Do the short, gray days of winter leave you not feeling like your perky old self? It’s normal to experience a bout of the winter blues, but if you routinely feel sad for no reason, have trouble sleeping, and regularly spend your days lounging on the couch, eating comfort food and binge watching your favorite shows, you might be experiencing seasonal affective disorder.
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SAD, also called seasonal depression, is a form of depression that generally happens in the late fall, when there is less natural sunlight and the days become shorter and colder. (Seasonal depression can also happen in the summer, but that is much less common.)
Women are more likely than men to experience SAD, and it’s more commonly seen in cloudy parts of the country or areas farther away from the equator.
Symptoms of SAD include:
- Feelings of sadness or a serious mood shift when the seasons change.
- Lack of energy.
- Cravings for carbohydrates.
- Loss of interest in pleasurable activities, including loss of sexual interest.
- Difficulty with sleep, either by sleeping too much or experiencing insomnia.
Here are three ways you can have a brighter mood and combat SAD this winter.
- 5 natural cures for seasonal affective disorder (SAD)
- Seasonal Affective Disorder (SAD)
- What is Seasonal Affective Disorder (SAD)?
- What are the symptoms?
- What are the causes of seasonal affective disroder?
- How is SAD diagnosed?
- What is the conventional treatment?
- What therapies does Dr. Weil recommend for SAD?
- Treating SAD with Natural Remedies
- Wintertime blues: How to manage seasonal depression
- Is seasonal depression real?
- Treatments for SAD
- Mind over weather: Making the most of winter
- Help patients cope with seasonal affective disorder and stress
- Natural Treatments for SAD – Seasonal Affective Disorder
- Treatment – Seasonal affective disorder (SAD)
- Light therapy
- Are You SAD This Winter? Coping with Seasonal Affective Disorder
- 4 Ways to Deal with Seasonal Affective Disorder
1. Try an exercise program
Most people naturally spend less time outside and, as a result, decrease their physical activity in the winter (because, brrr). But if you think you may have SAD, pushing yourself to exercise is a good way to combat it, says psychologist Scott Bea, PsyD.
“Moving your body will compete with that tendency to be sluggish and can produce good brain chemistry,” he says.
Look for indoor activities that you enjoy, such as yoga or running on a track or treadmill, or try winter activities like skiing or snowshoeing to make the most of the cold weather.
During the wintertime, the urge to hunker down and stay home can result in less social interaction, too.
If this sounds like you, Dr. Bea recommends that you try to push yourself to regularly connect with others. Often, once you make the effort, social interaction can lift your spirits.
The key is to get your attention and thoughts away from yourself, he says.
“Creating a new social obligation or inviting people into our homes can motivate us, because then there’s an obligation to entertain or to spruce up your house,” Dr. Bea notes. “Anything that forces your hand toward activity to being engaged outside of self-awareness would be useful for people with SAD.”
3. Use light therapy
Experts believe SAD is triggered by changes in our exposure to sunlight. Studies have shown that daily light therapy, which is sometimes called phototherapy, may help improve mood in 60 to 80% of people with SAD.
Light therapy is administered by a device that contains white fluorescent light tubes covered with a plastic screen that blocks ultraviolet rays. Light therapy boxes range in intensity, up to 10,000 lux of light. Many health professionals recommend treating SAD by sitting in front of 10,000 lux light for 30 minutes every morning, Dr. Bea says.
It’s generally safe and well-tolerated by most people, but those with certain conditions shouldn’t try it, he explains: “Light therapy is not appropriate for those with conditions such as diabetes or retinopathies or who are taking certain medicines, because of the potential risk of damage to the retina.”
Dr. Bea also recommends eating a well-balanced diet, which includes sufficient amounts of vitamins and minerals.
“This will help you have more energy even though your body is craving those starchy foods and sweets,” he says.
If your depressed mood sticks around for more than two weeks, talk with your doctor. Medication or psychotherapy may also help.
5 natural cures for seasonal affective disorder (SAD)
As you would expect, cases of SAD are much higher in cold, dark places but it is also largely a symptom of the modern world. It is estimated that 75% of the population used to work outdoors in natural outdoor light as opposed to only 10% presently. Concentrated city environments all see a higher number of sufferers due to high office hours and less time spent outdoors.
Symptoms usually occur around October/November time when the days shorten and the light diminishes. These will persist through to late February/March and disappear through spring.
Do you know that you suffer from SAD?
What are the Symptoms of SAD
There are several symptoms associated with SAD but here are the most common ones:
– Lethargy, lacking in energy, unable to carry out a normal routine
– A need for more sleep, while still suffering from low energy during the day and experiencing disturbed nights
– Anxiety, inability to cope
– Social problems, irritability, not wanting to see people
– Sadness and light depression, feelings of gloom and despondency for no apparent reason
– Increased appetite, with a particular craving for carbohydrates and foods containing sugar
5 Ways to Treat SAD Naturally
1. Light Therapy
Melatonin and Serotonin are the two hormones that control our energy levels. When we wake up to the daylight, we produce seratonin, which keeps us awake and focused. In the dark winter months, with a lack of outdoor exposure, the body produces excess levels of melatonin making us sleepy and increasing our risk of depression.
Light therapy aims to mimic the summer light levels during winter-time, helping to produce more serotonin. There is a huge selection of medically approved light boxes and while they can be expensive, many SAD sufferers report great improvements in a relatively short period of time (avg 1-2 weeks).
Depending on the style of light you choose, your time in front of the light will vary between 20 minutes and 2 hours. While this may seem a long time to spare per day, lightboxes can be placed on your desk as you work, on the kitchen table as you eat or by your side while you read.
2. Exercise Yourself to Health and Wellbeing!
Exercise is a vital stimulant when feeling low and helps the release of endorphins. There are many ways to make a little exercise part of your daily routine and you will reap the benefits fairly quickly. If you exercise outside rather than in a gym, you will also be exposing yourself to natural outdoor light, which is precisely what is needed to help restore your circadian rhythm.
Start with a light jog or maybe consider getting hold of a bicycle. Don’t forget these are modes of transport too so include them in your daily routine. Consider commuting to work on a bicycle instead of taking the bus, tube or driving a car. It is a superb way to begin your day as you will be releasing seratonin, exposing yourself to natural light all the while getting fit and healthy, which helps to increase general wellbeing.
Get hold of a bike or some running shoes
3. Break Away From Stimulants
When the weather turns cold and the mornings greet us with darkness, we often resort to stimulants. Coffee to wake up, sugar to keep us happy and numb and then perhaps a glass of wine to relax in the evenings.
Unfortunately these become coping mechanisms and force our bodies into unnatural states of high and low. It is particularly recommended that you cut these stimulants out as they undoubtedly aggravate symptoms linked to all types of depression including SAD. While they may help in the moment you consume them, you are subjecting your body to extreme mood variables – what goes up must come down!
