When the darker days set in, nights are longer and days are colder it is natural to feel a slight dip in energy levels. Feeling stuck in the house, cranky and in need of a nap are not uncommon when the weather is bad. But, it has been found that some people are more susceptible to feeling down when winter comes around, experiencing symptoms not unlike depression.
This has come to be known as Seasonal Affective Disorder (SAD). The effects vary in severity, but include fatigue, loss of interest and appetite, feeling of despair and even suicidal thoughts that only occur during the winter months.
Rosentha and Wehr describe SAD in their study published in 1987:
Seasonal affective disorder (SAD) involves recurring episodes of depression, mania, or hypomania during certain seasons. Criteria for a diagnosis of SAD include a previous depressive episode, fall–winter depression alternating with non-depressed periods during spring–summer, and no other variables accounting for mood changes. SAD is most frequent in women aged in their 30s and is accompanied by atypical vegetative symptoms.
More recently in 2006 Lurie, Gawinski, Pierce and Rousseau added to this with their study:
Patients with seasonal affective disorder have episodes of major depression that tend to recur during specific times of the year, usually in winter. Like major depression, seasonal affective disorder probably is under diagnosed in primary care settings. Although several screening instruments are available, such screening is unlikely to lead to improved outcomes without personalized and detailed attention to individual symptoms.
In the twenty years that lapsed between the studies there does not appear to have been much change in the understanding of this disorder. The studies agree that the effects on an individual can be severe in nature and this is the reason for the continued search for the cause.
Doctors Partonen and Lonngvist found that abnormal melatonin metabolism was not to blame, as had been previously thought.
Brain serotonin was seen to show disturbed activity in those suffering with SAD and the conclusion was that exposure to light in the morning could be beneficial. For those individuals who do not respond to light, they suggested that antidepressants should be considered.
SAD was at first believed to be related to abnormal melatonin metabolism, but later findings did not support this hypothesis. Studies of brain serotonin function support the hypothesis of disturbed activity. The short-allele polymorphism for serotonin transporter is more common in patients with SAD than in healthy people. Atypical depressive symptoms commonly precede impaired functioning, and somatic symptoms are frequently the presenting complaint at visits to family physicians. The best treatment regimens include 2500 lx of artificial light exposure in the morning. When patients seem to have no response or to prefer another treatment, antidepressants should be considered.
Lurie, Gawinski, Pierce and Rousseau echoed the advice to use light therapy in the morning, but mentioned the importance of substance abuse as a contributor to depression. Once again they suggested that drug therapy was another option to consider.
Physicians should be aware of comorbid factors that could signal a need for further assessment. Specifically, some emerging evidence suggests that seasonal affective disorder may be associated with alcoholism and attention-deficit/hyperactivity disorder. Seasonal affective disorder often can be treated with light therapy, which appears to have a low risk of adverse effects. Light therapy is more effective if administered in the morning. It remains unclear whether light is equivalent to drug therapy, whether drug therapy can augment the effects of light therapy, or whether cognitive behavior therapy is a better treatment choice.
Suggestions for Natural SAD Therapy
Artificial light has been found to be beneficial, but what your body is really craving is natural sunshine on your skin. Of course keep in mind that the sun can be damaging, but try to get out and about through the winter months. Taking a walk or even sitting by a window can all contribute.
Resist the temptation to load up with comfort foods. No matter if your urges are telling you to prepare for a long hard winter, you are not actually going to hibernate! Stay fresh with lots of fresh fruits and vegetables to stop your system from becoming sluggish.
Friends and Family
Have fun and life your spirits by spending time with the people that you love. Share a cup of tea or a game of monopoly to keep your mind active even if it is not possible to get outside.
Look for fun winter sports to try – they will get you off of your couch and who knows….you might just have fun! If sports are not your thing look for a new hobby or volunteer. Whatever you do, keep active and in touch with people to help stop the downward spiral of depression.
SAD is a real issue, and it can have a terrible impact on the lives of individuals. If you are struggling with symptoms that you think could be SAD, do not suffer in silence. Do not feel ashamed. Consider seeking the help of a professional. They can determine if you are suffering with SAD and suggest therapy that can help, with long-term benefits such as cognitive behaviour therapy.
We clearly need more research to help us fully understand the causes of SAD and how it can be treated. For now, there are things that we can do to help with some of the milder cases, and if it is unmanageable then approaching a doctor would be recommended.
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