Most people struggle with the “winter blues” when navigating seasonal change or the “holiday blues” which is a correlation of stress during holiday season. However, some people have a harder time coping with the seasonal change that results in thought, feeling, and behavioral changes. This is called Seasonal Affective Disorder (SAD). SAD is a form of depression that occurs in the darker months of the year often starting in fall lasting through spring (typically around daylight savings start and end).
Who is at risk for SAD? In short, everyone living in places of changes in sunlight. SAD is more common in people with depression, a bipolar disorder, ADHD, an eating disorder, and anxiety disorders. It is most common in northern areas of the world with less cases near those living closer to the equator where the sunlight is more consistent.
This can look like a decrease in energy, increase in fatigue, or feeling slowed down; difficulty concentrating, remembering, or making decisions; changes in sleep or appetite (oversleeping or overeating are common); physical aches or pains, headaches, cramps, or digestive problems; sad, anxious, or feelings of emptiness; feeling hopeless, guilt, worthless, or helpless; loss of pleasure and joy in things you typically enjoy; and in extreme cases thoughts of death or suicide can occur. If you or anyone you know is experiencing thoughts of death or suicide, go to the nearest emergency room or call 911. While therapy is an appropriate form of treatment for depression, it is not appropriate to wait for your next appointment in times of crisis.
SAD is influenced by our bodies production of melatonin, a sleep regulation hormone, which helps to run our circadian rhythm regulated by the sunlight. When our sunlight exposure changes, our bodies have a hard time adjusting resulting in symptoms of SAD as our bodies overproduce the hormone. Reduction in serotonin levels and vitamin D levels are also impacted by low sunlight exposure. This explains why the transitions into fall and spring are most noticeable times of the year with winters feeling emotionally, mentally, and physically heavy.
So, what can we do since we don’t have control over the season? Here’s a few tips:
· Light Therapy: this can be in the form of being out in sunlight as much as you can. Because this isn’t always an option, I recommend using a Light Therapy Box daily. Light Therapy Boxes (such as ones found on Verilux.com I do not receive any compensation for recommendations or advertising of products. This is to be referenced as an example only). Light therapy works by stimulating the production of serotonin and melatonin naturally. Here’s how to use it: every morning, sit in front of the light box (approximately 6-12 inches in eyesight without starring directly at it at 10,000 lux) every day for about 30−45 minutes. The light box, which is about 20 times brighter than ordinary indoor light, filters out the potentially damaging UV light so it’s safe to use (people with certain eye diseases or people taking certain medications that increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision. Those with anxiety or mood-related disorders might find this amount of time or brightness to be more agitation. I recommend starting with 20 minutes each morning and adjusting as needed.).
· Psychotherapy: Cognitive Behavioral Therapy (CBT) works to help by exploring and changing thoughts and perceptions of current situations out of our control. CBT-SAD is focused on shifting our views on the winter months. For example: instead of viewing snow as cold and bothersome, change this into an opportunity to try a new winter activity like skiing, snowboarding, snowshoeing, or even building a snowman! Behavioral Activation is another therapy technique that encourages the use of completing tasks (both for “mastery”/the “to-do list”/things we need to get done and for pleasure/things we enjoy) to help cope with the dark days.
· Antidepressant medication: if you have severe symptoms of SAD, you should talk with your doctor to explore if an antidepressant medication is right for you.
· Vitamin D: I highly recommend meeting with your doctor to test your vitamin D levels. If you are vitamin D deficient, your doctor will talk to you about your options for increasing your levels. Most of the time, this is in the form of a supplement. You’ll want to make sure you talk with your doctor about starting any supplements has some may have interactions with medications and to confirm the supplement is needed.