15 Nov If You’re Feeling SAD this Winter, You’re Not Alone

With daylight savings time squarely in the rearview mirror, we’ve moved into that gloomy time of year when the sun sets during early evening, the days are darker and chillier, and we spend more time than ever indoors. For many, this time of year is associated with the “winter blues” or feeling “down,” but for an estimated 5% of Americans – about 16.7 million, the change in season triggers a form of recurring annual depression.

Seasonal Affective Disorder – commonly referred to as SAD, the most fitting of all medical acronyms – is a form of depression associated with shortened days during the fall and winter months. While much is still not understood about the condition, research links SAD to a biochemical imbalance in the brain caused by shorter days and less daylight in winter. As such, January and February tend to be the most difficult months for those experiencing SAD. 

Hallmarks of SAD

• Onset typically occurs between the ages of 18 and 30, although it may begin at any age.
• A feeling of fatigue, even with oversleeping. 
• A noticeable increase in cravings for carbohydrates, other appetite changes, and  resultant weight gain.
• Social withdrawal
• A loss of interest in once-enjoyed activities.
• Feelings of sadness, worthlessness, and/or guilt
• Fogginess or a general difficulty in thinking, focusing, or decision-making

 
In high school, I began to notice my mood would start to change, just like clockwork, right around the seasonal transition from mid-Fall to Winter. While naturally gregarious, I found myself quieter in class, less willing to raise my hand and engage in dialogue – or with my classmates in the hall. Completing homework assignments became more difficult – focusing grew hard for me. I began skipping out on volunteer activities and regular practices for team sports. At the time, I didn’t know there was any such thing as seasonal depression. It took a few years repeating this cycle of personal hibernation through the wintertime, before my doctor diagnosed me with SAD. 

Facts and Myths

As SAD may be difficult to differentiate from major depressive disorder, or general feelings of light “winter blues” due to the shorter days, many people may be suffering from the condition without ever knowing it. As SAD is still relatively misunderstood, I’ll examine several commonly repeated statements to evaluate their merit – to either debunk or verify:

SAD is equivalent to the “winter blues.” 

False. The “winter blues” is associated with a mild and transient sadness that may come and go during the winter months, whereas SAD is a form of depression that interferes with an individual’s happiness, health, and motivation.

There is no treatment available for SAD. 

False. Preventative measures have been shown to be helpful in minimizing the effects of SAD. Predicting its onset during the changing seasons can be helpful so that you have treatments in place before major depression sets in. Treatments like bright light therapy can help – it is currently considered the most effective treatment available. 

Scientists don’t fully understand what causes SAD.

True. SAD is officially catalogued as a version of major depression disorder with a “seasonal pattern.” Responses to seasonal changes may result in hormone changes that impact neurotransmitter levels, like serotonin, and disrupt other biochemical balances in the body, such as melatonin levels and one’s natural circadian rhythm. 

Seasonal Affective Disorder only occurs in the winter.

False. A smaller number of individuals experience the onset of SAD during the summer months. While it is also associated with the change of seasons and considered a form of depression, summer-onset SAD affects individuals in completely opposite ways. Whereas SAD often causes carbohydrate cravings, weight gain, and an urge to oversleep – or hibernate – in those with winter-onset SAD, those who experience SAD in the summer tend to feel greater states of agitation, experience bouts of insomnia, and a lessened appetite. 

Treatment Options

While I used to despair about the onset of winter, I’ve come to embrace it. I still don’t love cold weather and snow, but by working closely with my health care team we’ve developed a tailored treatment plan that helps me cope. In the section that follows, I’ll share tips on what works for me, derived from my personal experience coping with SAD each year. If you suspect that you suffer from SAD, reach out to your healthcare provider to learn more and develop a tailored treatment plan tailored specifically for you. 

Light therapy: Bright Light Therapy was the easiest, and most cost-effective, strategy I started with. Through some online research and conversations with my health care team, I was able to find the time of day that worked best for me to use a light box, and worked to find one that fit my budget at the time. I also realized that some of the lights in my school and work environment had a similar light source and could be helpful for me if I was around them at my ideal times of day. As you prepare for a conversation with your health care team, take a look at this website to see what your ideal time of day might be.

Time outdoors: I’m not a fan of cold and snow, but there is a lot of truth to be said about getting outside and enjoying the fresh air and natural sunlight as much as you possibly can. It has been easier for me to do this with my son, as he loves to spend time outside. We now plan family walks on the weekends during the daytimes, and my partner and I will try to go for a lunchtime walk while our son is at school during the week. We wear lots of layers to stay warm, and don’t forget about the sunscreen even in winter months! I also like to reward myself with a nice cup of tea when we get back home!

Engaging with my healthcare team: For me, adding a light box and some additional fresh air wasn’t enough to combat the impacts of SAD. I have engaged additional members of my healthcare team and through my relationship with my therapist we engage in bi-weekly sessions to increase my awareness and skill sets to manage the challenging moments. Our use of validated screening tools, like the PHQ-9, clues us in to when we need to engage with other healthcare providers for medicinal interventions to allow me every opportunity to be present in day-to-day life.

Even though SAD is still relatively misunderstood, there are many proven ways to help treat the condition. Sharing information is a valuable effort to help combat the condition’s prevalence. While an estimated 5% of Americans are diagnosed with SAD – some studies project that as many as 1 in 20 Americans suffer from a form of seasonal depression. 

Behavioral health practices may see an influx of new patients during the Fall and Winter months, as individuals seek new ways to cope with SAD and seasonal changes. Keep your organization’s financial and clinical operations running smoothly with an EHR designed especially for practices like yours. To learn more about how a behavioral-health specific EHR, like NextStep Solutions, is purpose-built to help behavioral health practices operate at their best, click here.