Instead, eat healthy, wholesome food – it will benefit you in the long run.
Cut out caffeine, sucrose (sugar) and alcohol
4. Set Goals and Create a daily routine
When feeling the effects of SAD, it is very easy to retract and feel feelings of worthlessness and despair. You may feel unable to carry out the simplest of tasks
The best thing to counteract this is to create manageable goals. These might be very simple to begin with – for instance you may have decided to eat well everyday. In this case, pull out those dusty cookbooks and set aside some time to cook everyday. Creating a routine like this prevents one day from just blurring into the next.
Your goals should benefit you and your wellbeing. An example of this might be your decision to cycle into work every wednesday and/or cook a delicious healthy dinner for friends on a friday. You may even consider taking a few minutes to meditate ever morning, which will give you time for yourself and set you up for the day. Gently over a period of time and as you start to improve you can strive for bigger, more challenging goals.
5. St John’s Wort (Hypericum) Tincture
St John’s wort is now commonly known as the alternative anti-depressant and is highly effective in combating some of the symptoms associated with SAD. The one you are most likely to come across is A.Vogel’s Hypericum Tincture, of which it is recommended you take 20 drops twice a day with water.
In the wonderful Hedgerow Medicine book, Julie Bruton-Seal and Matthew Seal explain that St John’s wort contains hypericin, which “interferes with monoamine oxidase (MAO), which contributes to depression. Pharmaceutical products also act as MAO inhibitors, but St John’s wort is a slow treatment, and, crucially, has few side effects.”
It is also used to treat nervous depression and can help with sleep and your body’s absorption of nutrients, helping to restore vitality and wellbeing. While it provides a generally safe alternative to drugs such as Prozac, side-effects may a affect a very small proportion of people including diahorrea and skin sensitivity to the sun. It is also recommended that you do not take St John’s wort while on other medication as it may interfere with these. If in doubt, speak to a doctor or wellbeing practitioner.
DISCLAIMER: While we have provided some of the best ways to treat SAD naturally, it must be understood that depression is a serious condition – if in doubt always seek professional medical advice.
Sources and further information:
Kitchen Medicine and Hedgerow Medicine are superb books, which can help you to combat many health related ailments using natural ingredients.
Have a look at Chris Johnstone’s Find Your Power (now 25% off) – it may help you to prioritise, gain confidence and excel in the winter months.
Sebastian von Holstein is the online editor for permaculture.co.uk and also the founder of the newly launched Von Holstein Group, which aims to restore health and balance to communities through the arts, design and architecture.
Seasonal Affective Disorder (SAD)
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What is Seasonal Affective Disorder (SAD)?
SAD is a form of depression that occurs in the fall and winter months, probably in response to the fewer hours of daylight. Symptoms usually begin in late fall or early winter and go on until the following summer. A less common type of SAD, summer-onset depression, usually begins in the late spring or early summer and continues until the following winter. Between four percent and six percent of people in the United States are believed to suffer from SAD. Another 10 percent to 20 percent experiences a milder form of winter-onset SAD. This disorder is more common in women than in men. Although some children and teenagers are affected, SAD usually occurs in people between 18 and 30 years of age.
What are the symptoms?
Symptoms are typical of depression: fatigue, lack of interest in normal activities, social withdrawal, weight gain, and a craving for carbohydrate foods. However, some of these symptoms occur as a result of physical disorders including an underactive thyroid, hypoglycemia, infectious mononucleosis and other viral infections. If you think you have SAD, be sure to consult with your physician to make sure that your symptoms aren’t due to something else.
The symptoms of SAD that occurs in the summer are typically somewhat different from the more common type of winter seasonal depression. They include anxiety, insomnia, irritability, agitation, weight loss, poor appetite and increased sex drive.
What are the causes of seasonal affective disroder?
No one knows exactly what causes SAD, but research has found that it rarely occurs in locations close to the equator and becomes more common the farther away from it you live. According to the American Psychiatric Association (APA), SAD has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and a lack of sunlight in winter. The sleep-related hormone melatonin may also be implicated since it is produced at night and because longer hours of darkness can lead to greater production of melatonin. A drop in levels of serotonin, a brain chemical (neurotransmitter) that affects mood, may play a role; reduced sunlight can cause serotonin levels to fall. The APA notes that the most difficult months for those affected with SAD are January and February. Some researchers have suggested that the lethargy characteristic of SAD may have an evolutionary basis: it may reflect a genetically programmed attempt to conserve energy during the winter months, which historically has been the time when food is scarce.
How is SAD diagnosed?
There are no medical tests for SAD. It is diagnosed on the basis of a careful history of your depression after all possible physical causes of the symptoms have been eliminated on the basis of a physical exam and, if needed, medical tests. The criteria for diagnosing SAD are spelled out in the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM). They include:
- Depression and other symptoms that have occurred for at least two consecutive years, during the same season every year.
- The periods of depression have been followed by periods without depression.
- There are no other explanations for the changes in mood or behavior.
What is the conventional treatment?
Exposure to bright light daily via a special (full-spectrum) light source, also know as light therapy, is the treatment method most often recommended for patients whose SAD symptoms are severe enough to affect their daily lives. Typically, SAD patients must sit in front of the light for about a half an hour per day. Light therapy is reputed to work in 80 percent of all cases of SAD. The light affects brain chemicals that play a role in regulating mood. This treatment can relieve symptoms within a few days, but sometimes takes as long as two weeks or more.
Light therapy may be recommended by psychiatrists and other physicians or health care professionals who treat patients with SAD or other forms of depression. While light boxes can be purchased without a prescription, a physician or other mental health professional can provide guidelines as to how to use a light therapy box for maximum effectiveness and may recommend a particular light box (you may need a doctor’s prescription if you’re seeking insurance coverage for the cost of a light therapy box). For milder cases of SAD, the APA recommends a long daily walk outdoors or arranging your home or office so that you’re exposed to outdoor light from a window during the day.
If SAD symptoms are severe, some physicians also prescribe antidepressants including paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor) or an extended-release version of the antidepressant bupropion (Wellbutrin XL). Physicians may recommend starting to take the prescribed drug before SAD symptoms set in and continuing beyond the time SAD symptoms normally disappear.
Cognitive behavioral therapy (CBT) also has been studied as a treatment for SAD. Research at the University of Vermont suggests that CBT is very effective at preventing recurrences of SAD, perhaps even more so than light therapy or a combination of light therapy and CBT. In the study, CBT proved effective after only a few weeks, whereas light therapy must be continued throughout the winter season.
What therapies does Dr. Weil recommend for SAD?
