Winter depression

Who hasn’t experienced the winter blahs? The short days and long nights are too often accompanied by a sense of restlessness or sadness that can translate into weight gain and a shortage of energy.

Some people, however, experience a more serious form of the winter blues. When depression and fatigue become debilitating, this could signal a condition called seasonal affective disorder (SAD).

Symptoms of SAD include feelings of depression, lethargy, fatigue, cravings for sweets and carbohydrates, headaches, sleep problems, irritability and mood swings.

Seasonal affective disorder, which is thought to be caused by decreased sunlight during the winter months, commonly begins in young adulthood and is thought to be more prevalent in women. In Canada, 2 to 3 per cent of people are affected by the disorder.

Symptoms

Because it is a cyclical condition, the signs of SAD are present only during a particular season. In most cases, the symptoms of SAD appear only during the winter and/or late fall. (A more rare form of the condition is known as reverse SAD, which is characterized by hyperactivity during te summer.)

Many symptoms of SAD are similar to those of major depression. If you regularly experience these symptoms when the seasons change, you may have seasonal affective disorder:

– Sadness or despair

– Anxiety

– Lack of energy

– Withdrawal from friends and family

– Increased sleepiness and irritability

– Loss of interest in work and social activities once enjoyed, including sex

– Increased appetite and craving for foods high in sweets and carbohydrates

– Weight gain

– Difficulty concentrating and processing information

While most people experience “down days,” health experts advise seeing your doctor if you feel depressed or sad for days at a time or if life seems to be losing its pleasure. This is particularly important if your sleep patterns and appetite have changed — and certainly so if you think about death or suicide.

Cause

Doctors don’t know the exact cause of seasonal affective disorder, but heredity, age, the body’s chemical makeup as well as the availability of sunlight may all play a role.

Researchers believe the condition may be related to the body’s internal clock. Reduced sunlight may disrupt the circadian rhythms that regulate your body’s temperature and hormone production. And in turn, this disruption may cause depression.

Moreover, some scientists theorize that melatonin, a sleep-related hormone that’s also linked to depression, might be the culprit. Production of melatonin increases during long winter nights.

Other studies suggest that lack of serotonin, a brain chemical that regulates mood and behaviour, seems to be triggered by sunlight. People who are depressed are known to have decreased levels of serotonin.

Treatments

While there is no cure for SAD, like depression, it often can be successfully managed. Treatments may include:

Light therapy
This is the main treatment for many people with seasonal affective disorder. It consists of daily exposure to bright light (10 to 20 times brighter than ordinary indoor lighting) to help balance brain chemicals and reset body rhythms. Used to simulate sunlight, the treatment usually consists of sitting in front of a high-intensity fluorescent light source for thirty minutes or more each day. This can be done simultaneously with other activities such as reading or eating breakfast.

Light sources are available in a variety of strengths (usually from 2,500 to 10,000 lux) and include fluorescent light boxes, desktop lamps and lamp visors. White fluorescent light is thought to be safer than ultraviolet light (which is used in some tanning beds). Possible side effects include headaches, eye strain and nausea. For some people, it may take 2-4 weeks for relief of symptoms once you begin light therapy.

Most light boxes cost between $250 and $500 and are not covered by all insurance plans. Consult your doctor for more information if you’re thinking of buying a light box. Be sure to look for one that is approved by the CSA (Canadian Standards Association) and has a filter to block any harmful ultraviolet light.

Medication
Antidepressant medication may be prescribed in combination with light therapy, or as an alternative. According to the Mayo Clinic, about 70 per cent of people taking antidepressants have decreased symptoms of SAD, and about half experience remission while taking medication.

Examples of antidepressants used in the treatment of SAD include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor).

Psychotherapy
Psychotherapy can be used to help modify negative thoughts and behaviors that may contribute to SAD symptoms. Therapy is also used to help manage symptoms and prevent recurring episodes of depression.

Coping strategies*

Some lifestyle changes can also help you cope with winter depression.

– Bring more light into your home. Open blinds, add skylights and trim tree branches that block sunlight.

– Get outside. Walk outdoors on sunny days, even during winter. Outdoor light, even when the sky is overcast, is often brighter than light boxes.

– Exercise regularly. Physical exercise helps relieve fatigue, stress and anxiety. Being more fit can also do wonders for your mood and make you feel better about yourself.

– Find ways to relax. Learn techniques such as meditation or yoga to better manage stress.

– Get away. If possible, escape winter by taking a vacation in a warm, sunny location.

*Source: The Mayo Clinic

ON THE WEB
MayoClinic.com: Seasonal Affective Disorder
Seasonal Affective Disorder Association

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