Don’t Hit “Snooze” on Those Winter Blues: Understanding Seasonal Affective Disorder
It’s that time of year again. And we don’t mean the holidays. For 5% of Americans, the end of fall/beginning of winter marks the beginning of an annual slump. Some know it as “The winter blues”, “a seasonal funk”, or even “the holiday hangover”... in the clinical world, it’s known as Seasonal Affective Disorder (SAD), or Seasonal Depression.
Make no mistake - despite the shorter-term nature of SAD (typically lasting for the duration of winter and remitting in the spring), it is still a classification of Major Depressive Disorder, and must be taken just as seriously. Sufferers can experience the full range of symptoms that are characteristic of Major Depressive; these symptoms include:
Feeling “down”, sad, or depressed most of the day, more days than not, even for seemingly no reason.
Loss of motivation to pursue usual activities, as well as loss of interest in enjoyable activities altogether.
Increase in fatigue, loss of energy
Difficulty sleeping (either too much or too little)
Changes in appetite and/or weight
Feeling hopeless, worthless, or guilty
Suicidal and/or self-harm thoughts
For sufferers of SAD with a fall/winter onset, the most common symptoms are low energy, hypersomnia (oversleeping), overeating, weight gain, craving for carbs, and social withdrawal. There are some cases (though uncommon) in which SAD presents with spring/summer onset; the most common symptoms for this type of seasonal depression include poor appetite and associated weight loss, insomnia, agitation, restlessness, anxiety, and episodes of violent behavior.
What causes SAD?
Research shows a combination of factors that increase your risk of developing Seasonal Depression.
The usual suspects include:
Difficulty regulating serotonin levels.Serotonin is one of the key neurotransmitters involved in mood regulation, as well as appetite and sleep/wake cycles. Low levels of serotonin are typically associated with depression; in Seasonal Depression, the overproduction of serotonin transport proteins further impedes your brain’s ability to transmit serotonin as frequently or as far as it needs to go. Research suggests that for those who experience these seasonal, cyclical patterns of depression, the lack of sunlight may signal the sudden change in your brain’s ability to regulate serotonin effectively.
Overproduction of melatonin. Melatonin is the hormone associated with sleep, and plays a role in helping your body regulate its circadian rhythm. Greater exposure to darkness (such as when you go to bed at night) signals a need for sleep hormone from your body. In the winter, the shorter and darker days may signal your brain to produce more melatonin than is necessary, resulting in that lack of energy, fatigue, and loss of motivation.
Disruptions in biological clock.The winter season brings about physical changes in the body, as well as practical changes in lifestyle. The changes in usual food consumption, the increased stress around this time of year, and the changes in usual outdoor activity can all cause a disturbance in your body’s ability to regulate itself, on top of the hormonal changes brought about by the low light of winter.
Additional risk factors include:
Pre-existing diagnosis of Major Depression or Bipolar Disorder. While not everyone with Major Depressive or Bipolar will experience SAD, you are at a higher risk of developing SAD if you are predisposed to depressive episodes.
Family history of Depression.Depression (as well as most mood disorders) has a high degree of heritability between generations. People with a family history of depression are at a higher risk of developing depressive symptoms, although the severity may vary.
Distance from equator.Strange as it seems, SAD has a higher prevalence as you move further away from the equator, where exposure to the sun is most constant. One research study showed that 1% of the population of Florida report SAD symptoms, while 9% of the population of New England and Alaska experience SAD symptoms.
Statistically, cisgender women comprise ⅘of reported SAD sufferers in the United States, and are 4x more likely to develop seasonal depression; likewise, transgender women are at a higher risk of developing depression and anxiety than the general population, and while the exact prevalence of SAD in the trans population is unknown, it is important to be aware of the likelihood of cyclical depression in this population. The highest prevalence of SAD occurs in the 18-30 year old age bracket, and the onset of cyclical depression typically occurs between the ages of 20-30 (although there have been cases of adolescent and even childhood onset).