Dr. Weil endorses the use of light boxes for SAD, but views daily aerobic exercise as the most effective treatment for mild to moderate depression. Some research suggests that a vitamin D deficiency might underlie SAD and that supplementing with vitamin D might help. Since it is estimated that more than 70 percent of the U.S. population is D-deficient, Dr. Weil recommends that everyone take a daily supplement of 2,000 IU but notes that higher doses of vitamin D may be needed to effectively treat SAD.
If you’re using a light box for treatment of SAD, Dr. Weil recommends taking the following precautions:
- Be sure to position the box at an angle so that the light reaches your eyes indirectly.
- Don’t look directly at the light box; doing so can damage the eyes.
- Be aware that certain medications and supplements can make the retinas more sensitive to light and therefore increase the risk of eye damage. These include the drug lithium and the supplements melatonin and St. John’s wort.
- If you’re bothered by the glare from your light box, the blue light it emits is probably responsible. You can screen out blue light by wearing special eyeglass lenses or clip-ons during your daily treatment. There are also light boxes that filter out potentially irritating blue light.
Dr. Weil has also noted that, if possible, moving closer to the equator – where winter days are longer – can be helpful. He explains that this may work better than therapies based on artificial light because direct sunlight is about 13 times more intense than light from light boxes.
Dr. Weil recommends the following supplements and nutritional strategies for those suffering from depression.
- B vitamins. The B vitamins, especially folic acid and vitamin B6, can be helpful in mild depression (be aware that B vitamins can increase the efficacy of prescription anti-depressants).
- St. John’s wort. This herbal remedy has long been used in Europe as a treatment for mood disorders. Standardized extracts have proved as effective as Prozac in the treatment of mild to moderate depression. The dosage is 300 mg of an extract standardized to 0.3 percent hypericin, three times a day. It takes about eight weeks for the full effect to be felt. (Do not use St. John’s wort if you are taking any of with the following medications: anti-retrovirals, birth control pills, or antidepressant medications, especially SSRIs like Prozac or Celexa. St. John’s wort can alter the metabolism of numerous medications; ask your physician before combining the herb with prescription medications.)
- SAMe (S-adenosy-L-methionine). This supplement works more quickly than St John’s wort. Use only the butanedisulfonate form in enteric-coated tablets, or in capsules. Try 400-1,600 mg a day on an empty stomach.
- Fish oil. Recent studies suggest that omega-3 fatty acids found in fish oil may be helpful in maintaining a healthy emotional balance. Dr. Weil recommends a combined total of 1,000 – 2,000 mg of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the essential fatty acids found within fish oil, per day for mild depression. DHA is found in nerve and brain tissue.
- Diet. Be sure to follow a well-balanced diet such as the Anti-Inflammatory Diet and take a daily antioxidant multi-vitamin/mineral supplement to meet your needs for all the essential nutrients.
Do your energy levels plummet once the summer months are over? Does your motivation to socialize with friends and family or even leave the house disappear when the sun does? And do you start to feel more “normal” when springtime — and more daylight hours — return?
You might be suffering from seasonal affective disorder, or SAD.
The winter blues are well known and quite common — after all, these months come packed with a lot of holidays that can be emotionally draining. Combine that with minimal time in the sunshine, especially if you work in an office, and cold weather that seems to scream “stay home and get in a blanket,” and it’s no wonder that people tend to be a bit anti-social and grumpy from November until about April.
But for some people, the “winter blues” is more than just curling up with Netflix for a few weekends in a row. Those who suffer from seasonal affective disorder are actually experiencing a type of depression that rears its head during certain seasons.
What Is Seasonal Affective Disorder?
SAD is a form of clinical depression that comes and goes in a seasonal pattern. It’s also referred to as “winter depression,” because that’s usually the time when symptoms become more pronounced and noticeable. This bout of depression begins and ends around the same time each year (1).
About half a million Americans, mainly from northern climates, suffer from SAD in its strictest form each year; interestingly enough, three out of four people with SAD are women. SAD affects people from September to April, with peak (read: worst) times occurring in December, January and February.
For most people, their first winter experiencing seasonal affective disorder will occur between the ages of 18 and 30 years old (2), though a change in location, such as a major move later in life, can bring on symptoms.
Causes of Seasonal Affective Disorder
Researchers aren’t sure what causes SAD, but it is a type of major depressive disorder. SAD patients can be just as depressed as those suffering from other forms of depression — this is a serious condition.
While the exact reasons for SAD aren’t clear yet, it’s believed that a vitamin D deficiency and a lack of sunlight keeps a part of the brain, the hypothalamus, from working properly, leading to a disruption of circadian rhythms. When our circadian rhythms are out of whack, it can affect our levels of melatonin and serotonin.
In people with SAD, melatonin, the hormone that makes us feel sleepy, might be produced in higher levels, leading to increased feelings of lethargy. On the other hand, serotonin levels decrease. Serotonin is a hormone that affects our mood and appetite; not having enough serotonin is linked to depression (3).
Because seasonal affective disorder seems to be more common in women than men, being female is a risk factor. Additionally, there seems to be a genetic predisposition to seasonal affective disorder, as it often runs in families (4). And, unsurprisingly since seasonal affective disorder is so tied to sunlight, location makes a difference. SAD is more common among people who live far north or south of the equator, thanks to abbreviated daylight winter hours and longer days during summer months.
Symptoms of Seasonal Affective Disorder
Seasonal affective disorder symptoms vary from person to person. Generally, symptoms might start out mild and become more severe during the peak winter months of December through February. They start to ease up once sunnier spring days begin emerging.
People suffering from SAD experience a decrease in energy, trouble sleeping, a loss of interest in activities, difficulty concentrating, depressive feelings, a decreased sex drive, and appetite or weight gain changes — sugar addiction and cravings for carbs and other comfort foods are also common in people with seasonal affective disorder (5).
It can be difficult to determine if a person is suffering from “traditional” depression or if it’s SAD. The telltale sign is when you begin experiencing these depressive feelings. Usually, the feelings will begin in September, be at their worse during the peak winter months, and start easing up in March or April. A diagnosis will often not be made until two to three consecutive winter seasons with the symptoms.
Health professionals will evaluate that you’ve had depression that begins and ends in a specific season every year; no episodes of depression during other seasons; and more seasons of depression than seasons without depression. Your doctor will probably do a physical exam, which might include lab testing to rule out any other health problems, and a psychological evaluation.
Treating SAD with Natural Remedies
The tricky part about seasonal affective disorder is that in order to be formally diagnosed by your doctor and receive medication, you’ll have to suffer through at least two winters of depression. No one who is in mental pain for so long should have to wait to start feeling better. Luckily, there are several natural, prescription-free remedies you can try.
