We are in the depths of winter, where we wonder if the sun will ever come back. (Oddly enough, the sun is actually out today where I am and it brings a smile to my face!) At this time of the year, especially after the excitement of the holidays that help push us through, our mood and energy can slump. Some people even find themselves struggling with Seasonal Affective Disorder (SAD).
What is SAD?
Seasonal affective disorder (SAD) is a type of depression that’s related to changes in seasons. SAD begins and ends at about the same times every year. Most people with SAD will have symptoms start in the fall and continue into the winter months, sapping their energy and making them feel moody. Less often, SAD causes depression in the spring or early summer.
Treatment for SAD may include light therapy (phototherapy), psychotherapy and medications or natural supplements.
Don’t brush off that yearly feeling as simply a case of the “winter blues” or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year.
Seasonal affective disorder is a subtype of major depression that comes and goes based on seasons. So symptoms of major depression may be part of SAD, such as:
- Feeling depressed most of the day, nearly every day
- Feeling hopeless or worthless
- Having low energy
- Losing interest in activities you once enjoyed
- Having problems with sleeping
- Experiencing changes in your appetite or weight
- Feeling sluggish or agitated
- Feeling easily irritable
- Having difficulty concentrating
- Having frequent thoughts of death or suicide
Fall and winter SAD
Symptoms specific to winter-onset SAD may include:
- Tiredness or low energy
- Problems getting along with other people
- Hypersensitivity to rejection
- Heavy, “leaden” feeling in the arms or legs
- Appetite changes, especially a craving for foods high in carbohydrates
- Weight gain
How Do I Know When to See a Doctor?
We all have days that we feel down, and this is totally normal. If you feel down for days at a time and you can’t get motivated to do activities you normally enjoy, or start to experience more days than not where you are experiencing symptoms listed above, it’s time to reach out to your medical provider or therapist. This is especially important if your sleep patterns and appetite have changed or if you feel hopeless, think about suicide, or turn to alcohol for comfort or relaxation.
Although a specific cause of seasonal affective disorder remains unknown, it is possible that the following factors play a role:
- Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may disrupt your body’s internal clock and lead to feelings of depression.
- Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression.
- Melatonin levels. The change in season can disrupt the balance of the body’s level of melatonin, which plays a role in sleep patterns and mood.
Factors that may increase your risk of seasonal affective disorder include:
- Being female. SAD is diagnosed more often in women than in men, although men may have more-severe symptoms.
- Age. Young people have a higher risk of winter SAD, and winter SAD is less likely to occur in older adults.
- Family history. People with SAD may be more likely to have blood relatives with SAD or another form of depression.
- Having clinical depression or bipolar disorder. Symptoms of depression may worsen seasonally if you have one of these conditions.
- Living far from the equator. SAD appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter and longer days during the summer months. (This includes all of my fellow PNWesterners!)
What Can You do to Help Yourself?
Treatment for seasonal affective disorder may include light therapy, medications and psychotherapy. If you have bipolar disorder, tell your doctor — this is critical to know when prescribing light therapy or an antidepressant. Both treatments can potentially trigger a manic episode.
In light therapy (phototherapy) you’ll sit a few feet from a special light therapy box so that you’re exposed to bright light. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood.
Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to two weeks and causes few side effects. Research on light therapy is limited, but it appears to be effective for most people in relieving SAD symptoms and worth a try. Light therapy is recommended first thing in the morning (or before 9am) to reduce sleep disruption.
Before you purchase a light therapy box, talk with your doctor or therapist about the best one for you, and research the variety of features and options so that you buy a high-quality product that’s safe and effective. There will be different levels of light output that will require varying amounts of time that you will sit in front of the light.
Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe. Speak with a medical provider that you trust about this option.
Psychotherapy is another option to treat SAD. Psychotherapy can help you:
- Identify and change negative thoughts and behaviors that may be making you feel worse
- Learn healthy ways to cope with SAD
- Learn how to manage stress
- Feel supported
In addition to your treatment plan for seasonal affective disorder, try the following:
- Make your environment sunnier and brighter. Open blinds or add skylights to your home, if you can. Sit closer to bright windows while at home or in the office and look outside as often as possible. Decorate with brighter colors to make your environment feel sunnier.
- Get outside. Take a long walk, eat lunch at a park, or simply sit outside and soak up the sun. Even when the weather is cold and cloudy, outdoor light may help.
- Exercise regularly. Exercise and other types of physical activity help relieve stress and anxiety, both of which can increase SAD symptoms. If you do this in the morning outside, you’ve knocked out 2 of these suggestions!
Some people choose to take a supplement to treat depression, such as:
- St. John’s wort. This herb is not approved by the Food and Drug Administration (FDA) to treat depression in the United States, but it’s a popular depression treatment in Europe. It may be helpful if you have mild or moderate depression, but St. John’s wort should be used with caution. It can interfere with a number of medications and you should discuss with your doctor first if you are taking any medications. If you do try St. John’s Wort, I recommend using it from a company with stringent safety and efficacy standards, like Shaklee. They offer a MoodLift Complex that includes St. John’s wort.
- Melatonin. This dietary supplement is a synthetic form of a hormone occurring naturally in the body that helps regulate mood. A change in the season to less light may change the level of melatonin in your body. Taking melatonin could decrease winter-onset SAD, but more research is needed. Safety in children or with long-term use in adults has not been determined.
- Omega-3 fatty acids. These healthy fats are found in cold-water fish, flaxseed, flax oil, walnuts and some other foods. Omega-3 supplements are being studied as a possible treatment for depression. I recommend this pharmaceutical grade supplement – OmegaGuard or this vitamin pack that includes a quality Omega-3 supplement. Keep your Omega-3 fatty acids low.
- Vitamin -D. I’ve shared a lot about Vitamin D in a previous post here. We get most of our vitamin-D from the sun. Although the research is not yet conclusive, it makes sense that our vitamin D levels drop in the winter. Recent research has concluded that most of us are actually vitamin-D deficient and may benefit from supplementation. I always take extra D in the winter. This is my favorite Vitamin-D to take because it came out of the culmination of recent scientific research including two Shaklee industry-leading vitamin D studies. This supplemental vitamin D is clinically supported and proven to significantly raise blood levels of vitamin D.
Some herbal and dietary supplements can interfere with prescription medications or cause dangerous interactions, talk to your health care provider before taking any supplements.
Mind-body therapies that may help relieve depression symptoms include:
- Guided imagery
- Massage therapy
I’ll be sharing more on mind-body therapies such as meditation and yoga soon!
Now go outside and get some sunshine!