April. The set of symptoms was first observed in 1845, but not officially named until about the early 1980s. Researchers noted a cause-and-effect relationship between seasonal light variations and mental health. So, being part of nature, it would certainly make sense that our physical and mental energy might have a tendency to shift, somewhat during the change of seasons.

How do we diagnose SAD?

Evy Smith: We diagnose SAD diagnosed when symptoms occur every day over a two-week period for at least two years in a row. We also look to see if it interferes with daily functioning to the degree that a person notices that their work or personal relationships are affected. Typically, the symptoms might also be more severe to the point of not being able to function on a daily basis in areas such as work, hygiene, meal preparation, and so forth.

If these symptoms become so severe that that a person can’t function, it might be an indication that they need to seek deeper evaluation through the medical arena. If somebody expressed thoughts or feelings of suicidality, that would be an indication of a more severe form of depression, and would require immediate intervention of a medical nature through either a crisis service, or emergency consultation with a primary care doctor, or a psychiatrist.

Who is at risk for SAD?

Evy Smith: That’s a good question. There are some factors around gender, population, and age. SAD occurs more among people living in the Northern Hemisphere, as we could imagine. Or in higher altitudes, where the weather is subject to more extremes.

Typically, women are more affected by Seasonal Affective Disorder. I think part of the reason for that might have to do with women’s emotional nature and tendency to express emotions, and not hold them in. It’s also true that women tend to be multitasking with career pursuits and adapting in combination with starting new families and juggling all of the accompanying stressors. Anywhere from two percent to ten percent of Americans are affected by seasonal affective disorder. Three-quarters of that group are women in their 20s and 40s.

What causes seasonal affective disorder?

Evy Smith: It’s not just one cause. From a biological standpoint, light is a major factor and a major reason why seasonal affective disorder exists. There’s a documented drop in serotonin production, which is activated by light. We also see an increase in melatonin, also known as “the sleep hormone.” There are also changes in Circadian rhythms caused by decreased exposure to light. These shifts in brain chemistry are related to depressive symptoms.

Other causes include heredity, chemical composition, stress factors, self-attribution or patterns of thinking and/or expectations, along with lifestyle choices.

I think the stress of the impending holidays, plus the cold weather and extra financial burdens, along with the natural shifts of energy, create stress that may affect the brain chemistry and our overall sense of wellbeing.

What are the symptoms of SAD?

Evy Smith: Symptoms of SAD include fatigue, a need for increased sleep, insomnia, headaches, decreased level of energy, heaviness in the arms and legs, overall lethargy, tendency to forget things, weight gain, and social isolation. Carbohydrate cravings are also part of the symptom profile.

There is a summer seasonal affective disorder that has also been identified, which can begin in the light spring or early summer, and end in the fall. Symptoms with this disorder include weight loss instead of gain.

What are the next steps for someone with symptoms?

Evy Smith: If you are concerned about your symptoms, seek out medical assessment and evaluation. Talk to your primary care doctor to determine whether counseling or medications are an option.

Cognitive behavioral therapy is helpful. That’s working with a counselor or coach to practice stress management skills. That includes activities such as:

  • • Positive self-talk, or affirmations
  • • Visualizations
  • • Emotional positivity
  • • Enhancing social support networks and connections
  • • Increased exercise
  • • Getting outdoors, even on cloudy days, to have exposure to natural light
  • • Increasing vitamin D levels, by eating more fish, cheese, and egg yolk, which contain high levels of vitamin D
  • • Practicing good sleep habits

We also recommend that those who use tobacco or have excess amounts of sugar or alcohol minimize or eliminate them altogether.

What is the Lightbox approach?

Evy Smith: Lightbox therapy is available and can be easily purchased online or through pharmacies. It does involve sitting a few feet away from a lightbox for about 10 to 20 minutes per day, ideally, in the morning. The lightbox activates the brain chemistry in a favorable manner. It is suggested that a person not look directly at the lightbox, but allow the light to come into the side or the peripheral vision in order to avoid damage to the eyes.

I also strongly suggest natural approaches, like increasing the natural light in your home or workplace, if possible. Getting outdoors, even on cloudy days, taking walks, and getting to a regular routine of well-rounded nutrition to include foods that will boost your mood, fruits, vegetables, and whole grains.

Try exercise that is fun for you, that makes it easy to get that exercise. Join a book club or a class of interest. Do some of the things that you enjoyed doing as child, like dancing, sledding, and skating. And definitely, I can’t say enough about getting sufficient sleep. Some other hobbies and social activities that people choose that just bring fun to their life is a key piece. There are no ill side effects for many of these activities, and they can at least be helpful.

If the symptoms persist, consult a therapist or a primary care physician for further evaluation. Our Employee and Family Assistance Program at the University of Vermont Medical Center is available for depression screenings and to work with you on a plan of action. We are here to help.

 

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