1. Get a light box
If your outdoor hours are limited during the winter months, a light box might be a worthwhile investment. In fact, 60 to 80 percent of SAD patients see improvements in their disposition and currently, it’s the best treatment available. (6)
Light therapy allows you to get exposure to bright, artificial light during the most difficult months. It’s recommended that SAD patients use light therapy daily, from the first signs of symptoms, until the springtime, when SAD resolves itself. Most people require between 15 to 30 minutes of therapy a day and will start feeling improvements within two to four days, with the full improvement happening within two weeks.
Because seasonal affective disorder symptoms will return quickly once light therapy stops, remaining consistent with treatment during the winter months is crucial. It’s also often recommended that light treatment occur in the morning, to prevent difficulties falling asleep later in the evening.
Light therapy boxes are available without a prescription, but they can come with side effects, like headaches or eye strains. Because of UV exposure, it’s also recommended that you see a health provider who specializes in light therapy to ensure you get the right amount of light and filter out dangerous UV rays.
2. Keep exercising
I know — it can be difficult enough to hit the gym when you’re feeling great, never mind when you’re not up to par. But regular exercise has been proven to help with traditional types of depression, and SAD is no different (7).
Staying active increases the production of feel-good chemicals that can help ease depressive feelings and even brain fog. In one study, just 30 minutes of walking on a treadmill for 10 consecutive days was enough to produce a significant reduction in depression (8).
Research also suggests that it’s the frequency and consistency of exercising, rather than the duration or intensity, that has the most positive effects — you don’t need to run a marathon or start up Crossfit to reap the healing benefits of exercise. Join a group fitness class, rev up the treadmill or practice yoga; it will all help.
3. Add a vitamin D supplement
Vitamin D, or the sunshine vitamin, has been linked to depression. Patients with seasonal affective disorder often have low levels of the vitamin.
While scientists aren’t sure why that’s the case, it’s worth checking with your doctor to make sure your vitamin D levels are up to par (9). Because most U.S. adults have some type of deficiency in the vitamin, adding a supplement could help you feel better and even improve bone health and boost your immune system.
4. Get outside
When there is a ray of sunlight during the cold, dark months, take advantage.
Sleep with curtains and blinds open to get in any glimmer of sunshine in the morning. Break up your workday with an early afternoon walk to soak up some vitamin D naturally.
Bundle up and try to get as much natural light as possible. Your brain and body will both thank you for it. Bonus points if you can squeeze your workouts in outside, no matter if it’s an early morning stroll solo or a weekend game of fetch with the dog.
5. Talk it out
Cognitive behavioral therapy (CBT), a type of psychotherapy that helps people change unhelpful or unhealthy habits of thinking, feeling and behaving, can help alter your way of thinking and focusing on positive solutions, instead of saying, “Forget it, I’m skipping those dinner plans I made.”
While CBT is useful for many types of depression and mental health disorders, there’s renewed interest in using it as a treatment for seasonal affective disorder. In fact, a recent study published in the American Journal of Psychiatry, CBT could be more helpful to SAD patients than light therapy in the long run. (10)
The study tracked 177 people with seasonal affective disorder as they were given either light therapy or cognitive behavioral therapy designed for SAD over six weeks and then checked in with them over the next two winters.
During the first winter, light therapy and CBT worked equally as well in reducing depression symptoms. But by the second check-in appointment, CBT had pulled in the lead.
That’s because in the group of patients who received CBT to treat their seasonal affective disorder, 27.3 percent had their depression come back the following winter, while 45.6 percent of those who had received light therapy did.
And, for those folks who had been treated with CBT but still experienced a return of seasonal affective disorder, their symptoms were milder than those who were treated with the light therapy.
The difference, according to Kelly Rohan, a lead author of the study, might be that CBT teaches people skills and coping mechanisms they can employ at any time, while light therapy requires spending a certain amount of time daily to reap the effects, while not feeling in control of emotions.
6. Eat a healthy diet
It all comes back to food, doesn’t it? While people with SAD crave comfort foods — starchy carbs, sweet treats and more — eating that way ensure you’ll look and feel worse.
Instead, focus on a SAD-busting, healing diet. (11) Lots of lean protein, leafy greens and fish will keep hormones in check and boost serotonin levels.
When you do get the urge for carbs, choose complex, whole-grain varieties, like whole-grain pasta and bread, instead of nutrition-deficient white carbohydrates.
7. Reach out for help
Depression, no matter the type, can feel extremely isolating. Reaching out to friends and family and establishing a support network can help ease the burden.
If you suspect you’re at risk for seasonal affective disorder, be sure to reach out to your health professional. Even if they can’t diagnose you this year, it’s still worth consulting with an expert on your options. And if you or someone you know ever feels like harming themselves, call the National Suicide Prevention Hotline at 800-273-TALK (8255).
Read Next: Walnuts Help Both Your Heart & Mood
Self-help. There are many ways to minimize symptoms of SAD outside of professional medical help. Individuals who regularly exercise, have good sleeping habits, eat a healthy diet, and stay connected with others have improved moods during SAD months. Working towards a more balanced lifestyle can help manage stress and reduce the symptoms of depression. Using these self-help tools year round can help minimise the likelihood of suffering from SAD, and improves one’s overall health and well-being4.
Discussing medical treatment or support from a qualified healthcare practitioner can be a useful first step in identifying the ideal treatment option. SAD is a treatable disorder, where healthcare practitioners can provide resources to build resilience prior to months where SAD is at its peak.
Everyday tips to ease winter SAD4
- Avoid alcohol, and be aware of your caffeine intake. Both alcohol and caffeine can affect your sleep and make you feel groggy and grumpy. On the other hand, make sure you’re drinking enough water.
- Build routines to get you outside during the day. Try to find opportunities for a brief outdoor walk during daylight.
- Increase physical activities or exercise prior to typical SAD months. This can help to build a healthy lifestyle prior to SAD symptoms, potentially preventing or limiting SAD symptoms each year. Physical activity relieves stress, depression, and increases your energy, combatting the majority of the SAD symptoms.
- Keeping a journal can help you to deal with the negative feelings one can experience. Plan to write each day for a week, including your thoughts, feelings and concerns. The best time to write is often at night, which allows you to reflect on all that happened during the last 24 hours.
- Re-arrange your space to maximize exposure to sunlight throughout the workday. Try to keep the curtains open during the day and position yourself to face natural light where possible.
- Resist the urge to eat unhealthy sugary or high carbohydrate foods. Although often craved when experiencing SAD symptoms, this can increase depression and weight gain, further increasing SAD symptoms.
- Take a vacation, look for sunny destinations. Save throughout the year to alleviate potential financial strain. Reminder, symptoms of SAD can recur after you return home.