So what does treatment look like?
· Psychotherapy. Also known to some as “talk therapy,” seeking out counseling/therapy can help you identify negative thoughts or behaviors and process them into positive ones. Licensed therapists will then help you strengthen effective coping strategies to better handle seasonal depression. While this can take time, therapy has been clinically proven to help many SAD sufferers overcome seasonal triggers and depressive moods.
· Light Therapy. One of the most common treatments for SAD is light therapy. Research suggests that receiving “doses” of cool-white fluorescent lighting for several minutes a day can help regulate our biological clock, as this light is designed to mimic the effects of sunlight. One of the best benefits about light therapy treatment is you can do it in the comfort of your own home. It is important to note that light therapy is not intended to mimic an antidepressant effect - rather, it is intended to help “reboot” your body’s ability to regulate its natural rhythm, which is an important step in being able to pursue your usual activities and interests with greater energy and engagement. Not all light boxes are created equal, however, as some produce far more illumination or “LUX” than others, so do your research and talk to your doctor about how much LUX your body really needs.
Medication.Because SAD is a depressive disorder, there may be symptoms that are best addressed through the use of antidepressants. Talking with a doctor about the severity of your symptoms can help better determine the appropriateness of medication in helping you experience relief from your SAD symptoms. Medication may be used seasonally as a preventative factor, or it may be recommended that you continue medication throughout the year - your provider will work with you to determine the best course of action.
Prevention is key!If you are aware that your depression symptoms follow a seasonal pattern, be sure to prepare in advance! Planning self-care activities, surrounding yourself with supportive people, and speaking with mental health and medical providers before the onset of your SAD symptoms can help significantly increase your ability to cope with your symptoms.
· Body Movement. Getting the heart pumping is extremely beneficial for the body and mind when used appropriately. If your exercise regimen tends to take a backseat for the season, it’s important to stick to your usual routine in order to keep your hormones regulated and your body’s rhythm consistent. Even just taking a brisk walk on a sunny day is an excellent way to clear your mind and get your body moving while also getting a dose of the natural sunshine you’ve been missing. Relaxation techniques such as yoga or breathing exercises have also shown to reduce stress and anxiety in many people. Practicing a series of yoga poses while focusing on the breath, promotes a mind-body connection enabling the brain to slow down thoughts and create a more harmonious being.
· Socialize. This might be one of the harder things for us to do when we actually feel like hibernating, but spending time with family or friends can often provide the interaction we didn’t know we needed. Hiding under the covers is never the answer when managing SAD, so whether it’s a card game at home or volunteering in your community, surrounding yourself with people you enjoy can elevate spirits and help you avoid social isolation. Check out www.VisitKnoxville.com to see what activities you can take part in during the winter months.
· Take care of yourself. While we can’t control the seasons changing, we can control how we live during the colder months. Getting the right amount of sleep, staying hydrated, and eating nutritious meals have all been proven to have an effect on how the mind and body function. Researchers have found that drinking water has a direct impact on mood and thinking clearly. It may not be hot outside but keeping a bottle of water with you is still good practice even if you don’t feel thirsty. While grocery shopping try and reach for leafy greens and juicy fruits that are not only nutritious, but also naturally retain water which can help with staying hydrated. Studies have found that women who had a higher intake of fruits, vegetables, and whole grains had a lower incidence of depression in comparison to people who consumed higher amounts of sugar and refined carbs. If you’re unsure of what types of foods might be right for you, consult a Registered Dietitian to guide you on how to best fuel your body according to your needs.
Remember severity and diagnosis of SAD can vary from one individual to the next, so it’s always best to discuss any treatment options with your healthcare providers. Focus Integrative Centers offers psychotherapy, medication management, nutrition consults, and private yoga instruction. Our experienced team of licensed professionals are compassionate about helping individuals overcome Seasonal Affective Disorder along with any type of mental health or lifestyle issues.
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