by Nancy Mitchell, APRN
It’s that time of year again. The days are getting shorter, daylight savings time is around the corner, the skies are often overcast, the temps are getting chilly, and rain and snow can interfere with outdoor activities. It’s not uncommon to feel a bit blue or blah in the winter, especially around the winter holidays or after all the festivities have ended. Winter blues is not a medical diagnosis; it’s a slang term used to describe a minor shift in mood that clears up on its own in a fairly short amount of time. It is often linked to something specific, such as missing an absent loved one, sick family members, or the stress of cooking, shopping, decorating, and celebrating birthdays, holidays, graduations, or anniversaries.
Seasonal Affective Disorder (SAD) is a type of clinical depression that usually starts in adulthood and is cyclical in nature, that is, it occurs most frequently every fall and/or winter. Risk factors for SAD include: family history, having major depression or bipolar disorder, living far from the equator, low levels of Vitamin D, being a young adult, and being a woman. There are a few people that experience SAD in the spring and summer, but it is rare.
The main trigger for SAD seems to be shorter days of sunlight. Reduced sunlight can cause a drop in serotonin. Less sunlight triggers chemical changes in our brains that can disrupt our body’s internal clock, also known as the circadian rhythm. Our eyes absorb daylight and darkness and send messages to our brain, which in turn sends cues that signal parts of the body to either be awake, be active, and ready for action or slow down, get drowsy, and sleep. Less sunlight decreases the signals to be active and energetic, and more darkness causes the pineal gland to make more melatonin, which makes us tired and sleepy. This disrupted circadian rhythm can trigger a serious depression that can make people feel hopeless, worthless, and irritable. They may lose interest in activities, they isolate themselves from family and friends, lose energy, feel fatigued, oversleep, turn to alcohol and drugs, and they crave carbohydrates and gain weight. It’s almost like a form human hibernation. Without treatment, the symptoms worsen and will persist until after the days start getting longer. Some people can feel hopeless and think about suicide.
There are several treatments for SAD:
1) Exposure to sunlight outside, particularly early in the morning, even on a cloudy day.
2) Light Box Therapy (specialized bulbs that emit the same wavelength of light as the sun)
3) Psychotherapy, particularly CBT and interpersonal therapy
4) Antidepressants
5) A combination of all of the above
It’s normal to have some days when you feel down, blah, or blue, particularly in the winter. However, if you feel down and depressed for more than a week, and you can’t get motivated to do the activities you normally enjoy, see your health care provider. Reach out immediately to family, friends, your therapist, your medical provider, or call 988 if you are having thoughts of suicide.
5-6 months a year is a long time to be impaired and suffering. SAD is generally quite treatable, and some people see results in just a few weeks. Our highly skilled medication provider at Cardinal Counseling can evaluate you for Seasonal Affective Disorder and work with you to develop the best individualized, evidence-based treatment option for you, including prescribing medications and providing information on obtaining and using a Light Box. A Light Box should only be used under the direction of a medical professional. Our expert therapists can help guide you in taking the steps to keep your mood and motivation steady throughout the year. Research has shown that people treated with CBT have less depression and less return to SAD the following winter. Let us know how we can help you beat the winter blues and seasonal affective disorder!