- Take vitamin D supplements or eat foods high in vitamin D, such as cow’s milk, soy or rice beverages, orange juice, salmon, eggs, or fortified yogurts. Since getting more sun exposure is dependent on weather and time, change your diet during fall and winter can help you get the vitamin D you would typically receive from sun exposure.
- Try to spend more time outdoors during the day. Spending time outside for 30 minutes can help your body absorb enough vitamin D to help improve overall mood.
Wintertime blues: How to manage seasonal depression
When Jem Aswad was in college, he spent a semester abroad in London. The New York state native loved his classes, had lots of friends and lived in a fun and lively neighborhood. “But by the end of February, I was glum and depressed and absolutely could not understand why,” he says.
A trip to Madrid in March shed light on his strange funk. “I was practically intoxicated by all the sunshine,” he recalls. “I was actually giddy and having trouble sleeping while I was there. I realized my problem was the dismal English weather.” Winter days in London are short and gloomy, and his semester abroad coincided with the worst winter England had seen in 40 years.
Seasonal affective disorder (SAD) is a form of mild to moderate depression that descends in the fall or winter months and fades in spring. In addition to sadness and irritability, symptoms can include oversleeping, increased appetite, craving carbohydrates or sugar, social withdrawal and low energy. Some people feel the slump at the same time every year, but certain factors can bring it on for the first time. Moving to a new region or a home that receives less light, an especially harsh winter, working the night shift, and physical or emotional stress all predispose you to seasonal mood changes.
Is seasonal depression real?
The term “seasonal affective disorder” was coined in the 1980s by Norman Rosenthal, MD, a psychiatrist and research scientist who studied mood and biological rhythm disorders at the National Institutes of Mental Health. In his best-selling book Winter Blues, he revealed his own struggle with SAD and pointed to light deprivation as a major cause. By the 1990s, the concept of seasonal depression was generally accepted by most Americans.
In 2015, researchers announced they’d discovered a new explanation for seasonal ups and downs: Genes promoting inflammation are more active in winter. This could be why many chronic conditions ― including Type 1 diabetes, multiple sclerosis, rheumatoid arthritis and depression ― flare in the colder, darker months.
Then in 2016, a report analyzing data from 34,000 Americans suggested that SAD either doesn’t exist or is very rare. Was seasonal depression merely a widespread cultural myth? For every statistic that supports the winter blues, some experts argued, you can find another that indicates the opposite. Suicide rates are higher in spring and summer. And in some communities near the Arctic Circle that get little or no sun in winter, depression rates are steady year-round and sometimes lower than in regions much farther south.
In spite of the naysayers, most mental health professionals believe seasonal depression is real, according to Gabriela Cora, MD, a psychiatrist, wellness coach and medical director with Aetna Behavioral Health. “I’ve seen it in my clinical practice. And if you’re tracking your habits, it’s kind of obvious,” she says.
Treatments for SAD
Doctors and therapists often recommend a combination of therapies. “Depression is not one of those diseases where you can pinpoint one gene that’s responsible. So you can’t treat everyone with the same cookie-cutter approach,” Dr. Cora explains, adding that lifestyle factors play a major role. “During the summer, we go outside more, eat more fruits and vegetables. When it’s getting colder and darker, our habits change. Sleep patterns change. People may gain a little weight. It’s the chicken or the egg: Is it the sun, or your activities?”
For mild to moderate blues
“Focus on the four pillars of health: nutrition, exercise, sleep and relaxation,” Dr. Cora advises. “Plan more outdoor activities, and eat more plant-based foods.” Some SAD sufferers manage their symptoms with vitamin D supplements in the fall and winter months. Vitamin D deficiency has been linked to depression; your primary care physician can check your D level with a blood test.
A winter vacation can also do wonders for your state of mind, and some people suffering from SAD truly consider it a health requirement. Experts agree that spending a few days somewhere warm and sunny can quickly melt the most stubborn winter blues, due to serotonin flooding the brain.
If a trip south isn’t possible, make time for winter sports close to home. Hiking or skiing allows you to soak up more sunlight, boosts vitamin D and gets your heart rate up. But moderate exercise of any kind can have a significant impact on depression. At the very least, avoid placing added pressure on yourself: Postpone big projects until spring, and make the holiday season a time to recharge.
For moderate to severe depression
If you feel hopeless or unable to function, self-care is not enough. See your primary care physician or a counselor as soon as you can. You’ll be screened for common conditions that can mimic or worsen seasonal depression, from thyroid problems to anemia (a vitamin B deficiency). Therapy and medication have both been shown to alleviate major depression.
Light therapy can also raise your spirits, sometimes dramatically. Experts recommend using tabletop light boxes of at least 10,000 lux. (Not any bright light will do, so don’t try self-treating with regular bulbs.) If you’re an Aetna member, your plan may cover the use of light therapy for seasonal depression that recurs two or more years.
Mind over weather: Making the most of winter
A Scandinavian proverb advises, “There’s no such thing as bad weather, only inappropriate clothing.” In other words, proper preparation and a can-do attitude have a huge impact on our experience of winter.
Scott P. first noticed his seasonal mood pattern in his late teens, when the New Jersey native started college in Syracuse, New York, where the winters are bleak. “In October, I’d start to crave different foods, sleep more, put on weight and get the sads,” he says. He credits lifestyle adjustments with turning things around. “Over time, the extremes have moved toward the center. Daily exercise and keeping social as well as midwinter vacations south all help my mental outlook.”
So this winter, keep in mind what you love about the season ― a steaming cup of cocoa, sledding with the kids, the aroma of pine wreaths. A warm heart is a powerful antidote to the cold.
Maureen Shelly is a health and science geek living in New York City.
