Wintertime Blues

As the days get shorter, we all start to see the effects of winter blues on our day to day living. The days when it is a struggle to wake up, get motivated, to avoid eating all the carbs, and to maintain our baseline activity level. The allure of our beds increases, the holiday treats start to sneak up on us, and the appeal of going for a hike lessens as the cold seeps in. While most of us will experience a handful of days like this during the winter, for some these bad days start to outnumber the good. Estimates of those who experience seasonal onset depression, or seasonal affective disorder (SAD), range between .5% and 10% of the population, with young adults and women tending to be at increased risk.

Although many may not meet the diagnostic criteria for SAD, the importance of recognizing the impact of seasonal changes on our bodies and knowing when to get in touch with a doctor can make a huge difference.

There are two distinct seasonal version of SAD: one that affects individuals in the summer and the other affects individuals during the winter. The

most common variation is winter onset SAD and is the focus of this article. According to the Mayo Clinic, typically symptoms of SAD are: feeling sad almost every day, loss of interest in things you enjoyed, low energy, difficult with sleep (typically sleeping too much), craving carbs, weight gain, feeling hopeless, difficulty concentrating, and suicidal thoughts (https://www.mayoclinic.org). The difference between depression and winter SAD is that symptoms resolve as the season changes to spring and summer. Why then do we start to struggle in the winter? That is a question that has, and continues, to intrigue researchers. The top theory involves the seasonal shift of daylight and its impact on our serotonin and melatonin levels. These hormones control our circadian rhythm. As the amount of sunlight decreases, our body produces more melatonin making us feel fatigue and relaxed (lacking motivation). Additionally, as the sunlight decreases our vitamin D levels tend to decrease as well, thereby making it harder for our body to absorb serotonin. Serotonin, which is naturally produced by our bodies, plays a central role in regulating temperature, behavior, and attention span. So, as both melatonin and serotonin fluctuate with the changing season (decreased sunlight), our moods and behavior will also change.

There are two main treatments for SAD: medication (anti-depressants) and light therapy. Antidepressants have been used to combat depressive disorders for a long time, and there are studies that show that seasonal use of antidepressants can decrease the impact and longevity of depressive symptoms. However, antidepressants often are accompanied by a slew of side effects and are typically only prescribed if the severity of symptoms warrants the risk of these side effects. Bright light therapy has struggled to be accepted in mainstream society as treatment for depressive episodes. However, increasing research indicates that bright light therapy can effectively combat SAD, particularly for those with mild cases. Bright light therapy has limited to no side effects for most people, and can help increase vitamin D levels while simultaneously decreasing the production of melatonin.

So, what can you do if you start to notice the winter’s impact on your overall mood and wellbeing? First, make a plan. If you know that the winter can be a difficult time for you, be proactive. Use the fall as a transition period to set yourself up for success. Schedule social outings to combat the desire to isolate. Use a light box in the morning to help maintain your circadian rhythm, increase your vitamin D, and decrease production of melatonin. Find and try a new exercise routine to help keep you active, interested, and motivated. Talk with your doctor about checking your hormone levels and vitamin D levels. Start talk therapy- CBT combined either medication or light therapy has proven to increase effectiveness of treatments. And lastly- remember that you are not alone. Biologically, winter affects our bodies, and we need to recognize its impact while also being proactive to counter any negative effects we might experience.

One final thought- while many may not be diagnosed formally with SAD, most of us will notice seasonal changes in our appetite, activity level, and mood. While medication might not be the best treatment option, due to the severity of the symptoms and the increased risk of side effects, implementing concrete and simple lifestyle changes can help to curb the negative symptoms and decrease the number of bad days we experience throughout the winter months. So, what changes can you make today to set yourself up for success moving forward?