Aside from the benefit of getting an extra hour in bed, clocks turning back and telling us shorter days and longer nights can bring a sense of impending doom. Britain’s gray skies can darken anyone’s mood, but for those who suffer from Seasonal Affective Disorder (SAD), winter can be particularly miserable.
SAD can cause depression, fatigue, irritability, and sleep problems. This medically recognized condition affects around one in 20 people in the UK. But instead of dreading the next six months, know that there are practical ways to stay positive.
What is seasonal affective disorder?
“SAD is a type of depression caused by seasonal changes,” says Dr. Safia Dever, a general practitioner at the Mayo Clinic in London. “It is sometimes known as ‘winter depression,’ because symptoms are more pronounced, severe, and potentially debilitating during this time.”
The onset of SAD usually begins in the fall or winter and gradually improves in late spring or summer when daylight hours increase. It’s possible that SAD can cause depression, a feeling of sadness and lack of energy that can last into the spring or early summer.
Despite being a fully recognized medical disease, SAD has historically been at times trivialized by people who do not understand the condition, says a landmark 1984 study that first defined SAD. Psychiatrist Dr. Norman Rosenthal describes it as a mood disorder. “I think we tend to downplay the suffering of others if we haven’t experienced it ourselves.”
Symptoms and signs of seasonal affective disorder
- Feeling sluggish, sad, or depressed almost every day and most of the day
- Losing interest in activities you once enjoyed
- Feeling low in energy and sluggish
- I have a problem with sleeping too much
- Experience carbohydrate cravings, overeating, and weight gain
- difficult to concentrate
- Feeling hopeless, worthless, and guilty
Basically, symptoms include all symptoms associated with depression.
“It’s a lack of energy, an inability to do things, a feeling of wanting to be away from friends and family, and as a result, the stimulating effect of good company is lost,” Dr. Rosenthal explains. “And because they don’t want to be active and go out, they feel depressed and stay home, and they eat too much, especially sweets and starches, which causes them to gain weight.
“For most people, carbohydrates have a calming effect, but for people with SAD they have an energy-boosting effect, so they naturally want to do anything to boost their energy, so they crave carbohydrates. Eating too much can lead to weight gain, which can be another cause of feeling sluggish and depressed.
Dever also points out that sleep disturbances, anhedonia (loss of interest in things you used to enjoy), lethargy, and fatigue can “all feel like a cycle that’s difficult to break.”
What causes SAD?
The exact cause of SAD is not completely understood, but it is related to the seasons, and the main theory is that lack of sunlight can cause a part of the brain called the hypothalamus to stop working properly. That’s what it means. Dr. Dever explains that this has several implications, including:
- melatonin production
- production of serotonin
- our circadian rhythm
“Melatonin is a hormone that causes sleepiness. In people with SAD, the body may produce SAD at higher than normal levels,” Dever says. “On the other hand, serotonin is a hormone that affects mood, appetite, and sleep, so lack of sunlight can lead to decreased serotonin levels, which can lead to feelings of depression.”
Additionally, Dever explains that our bodies have an internal clock that uses sunlight to time various important functions, such as when we wake up. Therefore, reduced light levels during winter can disrupt circadian rhythms and cause symptoms of SAD.
Who is most at risk for SAD?
- people living in cold climates of the northern hemisphere
- Those who live or work in environments with limited natural light
- People who have relatives who are suffering
- woman
SAD is more prevalent in areas with long and dark winters. “Generally speaking, the further north you go, the shorter the winter days are and the more likely you are to get sick,” Dr. Rosenthal says.
“However, genetic diversity may also be at play. For example, a study conducted in Iceland found that while it is very common in the UK, it is common in Iceland (despite being in the far north) ) has been shown to be experienced less frequently than expected. Iceland’s population is genetically fairly homogeneous, with those who could not tolerate the North likely moving south, and those who prospered there. There is speculation that this may have had a positive impact on the gene pool.
“Women are also more likely to be affected, especially during their reproductive years,” Dr. Rosenthal says. “After menarche (the beginning of menstruation), the prevalence increases significantly in girls and women and continues to do so until after menopause. So there appears to be something about sex hormones that predisposes women to this condition. ” he says.
Dr. Dever says research shows that women are about four times more likely to be affected. “Interestingly, if men are affected, they may experience more severe symptoms. Those with a history of major depression are at higher risk for SAD, and those with bipolar disorder and other mood-related disorders “People who suffer from this may also experience a worsening of their symptoms as the seasons change,” she says.
Some studies also suggest a genetic component, and experts say SAD appears to run in families.
diagnosis
Dr. