SAD in the coldest months of the year

For many North Americans, winter’s shorter days bring with them a different kind of darkness: seasonal affective disorder, or SAD, which is a type of depression that strikes mostly during the colder months of the year.

While the disorder affects many types of people, medical experts say it can be treated and the seriousness of the illness reduced by watching for symptoms and taking early action. Those affected by SAD begin to see symptoms in late fall to early winter, said Dr. Peter Swanljung at Friends Hospital, a private psychiatric hospital, in Philadelphia. “To distinguish someone from seasonal affective disorder and a major depressive disorder (like clinical depression), it usually depends on timing,” he said.

The causes of SAD are not fully known, but there appears to be a relationship between depression and sunlight, Swanljung said. Northerners are more susceptible to the disorder, he said, because of the darker and shorter days – a person living in Florida is less likely to suffer from SAD than one in Maine, for example.

There are a few theories about why this connection exists, Swanljung explained. One is that the change in light exposure during the winter months effects levels of serotonin, which affects energy and mood, in the brain. Another is that SAD is related to levels of melatonin, a naturally-occurring hormone involved in regulating our sleep cycles. And a third, he said, is that the changes in the amount of daylight somehow affect our circadian rhythm, our body’s 24-hour clock.

A recent study from researchers at the Center for Addiction and Mental Health in Toronto discovered that there are greater levels of serotonin transporters in the brain in the winter than in the summer, the first time such a difference has been found. When there was less light, more serotonin transporters were found. Serotonin transporters remove serotonin, so the finding suggests that there is more serotonin removal in the brain in the winter.

“This offers an explanation for why some healthy people experience low mood and energy in the winter, and why there is a regular reoccurrence of depressive episodes in fall and winter in some vulnerable individuals,” Dr. Jeffrey Meyer, a researcher on the study, said in a statement. “The next steps will be to understand what causes this change and how to interfere with it.”

Winter is also a stressful time of year for many North Americans, because of the holidays and the increased spending, travel time and busy social schedules that often go along with them. But the symptoms of SAD go beyond simple winter blues or holiday stress, Swanljung said. They are similar to those of clinical depression and include tiredness, increased appetite and weight gain, loss of interest in usual activities and low energy. Symptoms like those shouldn’t be written off, he said, and if they include self-harm and suicidal feelings or attempts, they should be brought to the attention of a health professional as soon as possible.

SAD may not be as profound as other forms of depression, experts say, but it still warrants attention and treatment. “People need to understand that seasonal affective disorder is a real condition,” Robin Monson-Dupuis of Aurora Behavioral Health in Milwaukee, Wisconsin, said in an email response. People in northern climates, where winters are particularly harsh, may think that negative feelings during that time of year are just a consequence of their location, Monson-Dupuis said, but if they affect your day-to-day functioning then they require investigation.

Fortunately, there are treatment options available for SAD. Light therapy, where patients sit in front of a very bright lamp or light box, is an option that many people have found helpful, Swanljung said. Though a prescription is not required to buy the equipment, it’s worthwhile to talk to your health professional about it, he advised. Talk therapy can also be beneficial, as can simply keeping up with your contacts and avoiding social isolation. Exercise has been shown to help relieve depression, he said. Medication may be prescribed for more serious cases.

Paying attention to your mood and watching for patterns is a way to prevent seasonal depression from negatively affecting your life, Swanljung said. If it has been a problem for you in the past, beginning light therapy or medication ahead of time can help stave it off or reduce its severity.

For sufferers of depression, visit www.depressionfighters.com and learn ways to treat depression safely and naturally with no side effects.

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