Help patients cope with seasonal affective disorder and stress
When the weather turns dark and cold during the winter months, many people experience Seasonal Affective Disorder (SAD). In fact, SAD is estimated to affect 10 million Americans each year, according to Mental Health America. Patients with SAD, also known as the “winter blues” may experience a depressed mood and lethargy, which makes it more difficult than usual to deal with daily stressors. Individuals experience stress throughout the year, from things like work and school and personal life. However, if they don’t know how to cope in a healthy way, it begins to negatively affect their lives. Symptoms associated with SAD include depression, anxiety, mood changes, sleep problems, lethargy, and overeating. But what causes these things to occur? The reduced level of sunlight in the fall and winter months may affect an individual’s serotonin, a neurotransmitter that affects mood, according to a 2010 report by Dr. Darren Cottrell, a Locum Consultant at St. James Hospital in Portsmouth, England. Lower levels of serotonin have been shown to be linked to depression. Brain scans have shown that people who had seasonal depression in the winter had higher levels of a serotonin transporter protein that removed serotonin than in individuals who did not have seasonal depression, the report says. In addition, melatonin, a sleep-related hormone secreted by the pineal gland in the brain, has been linked to seasonal depression, says a2013 reportby Stuart L. Kurlansik and Annamarie D. Lbay in the Indian Journal of Clinical Practice. This hormone, which can affect sleep patterns and mood, is produced at increased levels in the dark. Therefore, when the days are shorter and darker the production of this hormone increases. Melatonin can also affect an individual’s circadian rhythm, or “biological clock”, resulting in ‘internal clocks’ being out of sync with ‘external clocks’, or the usual sleep and wake rhythms. This can result in some of the symptoms associated with seasonal depression. To treat seasonal depression, take a holistic approach to helping patients work through mental health issues, according to a recent release by the Tao Institute of Modern Wellness. Phototherapy or bright light therapy has been shown to suppress the brain’s secretion of melatonin. Light therapy has been shown to be effective in up to 85 percent of diagnosed cases. Patients remain in light up to ten times the intensity of normal domestic lighting up to four hours a day, but may carry on normal activities such as eating or reading while undergoing treatment. The device most often used today is a bank of white fluorescent lights on a metal reflector and shield with a plastic screen. Cognitive behavioral therapy (CBT) has also been shown to be effective. SAD can be prevented, says Mental Health America. Since seasonal depression has a predictable pattern of recurrence, preventative measures may help reduce symptoms. Some forms of prevention include beginning light therapy in the early fall before the onset of symptoms, exercising more, increasing the amount of light at home, meditation and other stress management techniques, spending more time outside, and visiting climates that have more sun.
Natural Treatments for SAD – Seasonal Affective Disorder
S.A.D. is an appropriate acronym for Seasonal Affective Disorder. It is a recurrent mood disorder that can take the form of depression in all ages. But the interesting thing is it is limited to the months where sun and light is all but non-existent. Symptoms of S.A.D. include a depressed mood which is typically worse in the evening, usually with certain characteristic features, namely incessant sleeping, extreme lack of energy, depression, and increased appetite, often with carbohydrate craving and weight gain.
Other than the direct tie-in to the sun connection, the cause of seasonal affective disorder is not fully understood. One important factor to consider is where you live in the world. Latitude is one of the most predictive factors as those who live at high or low points on the earth’s hemispheres are far more predisposed to S.A.D (as well as vitamin D deficiency) due to less overall sun (and therefore light) exposure. In cases of S.A.D, there is also a family history of mood disorder, usually depression, in about 50% of people. The condition is twice as popular in women as it is in men, the average age of onset is 23 years old, and stress seems to precipitate acute episodes of S.A.D. The condition regularly recurs during fall and winter nearly and spontaneously remits during spring and summer. One very common oversight is that thyroid dysfunction (hypothyroidism) may be an underlying condition. (Ask your doctor to run the necessary blood work to rule this out).
Ensure you speak to your family doctor if you have these symptoms:
- Depressed mood: feelings of hopelessness predominate. The future looks black, and life may not seem worth living. Normal activities and interests hold little pleasure. Sometimes depression is worse in the evenings (the reverse of classic depression). Depression is usually mild to moderate, but can be severe with risk of suicide.
- Irritability and anxiety: these are common, and may cause interpersonal and work difficulties
- Fatigue and lethargy: increased somnolence during the day and increased sleep duration at night
- Decreased libido
- Increased appetite: carbohydrate craving and, very often, substantial weight gain
But here is the good news. People with SAD respond very well to light therapy (phototherapy) and vitamin D supplementation as well as other forms of natural medicine.
70% of patients with mild-to-moderate symptoms respond to light therapy from a light box at 2500 lux 2h/day or 10,000 lux one hour/day, within 1-2 weeks where about 50% achieve complete remission. “Lux” is a unit of illuminance or luminous emittance from a light source. The latest research suggests that were wavelength might matter (the more blue the light, the better) the intensity of the light exposure is more important than the spectrum or wavelength. So, avoid getting lured in to buying one of the very expensive units which profess having a “special” wavelength that “mimics the sun”. Also, consider a dawn simulator to help wake you up in the morning and get that immediate exposure to light so as to shut down brain melatonin production and fire up serotonin production – which is all regulated by light!
It used to be suggested that 400iu vitamin D was enough in order to maintain good bones. That dose and that use of vitamin D is now considered very one dimensional. Vitamin D (in the D3 form known as cholecalciferol) should be taken by Canadians, on average, at 1-2000iu/day. Blood levels can be regularly assessed by your doctor using a simple blood test known as serum 25OHD. Vitamin D3 is now known to be useful for not only bone health, but also immune system health, inflammation, against all forms of cancer, and of course mood.
The conventional pharmacological treatment of S.A.D includes the class of drugs called Selective Serotonin Reuptake Inhibitors, or SSRI’s. These drugs are postulated to work by keeping serotonin – a feel good brain chemical – “alive” longer to induce “feel good” messages in the brain. But, in natural medicine it is commonly believed that in the case of S.A.D., people don’t produce enough serotonin to begin with (or run out of stores in the winter months). Grifonia seed contains a high amount of an amino acid called 5-HTP which can be supplemented orally in order to increase the amount of available serotonin in the brain to contribute toward improved mood (rather than to prevent the breakdown of a suboptimal amount – as in the action of drug SSRI’s). Simply put, 5-HTP increases the production of serotonin and has been used successfully to treat depression and S.A.D.
HOMEOPATHIC DILUTION MEDICINE
Homeopathic medicines used for mood balancing can be very effective, but it is always advisable to seek a professional’s advice when selecting the right remedy for your condition.
Aurum metallicum can be used if you are experiencing a depression and loathing of life after having worked through the holidays (high stress) and are aggravated mostly at night.
Arsenicum should be taken when you have deep-seated insecurities with restlessness and anxiety, extreme weakness, fear of being alone, and you are really chilly with frequent thirst for small quantities and a strong craving for bread and other carbohydrates.
Pulsatilla may be your best bet if you are emotional, overly sympathetic, and cry easily because of a feeling of being forsaken (and where many symptoms you experience could be related to hormonal fluctuations).
Nat-mur is administered for extreme emotional vulnerability leading to introversion. It is a great remedy for symptoms of ailments from grief and an intense craving for salt.
MINDFULLNESS AND OTHER CONSIDERATIONS
To maintain a healthy mood, it is also important to maintain a healthy diet with lots of dark green vegetables, nuts and seeds, and mangoes. A natural chemical constituent found in mangoes actually increases good mood. In addition, supplement with a good vitamin B complex (high in B6, B12, and folic acid), and magnesium. Take no less than 5 grams of omega-3 essential fatty acids daily. Last but not least, remember to exercise – high intensity – during the winter months. And, at this point, it should go without saying, you should exercise under bright lights to offset the lack of the golden summer sun.
