Sara Pawlowski, MD, is a child and adolescent psychiatry fellow at the University of Vermont Medical Center.

Sara Pawlowski, MD, is a child and adolescent psychiatry fellow at the University of Vermont Medical Center.

As the weather begins to turn from summer to fall, many elevator and office small-talk conversations change from appreciation of the summer sun and crisp fall weather to pre-winter grumblings.

By now, most people have heard of seasonal affective disorder, a condition where a dip in mood coincides with a shift in the amount of daylight we have each day. What many people do not realize is that this dip in mood can happen to all of us and coincides most frequently with a change in our activities from more outdoor ones to indoor ones.

We are all vulnerable to a downturn in mood after long summer days are gone and replaced with short winter ones. It’s important to know that these mood changes can start as early as the end of the summer and fall. As we anticipate the upcoming change in seasons, here are some things to keep in mind as you prepare to transition your brain and body to the fall and winter:

Vitamin D

As I say to many of my patients, Vermonters are often at risk for having a low Vitamin D level because Vitamin D is a mineral in our bodies that requires sun to make it into its active and useable form in our bodies.

Generally, children should have vitamin D levels over 20 ng/dL and adults should have vitamin D over 30 ng/mL although there is some argument about the best level of vitamin D.

If you do notice depression symptoms, which can run the gamut from sadness, loneliness, irritability, a decreased appetite, overeating and fatigue, it may be helpful to think about your level of vitamin D. Vitamin D deficiency can be an underlying cause for depression or an additional reason for depression, especially if your depression is not responding to regular treatments like therapy and medications.

With a blood test, you can tell if you have low levels of vitamin D that require you to take a supplement in addition to a multivitamin. Vitamin D supplementation is very well tolerated and your doctor can help you learn if a low Vitamin D level may be impacting your mood.

Light Therapy Boxes

Many people – with or without seasonal affective disorder – tout the benefits of phototherapy, which is provided through the use of a light box in the morning. Many people begin using a light box as early as October or November, rather than waiting for winter to hit with its full force.

Generally, a light box is used for about 20 minutes in the morning at 10,000 lux of light about 18 inches away from the face with an indirect gaze. There are few side effects with headaches and eyestrain being the main ones. If you are considering using one to help treat your low mood with seasonal changes, it would be wise to also consult with your doctor about your mood and rule out other potential or additional causes of depression such as a low vitamin D level or an underactive thyroid.

A light box is not right for everyone. For instance, for people with bipolar disorder, a light box has been shown to potentially provoke manic or hypomanic episodes. Because light boxes are not FDA-regulated, it’s important to find one that is right for you. Talk to your doctor about what could be most beneficial for you.

Outdoor Time

As the weather changes, often the instinct is to remain inside and binge-watch Netflix. Bears would do the same thing if they had access and interest. It’s our own form of bear hibernation for the colder months! But those who enjoy the changing weather, who take it as it comes and appreciate it for what it brings, tend to fare better mood-wise in the coming months.

If Vermont downhill skiing is not for you, consider cross-country skiing or snowshoeing. If you’re on a budget, talking a walk on trails in the woods and then capping off an outside day visiting the local Maple sugar farms for “sugar-on-snow” may be a better bet. Some of our best local sunsets are the ones in the winter and they often go unseen! Keep tea and hot chocolate at home and reward yourself with a hot drink to warm up when you return.

The instinct may be to hibernate and remain indoors, but I often use the adage to “act opposite” when it comes to combatting a low mood. Our instinct may be to remain in bed because it’s cozier there, but much research has shown that this ultimately makes our moods worse over time. Try to act opposite to the urge to hibernate and see what’s out there. There may even be sun!

Overall, it’s best to approach the seasonal change with a combination of acceptance of its inevitability and some commitment and planning to work with the weather, not against it.

Sara Pawlowski, MD, is a child and adolescent psychiatry fellow at the University of Vermont Medical Center. She received her Doctorate of Medicine from the State University of New York at Downstate Medical Center in Brooklyn, New York before completing her adult psychiatry residency at the University of Vermont. Her clinical interests include the prevention of child maltreatment, bullying, adolescent and college student mental health and psychodynamic psychotherapy.

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