Winter has arrived. It’s dark and cold. It will be dark and cold again tomorrow.
The good news is that we have made it past the winter solstice. The days are getting longer. However, January tends to be a long and challenging month for many, especially those living with seasonal affective disorder.
Seasonal affective disorder is a form of depression that affects 5 to 14 percent of the United States population, depending on the study. Seasonal affective disorder typically occurs in the fall and winter months and is often referred to as SAD or “the winter blues.”
SAD is more common in women than in men and tends to run in families. If you have family members who have experienced seasonal affective disorder, depression, or bipolar disorder, you may be at higher risk of experiencing SAD. The further you live from the equator, the higher your chances of developing seasonal affective disorder due to the decreased sunshine in the winter months.
The good news is that seasonal affective disorder is manageable with a variety of treatment options. If you are experiencing seasonal affective disorder symptoms, talk to your therapist or primary care doctor for more information.
What To Watch For
Symptoms may include:
Changes in your mood including increased sadness and irritability; and may include feelings of hopelessness and worthlessness. Physical symptoms may include low energy, feeling tired or fatigued even while sleeping more than usual. Social symptoms include withdrawing from others, avoiding social situations, and losing interest in things you may ordinarily enjoy.
Causes
While the definitive cause is unknown, several things are known to contribute to seasonal affective disorder. These include changes to our body’s clock due to changes in the amount of sunlight available and, in North America, the shift to daylight savings time can wreak havoc with our circadian rhythms. Less sunlight is thought to be a contributing factor in both diminished Melatonin and Seratonin levels. Seratonin is a hormone that helps to stabilize mood, while Melatonin is a hormone that induces sleep.
Treatment
There are six primary modes of treatment for seasonal affective disorder. Many people choose one or two modalities depending on the severity of their symptoms.
Light Therapy
Light therapy, also called phototherapy, helps the body adjust to the decreased daylight in the winter. Special lights with 10,000-lux are generally recommended. Lightboxes are used for 20-30 minutes per day as directed by your physician. The light is approximately ten times stronger than typical indoor lighting. Note that overuse of lightboxes can cause eyestrain, headaches, and difficulty sleeping.
Easy to use and relatively inexpensive, lightboxes can be placed on a desk or table, and you can continue to read, work, or eat while engaging in the treatment. Light therapy must occur at a similar time each day to be most effective. Because it takes time for lightboxes to produce results, it is recommended that those with a history of seasonal affective disorder begin using their lightboxes in the fall when the days become shorter and continue into early spring.
In Scandinavian countries, including Norway and Sweden, clinics have created light rooms to provide treatments to the nearly 15% of the population which experiences SAD.
Counseling
Brief therapy interventions using Cognitive Behavioral Therapy for 6-12 weeks has been shown to be as effective as light therapy. Also known as CBT, this therapy can be in individual or group settings and works to address the thoughts and emotions affected by seasonal affective disorder and interfere with daily functioning.
The cost of therapy varies by region. However, many therapists in clinics and private practice offer sliding scale fees to make treatment more cost-effective. Additionally, with the increase in telehealth use, many clinicians offer counseling sessions via confidential video conferencing, increasing accessibility for those who live rurally or who have challenging work schedules.
Vitamin D
The human body synthesizes Vitamin D from the sun’s ultraviolet B (UVB)rays through the skin. Vitamin D helps the body regulate calcium in the body and supports the production of Seratonin and Dopamine to regulate mood. Low levels of Vitamin D have been shown to increase SAD symptoms. Research has shown that relatively high doses of Vitamin D taken orally are necessary to improve seasonal affective disorder symptoms. Your doctor can monitor your Vitamin D levels with a simple blood test to measure the amount of Vitamin D in your blood.
Anti-Depressant Medications
If your symptoms are severe, consider discussing the benefits of anti-depressant medications with your doctor. Many well-tested drugs can provide relief from symptoms. You may only need to take medication for a few months to provide support from fall through spring.
Good Self-Care
One of the best preventative measures for depression related disorders is good self-care.
- Nutrition – Eat a balanced diet, limiting sugar and starches to prevent mood swings.
- Movement – Get some physical activity each day. Take a walk, do some yoga, or stretching.
- Connect – Engage with friends and family – Avoid the urge to withdraw and spend some time with others: Watch a movie, play a game, or go for a hike.
- Get Outside – Go for a walk, clean up the garden, or play with the dog. A few minutes of fresh air and sun each day can help to boost mood.
- Destress – Reduce stress by engaging in relaxation activities such as yoga or tai chi, listen to music, create art, or meditate.
Create a Plan
While seasonal affective disorder affects millions of people worldwide, it is a manageable condition. Any one of these treatments can help reduce symptoms; however, most people find that a combination of 2-3 of the treatments produces compound benefits. Consider layering self-care, light therapy, and counseling, or a combination of Vitamin D, anti-depressant, and counseling.
Whichever combination you choose, take action now to avoid the “winter blues.”
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Seeking Health and Happiness One Day at a Time.
Marcy Berg is a writer and therapist living in the Pacific Northwest and exploring thoughts on mental health, wellness, and happiness. She can be found at Growing Through Life and Seeking Greener Pastures.