Cognitive behavioral therapy (CBT) also has been studied as an effective treatment for SAD. The University of Vermont has published research showing that CBT is effective at preventing SAD. In the study, CBT proved effective after only a few weeks compared to light therapy that must be continued throughout the winter season. The use of light therapy, CBT and vitamin D compliment very well together.
St. John’s wort is an herbal remedy that has proven as effective as Prozac in the treatment of mild to moderate depression. You may want to consider a dose of 300 mg of an extract standardized to 0.3 percent hypericin, three times a day. It takes about 2 months before you feel the full effect. (Do not use St. John’s wort together with anti-retrovirals, birth control pills, or antidepressant medications, especially SSRIs like Prozac or Celexa.
Another interesting aid may be SAMe (S-adenosy-L-methionine). This works pretty quickly – especially compared to St. John’s wort. Find the butanedisulfonate form in enteric-coated tablets, or in capsules at 400-1,600 mg a day between meals.
Speak with your physician before combining any of the above recommendations with prescription medications.
Tags: Mental Health, SAD
Seasonal affective disorder (SAD)
Seasonal affective disorder (SAD)
Some people with SAD find that light therapy can help improve their mood considerably. This involves sitting by a special lamp called a light box, usually for around 30 minutes to an hour each morning.
Light boxes come in a variety of designs, including desk lamps and wall-mounted fixtures. They produce a very bright light. The intensity of the light is measured in lux – the higher lux, the brighter the light.
Dawn-stimulating alarm clocks, which gradually light up your bedroom as you wake up, may also be useful for some people.
The light produced by the light box simulates the sunlight that’s missing during the darker winter months.
It’s thought the light may improve SAD by encouraging your brain to reduce the production of melatonin (a hormone that makes you sleepy) and increase the production of serotonin (a hormone that affects your mood).
Who can use light therapy?
Most people can use light therapy safely. The recommended light boxes have filters that remove harmful ultraviolet (UV) rays, so there’s no risk of skin or eye damage for most people.
However, exposure to very bright light may not be suitable if you:
- have an eye condition or eye damage that makes your eyes particularly sensitive to light
- are taking medication that increases your sensitivity to light, such as certain antibiotics and antipsychotics, or the herbal supplement St. John’s Wort
Speak to your GP if you’re unsure about the suitability of a particular product.
Trying light therapy
Light boxes aren’t usually available on the NHS, so you’ll need to buy one yourself if you want to try light therapy.
Before using a light box, you should check the manufacturer’s information and instructions regarding:
- whether the product is suitable for treating SAD
- the light intensity you should be using
- the recommended length of time you need to use the light
Make sure that you choose a light box that is medically approved for the treatment of SAD and produced by a fully certified manufacturer.
Does light therapy work?
There’s mixed evidence regarding the overall effectiveness of light therapy, but some studies have concluded it is effective, particularly if used first thing in the morning.
It’s thought that light therapy is best for producing short-term results. This means it may help relieve your symptoms when they occur, but you might still be affected by SAD next winter.
When light therapy has been found to help, most people noticed an improvement in their symptoms within a week or so.
Side effects of light therapy
It’s rare for people using light therapy to have side effects. However, some people may experience:
- agitation or irritability
- headaches or eye strain
- sleeping problems (avoiding light therapy during the evening may help prevent this)
- blurred vision
These side effects are usually mild and short-lived, but you should visit your GP if you experience any particularly troublesome side effects while using light therapy.
Are You SAD This Winter? Coping with Seasonal Affective Disorder
People with SAD experience a variety of physical, emotional and cognitive symptoms that impairs their daily functioning. They’re usually unable to perform at school or work and have difficulty interacting with others. Tasks that once seemed simple, such as household chores or paying the bills, suddenly become overwhelming.
The ability to think clearly also becomes impaired. In fact, according to SAD expert Dr. John Docherty, the disorder causes many problems for people at work. Dr. Rosenthal cites Docherty in his book. He lists these at-work problems by how often they occur: “decreased concentration, productivity, interest, and creativity; inability to complete tasks; increased interpersonal difficulties in the workplace; increased absences from work; and simply stopping work.”
According to Rosenthal, the physical symptoms can be especially prominent and debilitating. They include sleeping problems, fatigue, a revved-up appetite, loss of interest in enjoyable activities and diminished sex drive. And while mood changes are salient, individuals may feel the physical signs first. In the book, a middle-aged woman describes her physical symptoms:
I don’t really feel depressed. I just feel like all my systems have been turned off for the winter. I feel leaden and heavy and just want to lie about all the time. It’s only when I am expected to do something out of the ordinary, and I realize that I cannot do it, that I feel my mood being pulled down.
Light therapy, cognitive-behavioral therapy and antidepressants are effective in treating SAD. In 2006 the Food and Drug Administration approved the antidepressant Wellbutrin XL for preventing episodes of SAD.
Extensive research has shown that light boxes work well in boosting mood and energy. Light boxes emit artificial light that mimics the sun’s rays. They emit anywhere from 2,500 lux to 10,000 lux. (Lux is a measure of intensity.) Light therapy requires a daily commitment. It’s best to use light boxes in the early morning for 30 minutes or more during the winter months. (The 2,500-lux light boxes might even require two hours.) However, you can read or talk on the phone as you’re receiving light therapy. According to Rosenthal, you can do anything during your sessions, as long as your eyes are open, you’re facing the light box and there’s a proper distance between you and the box.
Early research has shown that CBT for seasonal affective disorder may be even more effective than light therapy (and doesn’t require the extensive time commitment as light boxes do). In this 2009 study, Rohan and colleagues compared SAD-tailored CBT to light therapy (along with a combination of both treatments and a wait-list condition). They found that CBT, light therapy and both CBT and light therapy were all effective in treating SAD.
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However, at the one-year followup, participants treated with CBT were doing much better than individuals in the light therapy condition. In secondary analyses, Rohan also controlled for ongoing treatment, and the CBT participants still fared better.
Rohan is currently conducting a five-year randomized trial with 160 participants to further test CBT’s effectiveness.
CBT for Seasonal Affective Disorder
So what is SAD-tailored CBT? Specifically, it helps clients identify and incorporate enjoyable activities into their lives and to identify, challenge and change negative thoughts, according to Rohan. It’s classic CBT with a focus on coping more effectively with the wintertime.
For instance, people with SAD tend to view winter very negatively. They commonly say that they hate the cold and can’t do anything during the winter months. Rohan helps clients gain a more realistic perspective. She begins by challenging the strong word “hate.” Remember that you can hate poverty or prejudice, but you probably dislike the winter or simply prefer the warmer months. This slight shift in perspective is a big help. She also asks clients to come up with the evidence that they can’t do anything during the winter and to think of the times they have done fun things. Together, they also devise a plan that includes enjoyable activities.
