WINTER BLUES:What to do when seasonal affective disorder makes normal living impossible
Winter blues is midpoint on the spectrum of reactions to seasonal changes.
Most people experience some changes with the seasons – they may feel less energetic, sleep and eat a little more in winter and sometimes have low moods.
It’s when these seasonal changes disrupt your daily life – making it difficult to get to work on time (or indeed do your work) or causes more arguments with family and friends that they are described as the winter blues.
Seasonal affective disorder (SAD) is when the symptoms – depression, changes to sleep and eating habits and energy levels – make normal living impossible. Seasonal affective disorder was first classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) by the American Psychiatric Association in 1987.
Who does it affect and why?
SAD can affect people of all ages – children included.
The onset and duration of symptoms vary with some people noticing a slump in September while others don’t feel their mood drops until after Christmas. Similarly, some feel better by March and for others it may be April.
More people seem to be affected in the northern hemisphere where winters are longer and darker.
However, SAD also crops up as a problem for people in sunnier climes where night falls earlier and more abruptly.
SAD is believed to be caused by the increased production of brain chemical melatonin in winter months.
What can you do about it?
Light therapy, antidepressants, psychotherapy, exercise and meditation are among the treatment options for SAD and winter blues. In his book, Winter Blues, – Everything You Need to Know to Beat Seasonal Affective Disorder (Guilford Press, fourth edition), Dr Norman Rosenthal advises people to have other conditions including underactive thyroid, hypoglycaemia, chronic viral illness and chronic fatigue syndrome ruled out before diagnosing SAD.
He also suggests that people with milder symptoms can try to moderate the symptoms themselves while those with severe and/or chronic symptoms will need expert help.
Light therapy
Increasing numbers of people are turning to artificial light boxes to help alleviate seasonal blues. Rosenthal suggests light therapy works for some because it restores daily rhythm by decreasing the duration of melatonin secretion while also boosting brain neurotransmitters such as serotonin, dopamine and norepinephrine.
In his book, he says that light boxes are best used early in the morning for between 20 and 90 minutes depending on severity of symptoms.
Besides formal light therapy, getting outdoors on sunny winter days and having more lights and lamps in your home is also recommended.
Antidepressants and psychotherapy Many psychiatrists prescribe antidepressants for SAD. Psychotherapy or counselling can be helpful to those who feel stuck in their lives or trapped in gloomy ways of viewing themselves.
Meditation
Meditation helps calm the mind and body and has a role in stress reduction. Many people find various forms of meditation – mindfulness meditation, transcendental meditation, etc – helps them cope better with fluctuating moods.
Exercise and healthy eating
The value of regular exercise and a healthy balanced diet for the treatment of all depression – including SAD – is well established. Healthy eating is particularly important for those who crave carbohydrates in the winter months.
Norman's wisdom: 'I now celebrate the joy of winter'
Dr Norman Rosenthal, the author of Winter Blues, is a psychiatrist based in Washington DC and one of the first researchers to examine the use of light therapy in the treatment of SAD.
He first realised that he suffered from SAD himself when he moved from his native South Africa to New York City in the 1970s.
He now treats himself with daily light therapy in the winter months, daily meditation and exercise.
"I regard myself as lucky to be living after the recognition of SAD and the discovery of effective treatment strategies.
"Many people with SAD enjoyed the winters of their childhood.
"Then they suffered for years until they understood the nature of their problem and found successful treatments for it.
"After their SAD symptoms had been treated for several years, they began to rediscover the quiet pleasures of winter and to feel reconnected with their childhood.
"I now celebrate the joy of winter that has eluded so many of us for so long."
Why so SAD? what it feels like
"I feel as though I 'live' only during the sunny months. The rest of the time I seem to shut down to an idle, waiting for spring, enduring life in general. This is no joking matter to those of us who are like this. We, in effect, live only half our lives, accomplishing only half of what we should. It is really rather sad, when you think of it."
"November marks the onset of real difficulties for me. I become sad and worry about small things that wouldn't bother me at all in the summer. Preparing for Christmas is always an enormous chore. I am bad about getting my cards off and my gifts wrapped. I tend to avoid the usual round of parties. January and February are my worst months. On many days it's all I can do to get in to work and often I don't. I call in sick. Once I'm there it's very hard to get my work done. In March and April, my energy begins to come back and that's a relief but it's late spring and summer before I feel myself: friendly and happy."
"Since I started using the lights in winter, my brain seems to be clearer, I seem to be happier and the writing goes better. Not only am I much more productive, but I also seem to be much more creative . . . I also don't mind being at my desk and writing as much as I did before. When I used to think of having to write in the winter, it was a great effort . . . Now, I have a much lighter feeling about it. It's more fun."
These stories are excerpts from Winter Blues – everything you need to know to beat Seasonal Affective Disorder (Guilford Press, fourth edition) by Norman E Rosenthal MD
See also
normanrosenthal.com cet.organd
brighterday.ie
