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Don’t Worry, Be Happy: Beating the Seasonal Blues of SAD

Winter might not officially begin until December 21st, but its presence has already been well established. The shorter, darker days, chilly weather, increasing hermit life, and plummeting green foliage make for a depressing picture, and it hits some of us harder than others. Seasonal affective disorder (SAD) is a full-blown diagnosis for those struck down by a wintery depression. This is more than just a case of the “winter blues”; SAD can feature more serious mood changes that influence how a person thinks, feels, and behaves. It’s characterized by lethargy, sadness, and a vague feeling that warmth and sunlight are gone for good. Unsurprisingly, SAD isn’t as commonly reported in countries where the sun shines all year round. Symptoms of SAD include: <ul> <li>Feeling hopeless</li> <li>Low energy/fatigue</li> <li>Issues with concentration</li> <li>Strong appetite</li> <li>Desire to isolate</li> <li>Thoughts of suicide</li> <li>Weight gain</li> </ul> <figure><img alt="" height="411" src="https://cdn.storymd.com/optimized/1dmkwefLAp/original.jpg" width="731" /> <figcaption>Seasonal Affective Disorder Source: TheVisualMD</figcaption> </figure> Symptoms usually last 4–5 months and resolve with shifts in the weather come spring and summer. SAD usually starts in young adulthood and affects women more often than men. It can be mild, making you feel a bit out of sorts, or it can be serious enough to interfere with relationships and work. Some 11 million Americans deal with it each year. SAD has an almost poetic quality given its association with shifting atmospheres and environments, but we’re not sure of its causes. Some theorize that certain hormones made deep in the brain may trigger mood changes at this bleaker time of year, SAD being one of them. Less sunlight during fall and winter decreases serotonin production in the brain, the feel-good chemical involved in mood regulation. Nerve cell pathways in the brain rely on serotonin to function properly, and short supplies can lead to feelings of depression, along with tiredness and weight gain. Melatonin, a hormone associated with sleep, has also been linked to SAD. Your body makes more melatonin when it’s dark, so with shorter and darker days, more melatonin is made. This can throw off your circadian rhythm (your body’s internal clock that regulates the sleep-wake cycle). SAD is mostly a winter phenomenon, but it turns out that Lana del Ray wasn’t being melodramatic when singing about that summertime sadness. It might be most people’s favorite time of year, but others get sick during the summer for reasons we don’t understand. Just 5% of SAD cases are found in the summer months. Whereas the winter cohort of SAD patients often feel muggy, preferring to hibernate and overeat, their summer counterparts have the opposite problem: insomnia, anxiety, a loss of appetite, and even aggression are among the reported symptoms. SAD is more common in people with depression or bipolar disorder (particularly bipolar II disorder). Patients with SAD frequently have other mental disorders like ADHD, eating disorders, or anxiety/panic issues. <h2>Clawing back some light</h2> Treatment for SAD differs depending on the nature of your case. For some, a more active effort to engage with sunlight and get outside can be enough, while other cases are more complex when they are connected to pre-existing conditions like bipolar disorder. Light therapy, antidepressants, talk therapy, or some combination of the above is how it usually goes. <h3>Antidepressant medications</h3> Antidepressants are a common line of treatment for seasonal depression. They take time to work (4–8 weeks), and problems related to sleep, appetite, and concentration may be alleviated before your mood is. If you go this route, be patient; these medications need to be given a proper chance to work before you decide if they’re right or not for you. Sometimes several medications have to be tried before you find the one that works. Since SAD, like other types of depression, is connected to abnormal serotonin activity, doctors sometimes use selective serotonin reuptake inhibitors (SSRIs) to treat symptoms. Bupropion XL (Wellbutrin) is a popular medication for treating depressive episodes in people with SAD. <h3>Light therapy</h3> Getting more natural light exposure is an obvious but effective means of treating the issue. Going outside to catch some wintery rays isn’t always possible because of how dark winter can be depending on where you live, so using artificial light is an alternative. Light therapy uses special boxes that produce a bright white light that’s as good as the real thing as far as your brain is concerned. For those without a SAD diagnosis, light therapy may be an effective preventative measure to stop it from developing. Light boxes are all over the marketplace, and there are a few things you should know before investing. The first is to make sure the product features a minimum of 10,000 lux exposure. Lux is a measurement of light intensity, and a bright day features 50,000 lux or more. Positioning is important. You don’t want to stare directly into the light, so keep it off to the side about a foot away. You can do other activities at the same time like watching TV or reading. Finally, timing and duration matter. Bask in some artificial light for 30 minutes a day (doesn’t have to be consecutive) and try to get it in early if you can (before 10 am). Most SAD patients experience improvements from light therapy within a week or two, and to maintain the benefits, the practice should be kept up throughout winter. If SAD is a regular annual occurrence for you, get ahead of the curve by using light therapy in the fall in advance of the darker chapter that lies ahead. As the days become longer and spring approaches, light therapy can be downgraded as a tool, but you can pick it back up on particularly cloudy weeks. Some have reported mild side effects like headaches, but the practice is generally regarded as safe. Note that certain medications can make your skin more sensitive to light (for example, antibiotics like tetracycline). Also, if you have a family history of macular degeneration, light therapy may increase your risk. Talk to your doctor before proceeding. <figure><img alt="" height="583" src="https://cdn.storymd.com/optimized/rA3MWlT4dM/original.jpg" width="534" /> <figcaption>Typical light therapy unit used for Seasonal Affective Disorder Source: Lou Sander</figcaption> </figure> <h3>Psychotherapy</h3> Psychotherapy can help people suffering from SAD by teaching them new ways of thinking and behaving and changing negative habits that reinforce depression. Cognitive behavioral therapy (CBT) is a more straightforward type of talk therapy that aims to help people learn to challenge and change destructive thinking patterns. This can improve feelings of depression and anxiety. A specific variation called CBT-SAD has been adapted for people with the disorder. CBT-SAD is usually conducted as 2 weekly sessions across 6 weeks, and the meetings are focused on developing more positive thoughts in place of the negative ones related to winter’s darkness. An interesting feature of CBT-SAD is a process called “behavioral activation”. This means helping patients to identify and organize activities that offset the apathy and boredom they usually experience in winter. CBT-SAD has been found in some research to be equally as effective in improving SAD symptoms, although light therapy worked slightly faster for some symptoms. On the flip side, long-term research has found that the benefits of CBT stuck for longer. <h3>What about vitamin D?</h3> If you know anything about SAD, it’s probably that people take vitamin D to counter it. The thing is, we’re not sure that actually works. Most of your body’s vitamin D intake is through exposure to sunlight via the skin, and many people with SAD have low levels. Vitamin D is known to boost serotonin activity, so there may be a connection between the two. Research, however, has been unable to firmly establish a link between vitamin D supplementation and relief of SAD symptoms. The available research on vitamin D supplements has produced mixed results. Some say it’s as good as light therapy; others find no effect whatsoever. <h2>More on Seasonal Affective Disorder</h2><ul><li><a href="https://soulivity.storymd.com/journal/6we77n6u5j-seasonal-affective-disorder" target="_blank">Seasonal Affective Disorder: More Than the Winter Blues</a></li><li><a href="https://soulivity.storymd.com/journal/vm9nx64sgw-depression" target="_blank">Depression: Types, Causes, Symptoms, Treatment</a></li><li><a href="https://soulivity.storymd.com/journal/5mryykvuzj-mood-disorders" target="_blank">Mood Disorders (Affective Disorders)</a></li></ul>

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