As Rohan noted, this sounds a lot easier than it really is. Depression zaps your energy and desire to do anything, so engaging in activities may be incredibly difficult. That’s why Rohan starts small. Clients commit to doing 10 minutes of a specific activity. They also discuss potential barriers to engaging in the activity and problem solve to overcome them.
Seeking Treatment for SAD
If you think you might have SAD, it’s vital to see a therapist for a proper evaluation. “It can be dangerous to try to engage in self-diagnosis and self-treatment,” Rohan said.
In his book, Rosenthal outlines the signs to seek medical help:
- Your functioning is significantly impaired. You have difficulty completing tasks that were easier before; you’re falling behind with bills and chores; you make mistakes more often or take longer to finish projects; you tend to withdraw from loved ones.
- You feel considerably depressed. You feel sad more often than not; you feel guilty or hopeless about the future; you have negative thoughts about yourself that you don’t have at other times of the year.
- Your physical functions are greatly disrupted. During the wintertime, you sleep more or have a hard time getting up in the morning; you’d rather stay in bed all day; your eating habits have changed.
If you’re struggling with a mild case of the winter blues, the principles of CBT can be helpful, according to Rohan. Identify fun activities that you can do in the cold months, and avoid spending a lot of time in bed and isolating yourself. Also, be mindful of your negative attitudes and thoughts about winter, and try to challenge them.
And remember that SAD is highly treatable, and there’s always hope!
Are You SAD This Winter? Coping with Seasonal Affective Disorder
Margarita Tartakovsky, M.S.
Margarita Tartakovsky, M.S. is an Associate Editor and regular contributor at Psych Central. Her Master’s degree is in clinical psychology from Texas A&M University. In addition to writing about mental disorders, she blogs regularly about body and self-image issues on her Psych Central blog, Weightless.
Tartakovsky, M. (2018). Are You SAD This Winter? Coping with Seasonal Affective Disorder. Psych Central. Retrieved on February 2, 2020, from https://psychcentral.com/lib/are-you-sad-this-winter-coping-with-seasonal-affective-disorder/Last updated: 8 Oct 2018 (Originally: 17 May 2016)
Last reviewed: By a member of our scientific advisory board on 8 Oct 2018
4 Ways to Deal with Seasonal Affective Disorder
With the days getting shorter as fall approaches, many people may experience seasonal affective disorder, or SAD. SAD is a form of depression brought on by the change of seasons. It most commonly causes people to become depressed in the fall or winter, but there are people who get it in the spring or summer. It’s important to distinguish SAD from the normal seasonal blues most people experience to some extent during the fall and winter. SAD is an episode of major depression, the symptoms of which include feeling depressed most of the time, feeling hopeless or worthless, fatigue, losing interest in things you used to enjoy, irritability, changes in appetite or weight, slow movements, difficulty concentrating, and thoughts of death or suicide. These must persist for two weeks to be considered depression. Winter SAD and summer SAD might have slightly different symptoms. Common symptoms of winter SAD include having little energy, sleeping too much, eating too much, craving carbs, and socially withdrawing or hibernating. Symptoms of summer SAD, on the other hand, include poor appetite, insomnia, agitation, anxiety, restlessness, and violent outbursts. We don’t know exactly what causes SAD. One factor might be that people who are prone to SAD have too little serotonin, a neurotransmitter thought to improve mood. One study found that people who experience SAD have higher levels of serotonin transporter proteins in the winter, reducing the levels of serotonin in the synapses. Another hypothesis is that the longer hours of darkness cause people with SAD to produce too much melatonin, causing them to sleep too much. A third hypothesis is that the shorter hours of sunlight during the winter leads to a vitamin D deficiency. Vitamin D does many important things, including regulating your immune system, hormones, and levels of serotonin. Low levels of vitamin D have been associated with depression. The risk factors for SAD are mostly the same as major depression. Of course, if you have already been diagnosed with major depression or bipolar disorder, the change of seasons is more likely to trigger a depressive episode. Women are more likely than men to experience SAD. Having a family history of depression makes SAD more likely, as does being young, as teens and young adults are at a higher risk of depression. One risk factor related specifically to the change of seasons is how far you live from the equator. Someone who lives in New England is about nine times more likely to experience SAD than someone who lives in Florida. So what can you do about SAD? If you’re experiencing SAD, don’t dismiss it as winter blues. Talk to your doctor about treatment. Here are some common ways of treating SAD.
As with other forms of depression, medication, typically SSRIs are often effective in treating SAD. These medications boost levels of serotonin, which are thought to be low in the winter months. These can take about four to six weeks to start working and you may have to try several different medications before you find one that works. More than half of people with depression improve significantly with the right medication.
Since lack of sunlight is thought to play a major role in SAD, it makes sense to try to compensate with artificial light. During the winter months, you may get out of bed in the dark, work all day inside, then go home in the dark. This causes two main problems. One is that your circadian rhythm is controlled by sunlight. It controls the release of hormones that make you tired and wake you up. When it’s always dark, you’re always tired. Light therapy may help your brain adapt to the lack of sunlight. A light box is a device you can set on your desk or table. It’s many times brighter than regular indoor lighting and it can fool your brain into thinking you’ve been exposed to normal morning sun. This helps you wake up and keep a more normal daily rhythm. The other problem with lack of sunlight is that you don’t produce as much vitamin D. As noted above, vitamin D is important for immunity, hormones, and serotonin. It’s mostly produced in the skin when exposed to sunlight. Too little sunlight means too little vitamin D. Light boxes won’t help you make more vitamin D because they don’t emit the ultraviolet light needed to stimulate vitamin D synthesis. One option for producing more vitamin D is to visit a tanning booth once a week, but that may also increase your risk of skin cancer.
Supplement with vitamin D
A more straightforward way to increase your levels of vitamin D without the need for tanning beds or increased risk of skin cancer is to simply supplement with vitamin D. You’ll want to have your doctor check your levels of vitamin D and, if they’re low, recommend a dosage for getting them back to normal. Typically, someone with low vitamin D levels should take a high dose for several months, then have her levels checked again. After that, she can switch to a lower maintenance dose. If your vitamin D levels are normal and you take high doses for a long time, you may get too much calcium in your blood, leading to symptoms like nausea, vomiting, and weakness. It can eventually lead to bone pain and kidney stones. So it’s very important to have your levels checked if you’re taking high dose supplements.
Just as with other forms of depression, cognitive behavioral therapy, or CBT, can be effective in treating SAD. CBT works by helping you change maladaptive beliefs and ways of thinking and by helping you identify activities you might enjoy, despite the lack of sunlight.
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