If you’re like most people, you wish you could hibernate during the dark winter months. As the cold season progresses, you find your credit card maxed out, your house overflowing with holiday toys, and the whole family has spent weeks stuffing their stomachs to the max with cookies, turkey and fudge. Kids get colds, cars won’t start, the daylight hours are short, and the frigid skies are mostly cloudy. Let’s face it… the winter months are cold, dreary and often down right depressing. But how depressing does it get? For those suffering from seasonal affective disorder, also known as SAD, the winter months can be devastating.
What is SAD? Seasonal affective disorder is a type of depression that most often begins in late fall or early winter as the daylight hours shorten, and continues on until spring. As seasons change there is a shift in our internal biological clocks, also known as circadium rhythms, and a person with this disorder may fall out of sync with their normal schedule. “It really has to do with the amount of light a person gets,” says Dr. Martin Rosenzweig, a psychiatrist at the University of Pennsylvania School of Medicine. “It’s kind of like a hibernation. You know, bears go through a time when all they do is sleep; they eat a lot and want to be left alone. Humans go through it, too, but it just affects some people worse than others.” While the exact causes are not known, melatonin, a hormone secreted by the pineal gland in the brain has been linked to SAD. In the dark, this hormone, which is responsible for causing symptoms of depression, is produced at increased levels, making it more prevalent in the body during the winter months when the daylight is shorter. Seasonal affective disorder may have been around forever, but is a relatively new diagnosis. Dr. Norman Rosenthal, renowned physician and author of Winter Blues, the premier book on seasonal affective disorder, was one of the modern pioneers involved in bringing attention to this disorder. “When we began our work over 20 years ago, many of our colleagues considered it strange and eccentric,” says Dr. Rosenthal, who adds that while many more individuals are being diagnosed and treated today, there is still a need for more research. “We still do not understand the fundamental biological abnormalities of SAD or how light works,” explains Dr. Rosenthal. “Perhaps the next decade of research will provide answers to these questions.” Today, SAD has been recognized at many centers around the world, and according to the National Mental Health Association, an estimated 25 percent of the population suffers from a mild form of SAD during the winter months, while 5 percent suffer severely.
What are the symptoms? Beyond its ironic acronym, seasonal affective disorder is more than just about being sad. The condition may include bouts of depression, loss of interest in everyday activities, reduction in productivity, and withdrawal from friends and family. While most people may experience a slight let-down from holiday activities or feel overwhelmed by the anticipation of the new year, a person experiencing SAD may have severe physical symptoms including uncontrollable cravings, chronic fatigue, and heaviness in their arms and legs. Emotional symptoms can include irritability, social anxiety, and increased sensitivity to social rejection. The milder form of SAD, more commonly known as the winter blues, can hover over folks during the dark months of the year. Kids may not find joy in their usual enthusiasms, may seem extra irritable, and exhibit bad behavior. Parents may have difficulty keeping up with errands, may become forgetful and unproductive at work. A drop in energy and an increased appetite may signal the onset of the winter blues, and include all or some of the more severe symptoms mentioned above.
Who is really “affected”? Seasonal affective disorder is potentially responsible for many of the behaviors families blame on other things during the dark winter months. Parents may have less patience with their children, and spouses may quarrel more over money, chores and responsibilities — blaming their short tempers and frustrations on holiday stress. Kids may become lethargic, glued to the television, and begin to slack off on their assignments. It may be harder than usual for families to get out the door together in the morning, get chores done, and keep up with homework and housework. Whether it is a parent or a child, seasonal affective disorder can disrupt family life and cause squabbles, anxiety and frustration. Because many people with SAD go undiagnosed, they also go untreated, giving the cold darkness of winter a new meaning.
Who is at risk? Women and young people are at greatest risk for SAD. Whether physically or emotionally drained, stressful situations can exacerbate SAD. Genetic predisposition to depression and mood disorders may put a person at higher risk. And while the numbers of people suffering from SAD and living in Florida is estimated at 1.4 percent, SAD sufferers in New Hampshire tally up to 9.7 percent, clearly putting those in the northern regions of the country at a higher risk than those down South.
