Feeling SAD About Shorter Days?
by Patricia Summers, Marriage & Family Therapy Intern
For many people, autumn is their favorite time of year with its crisp air, the aroma of fallen leaves, and the return of longer, cooler nights. For others, however, the shortening of daylight hours in our northern hemisphere brings with what many call the “winter blues.” However, if a ‘blue mood’ persists for more than a few weeks, its important to determine if you have a more serious condition—depression.
What are the Signs and Symptoms of Depression?
Depression has many causes: Adjustment to stressful life events, medication side effects, hormonal imbalances, pain, major losses, chronic medical conditions, seasonal changes, and many other factors can lead to depression. Regardless of the cause, depression might be the problem if you or someone you know is feeling sad, tearful, hopeless, or “empty,” and/or noticing a dramatic decrease in interests or significant loss of pleasure in activities, in addition to a number of the following symptoms:
- Substantial gain or loss of weight without intentional changes in diet;
- Changes in sleep patterns such as daily difficulty falling or staying asleep, or sleeping too much;
- Loss of energy or frequent fatigue;
- Feelings of worthlessness or guilt (in children and teens this might look like irritable moods);
- Difficulty concentrating, decreased ability to think, or more trouble making decisions;
- Frequent thoughts of death, including ideas of suicide—with or without a specific plan.
Finally, if you or someone you know with some or all of these symptoms nearly every day finds it difficult to be involved in the usual social events, work, school, or other important daily activities, it is time to visit a medical or mental health provider for an assessment.
Is it Depression or SAD?
Seasonal Affective Disorder (or SAD for short), is one type of depression which researchers believe to impact approximately five percent of the population each year. The symptoms for SAD are similar to those of other forms of depression, however, it is the timing of symptoms that sets SAD apart. Other forms of depression can occur at any time of year. According to doctors at the Mayo Clinic, SAD usually begins in the fall and continues throughout the winter months. Although less common, some individuals experience SAD at the opposite times of year—experiencing depression in spring or early summer. The doctors of Mayo Clinic warn that you should not ignore these kinds of symptoms as just a “seasonal funk” or “winter blues.” There is no need to tough it out, and when treatment is started early, it tends to be more effective and more likely to prevent complications.
Who is At Risk for SAD?
Women are more often diagnosed with SAD than men. Having a blood relative with SAD or another form of depression also places you at risk. For those who have already been diagnosed with major depression or bipolar disorder, symptoms may be worse during seasonal periods. Research has also shown that people living further from the equator are more likely to experience SAD. While no specific source for SAD has been found, most theories point to the lack of exposure to sunlight as its cause. Reduced levels of sunlight in winter are thought to upset the body’s internal clock (or “circadian rhythm”), which can trigger a drop in serotonin levels (a chemical in the brain that affects mood) as well as disturb the balance of melatonin (another chemical in the brain that helps to control mood as well as sleep).
What is the treatment for SAD?
Experts recommend you seek the advice of a health professional to assess your symptoms and work with you to find what treatment option(s) make the most sense. In Colorado, we are fortunate to have access to natural sunlight for much of the winter, so taking a daily walk in full sunlight might have the dual benefits of physical exercise and bright light exposure (just remember to apply sunscreen first). In addition to standard treatments for depression, such as psychotherapy, medications, or a combination of these, Hartwell-Walker notes that SAD can be treated with daily, pre-dawn phototherapy—that is, time spent under a very specific type of artificial, bright light (although other times of day may work, too). The specialized lightbox mimics natural sunlight’s signals to the brain as received through the eyes. Research has shown this treatment brings some relief for many people within four consecutive days of treatment, with roughly half of those exposed finding significant improvement in symptoms after a full week. Hartwell-Walker states that some might develop “side effects such as eyestrain, headaches, and difficulty sleeping” yet notes adjustments to the treatment usually provide relief. Experts also recommend a visit with your eye care professional as well as medical or mental health provider before beginning treatment.
How Long Does Treatment for SAD Last?
Whether using medication, psychotherapy, and/or phototherapy, experts note that consistency of treatment throughout the late fall and winter seasons is important in order to effectively deal with symptoms of SAD. As with many forms of treatment, Hartwell-Walker says the benefits of phototherapy are likely to be lost quickly if daily exposure to this specialized form of artificial light is cut back or stopped entirely before the longer days of spring return. Once diagnosis is confirmed, which Blaszcak notes requires more than one season of symptoms), treatment can begin before a full onset of depression hits, limiting and/or preventing symptoms from impacting your health, lifestyle, or ability to function well.
References:
American Psychiatric Association. (2013). Depressive disorders. Diagnostic and statistical manual of mental disorders (5th ed, pp. 155-188.). Arlington, VA: American Psychiatric Publishing.
Blaszczak, J. (2016). 10 things you didn’t know about seasonal affective disorder. Psych Central. Retrieved on October 21, 2018, from https://psychcentral.com/lib/10-things-you-dont-know-about-seasonal-affective-disorder/
Grohol, J. M. (2016). Seasonal affective disorder. Psych Central. Retrieved on September 8, 2018, from https://psychcentral.com/lib/seasonal-affective-disorder/
Hartman-Walker, M. (2016). Shedding light on winter depression. Psych Central. Retrieved on September 9, 2018, from https://psychcentral.com/lib/shedding-light-on-winter-depression/
Mayo Clinic. (2017, October 25). Seasonal affective disorder (SAD) symptoms and causes. Mayo Clinic. Retrieved October 21, 2018, from https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651