More than just the winter blues?
It’s natural to feel a little despondent when it’s cold and dark outside, but for some, the problem goes deeper and could require treatment.
Most people experience a measure of winter gloom. Cabin fever, dark mornings and icy temperatures inevitably make us want to sleep and eat more, and less inclined to get out and socialise or exercise. Nevertheless, these shifts in mood and energy don’t usually impact our day-to-day lives too drastically. For some, however, the feeling of gloom descends into a type of clinical depression that ebbs and flows according to the seasons: seasonal affective disorder (SAD).
What is SAD?
The medical community’s been aware of SAD for over 150 years, but it only became recognised as a disorder in the 1980s. Even with its official diagnostic status, however, many still suffer in silence, unaware that they’re afflicted with a condition that could require treatment.
SAD is often difficult to diagnose, as it shares many symptoms with other mental illnesses, including clinical depression and bipolar disorder. It can usually be determined if symptoms have recurred for at least two consecutive winters, where symptoms can’t be otherwise explained. Family history is also taken into consideration, as mood disorders and alcohol abuse in close relatives could indicate a greater risk of SAD in the patient.
According to the South African Depression & Anxiety Group (SADAG), around 20% of the population is affected by symptoms associated with SAD during autumn and winter, 75% of whom are women. Research suggests that only around 2-3% of the population will actually suffer from diagnosable SAD, however, with the remaining symptom-sufferers experiencing less severe ‘winter blues’. It isn’t understood why women are particularly vulnerable to the disorder, although it’s thought to be linked to hormones, as women most often show signs of SAD after puberty, with a
decreased number of diagnosed cases presenting after menopause.
At its worst, SAD can become completely debilitating, preventing sufferers from functioning normally to the point where their personal and professional lives are badly affected.
- Social withdrawal
- Difficulty concentrating
- Fatigue and lack of energy
- Cravings for carbohydrates, overeating and weight gain
- Loss of interest in previously enjoyed activities
The causes of the disorder are unknown, although researchers largely speculate that the depression specific to SAD is somehow triggered by the brain’s response to a decrease in daylight. Some of the factors that may be affected are serotonin and melatonin levels, as well as the circadian rhythm, which all experience disruption when we aren’t getting enough exposure to sunlight. Natural light regulates our internal clock, or rhythm, which controls our sleep-wake cycle. It’s been shown that overcast skies, working indoors, travelling across time zones and other ways in which natural sunlight is diminished, even during summer, probably also contribute to SAD. Studies have also found that SAD-sufferers tend to have difficulty regulating serotonin, over-produce melatonin and produce less vitamin D than usual, all of which are likely to be contributing factors.
How should SAD be treated?
As with many mental disorders, there isn’t a cure, but the condition can be managed with proper treatment. There are different ways to go about coping with SAD, which have shown varying levels of success according to the individual sufferer. These include:
Researchers suggest that this treatment should be considered the first course of action when tackling the disorder. Leading medical centres across the world have used light therapy to treat SAD, jet lag, sleep disorders and PMS, among other issues, with a 90% average success rate.
It works by simulating the experience of sunlight exposure using a special lamp called a light box. The therapeutic light boxes, which are 20-50 times brighter than a standard indoor light, help reset the body back to its natural 24-hour rhythm, relieving the symptoms of SAD. Between 2 500 and 10 000 lux (the measurement for luminous emittance) is needed to suppress the sleep hormone melatonin and, in turn, signal to the brain that it’s time
to wake up. This helps to re-establish the natural wake-sleep cycle.
The treatment is not only effective, but also fairly effortless. The patient is exposed to the light for about 30 minutes a day. It doesn’t require much action on the patient’s part – the light can be glanced at every now and then in between reading, eating or watching TV (from a prescribed, safe distance). Light exposure in the morning is usually best, as
it resets the body clock to make waking easier. Patients usually notice improvement within the first week.
Ensuring you get exercise at least twice a week can dramatically improve the symptoms of SAD. This can take quite an effort, as winter makes snuggling up indoors and hiding from the world very tempting, but it will pay off in the long run. A 20-minute outdoor walk or jog two or three times a week will help lift your mood, expose you to feel-good natural light and increase your intake of vitamin D. You should also take stock of your eating habits – cold weather
is notorious for upping those carb-cravings, so be mindful when preparing your meals. Eat to increase your vitamin D and omega-3 levels by incorporating more oily fish, vegetables, fruits and eggs in your diet.
SAD, like many other mental disorders, can be effectively managed using psychotherapy, particularly cognitive behavioural therapy (CBT). There’s even a specific adaptation of the therapy – CBT-SAD – which relies on basic techniques like identifying negative thoughts and working to replace them with positive ones.
Antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs), have been shown to be effective in combatting SAD, although they should only be taken under the guidance of a mental health professional.
FEATURE: CAITLIN GENG PHOTO: FOTOLIA.COM