The light at the end of the tunnel… The good news is that there is treatment for SAD. “People don’t recognize this as a treatable disorder, but it is,” says Dr. Rosenzweig. Because SAD is believed to be caused by a biochemical reaction to the body’s need for sunlight, light therapy, or phototherapy, is one option for treating severe forms of SAD. A doctor may prescribe time in front of a specially designed light box, created to boost a person’s exposure to light when natural sunlight is not available. Dr. Michael Terman, director of the Winter Depression Program at the NY State Psychiatric Institute at Columbia University, reports that light therapy has become the first-line treatment for winter depression. “Its overall efficacy is stronger than drugs, there are far fewer side-effects and improvement sets in more rapidly — often within days. Timing and intensity of light are all-important dosing factors, however. “The amount of light needed to resolve mild winter doldrums is the same as used for SAD with a major depressive episode — it’s not as if lower severity requires less light. For almost everyone with SAD, early-morning light exposure gives the strongest effect. The higher the light intensity (but not more than 10,000 lux), the shorter the necessary duration of exposure. Such light should be diffused, carefully filtered for UV rays, and projected from above the line of site.” Dr. Terman recommends taking the Automated Morningness-Eveningness Questionnaire at www.cet.org, the website of the Center for Environmental Therapeutics. This website also sells therapeutic light products like lamps and ionizers. Medicine and behavior therapies may also be used to treat severe cases of SAD. For milder cases, catching some winter rays may help families manage the winter blues and get them to spring. Whether it’s rearranging the house to take advantage of sunny windows or making an effort to spend a little time outside, small efforts to get a little exposure to the sun during the winter months can greatly improve mild symptoms. Healthy eating and exercise routines can counteract some of the symptoms associated with mild SAD as well. But of course, only a professional can diagnose this disorder and create a proper treatment program. Never hesitate to seek a doctor’s care if you or your child experience all or one of the symptoms associated with seasonal affective disorder.
KEEPING SPIRITS BRIGHT Feeling blue this winter? Try these tips for keeping the whole family on the sunny side of things:
(1) Eat breakfast in your living room if it’s sunnier, and put your television in your bedroom if the afternoon rays stream in through your bedposts. Spreading the kids out in that great sunny spot on the rug in the hallway, even if it’s just a few minutes, can make all the difference. Open the curtains, rearrange the furniture, and change your family’s routine to take advantage of the valuable winter sunlight that can brighten up your home and your spirits.
(2) Feel better inside by going outside. Have a cup of hot tea on your deck or go build a quick snowman with your kids that you can all see from your window. You may have to bundle up, but just a few minutes of sun on your faces and a breath of chilly, yet fresh air will do you all a world of good.
(3) Exercise your right to a good mood by exercising regularly. Whether you take the dog for a walk each morning outside or chase the kids up and down the stairs in your hallway 10 times before you start your day, an exercise routine will help your family stay in shape, as well as chase those winter doldrums away.
(4) Treat yourself to good food. While it may be impossible to eliminate starches and sugars altogether, the more you limit them, the happier you’ll be. Though they may seem like comfort foods, you’ll find even more solstice by feeding your family wholegrain breads and pastas, and homemade vegetable soup. Even though out-of-season fresh fruit may be expensive, it will be worth the investment in all your good moods.
(5) Minimize stress. High intensity situations can make everyone more susceptible to the effects of seasonal depression. Resist the urge to “do it all”, take advantage of vacation time to really take a break, and concentrate on enjoying down time with family and friends.
Resources: For more information on seasonal affective disorder, check out these books: —Winter Blues by Norman E. Rosenthal, M.D. —Seasons of the Mind by Norman E. Rosenthal, M.D. —Don’t Be Sad–Fight the Winter Blues: Your guide to seasonal affective disorder by Celeste A. Peters —Seasonal Affective Disorder: Who Gets It, What Causes It, How to Cure It by Angela Smyth/ Chris Thompson —The Light Book: How Natural and Artificial Light Affect Our Health, Mood and Behavior by Jane Weigscheider Hyman and Michael Terman
