Your Mind Your Body

As fall weather merges into the darkness of winter and daylight hours become short many people find themselves experiencing symptoms resembling depression. For some, the symptoms are relatively brief. Tempers may seem shorter for parents stuck inside with cranky or sick children. An increased sense of lethargy with a desire to lie around and binge on sweets rather than do chores is not uncommon on a dreary winter day. For others, however, these symptoms last and can become quite disabling. They are more than just the winter blues. When a pattern of depression occurs for at least two years in a row during the fall or winter months followed by a seasonal remission and the seasonal episodes of depression substantially outnumber any nonseasonal depressive episodes over the individual’s lifetime a diagnosis of a seasonal depression can be made. This pattern has come to be known as Seasonal Affective Disorder or SAD. The prevalence of winter-type seasonal pattern appears to vary with latitude, age and sex. Prevalence increases with higher latitudes. Symptoms are rare in those living within 30 degrees of the Equator where daylight hours are longer in the winter.  Younger persons and women appear to be at higher risk The diagnosis of SAD is not given to individuals who are  experiencing obvious seasonally related stressors(i.e. being unemployed every winter, having a difficult relative come to stay for the winter months) .  

Symptoms of seasonal affective disorder include sleep difficulties, lethargy, overeating (an increased desire for carbohydrates and sweet foods resulting in a weight gain), increased consumption of alcohol and general feelings of depression including a sense of hopelessness and despair, feelings of guilt, apathy and loss of self-esteem. Feelings of irritability and a desire to avoid social contact are not uncommon. Many report increased feelings of anxiety, loss of sexual desire and mood swings, including short periods of overactivity, especially in the fall or spring. These symptoms can vary in severity and often can interfere with your personal relationships.

Bright visible- spectrum light is often a very effective treatment in up to 85% of cases. This type of light is approximately 10 times the intensity of ordinary domestic lighting. The goal is to achieve exposure to light which resembles sunlight. Recommended exposure is up to four hours per day. Light boxes which emit even brighter light are available and can be used to shorten exposure time. Many patients report positive results after exposure of a few days.

The use of antidepressant medication, particularly the SSRI group can be very helpful in treatment of seasonal depression. In addition, psychotherapy to help the patient understand the disorder, cope with its effects and find the right combination of treatment is extremely beneficial. It is very important for individuals to discuss their symptoms with their health care provider to determine if they have a seasonally related depression. As fall begins to wind down it is helpful to try and prepare emotionally for the shorter days of winter. Some ideas to consider to avoid the winter blues include:

• Expose yourself to as much light as possible. Read by the light of a window. Set up a coloring station or play-doh table by a window for your children.
• Plan interesting outdoor winter activities. Find out where the local skating rinks are. Take up a winter sport. 
• Stay physically active, even if your activity is indoors. Some of us really hate the cold weather. It is well documented that physical activity improves mood.
• Cook an interesting soup from scratch. Make a warming meal with lots of vegetables in the crock pot.
• Soak in a warm bath.
• Sit on the floor in your bathroom with a cup of herbal tea while your kids put on bathing suits and pretend its summer while playing with toys in the bathtub.
• Snuggle with your significant other
• Snuggle with your kids
• Snuggle with your pet…petting your dog or cat can blood pressure and increase a sense of well-being
• If you find that you really just can’t move beyond a sense of gloom or feel your mood sliding downhill, talk to a mental health professional, such as a psychologist  familiar with symptoms of Seasonal Affective Disorder. You are not alone and there really is help.

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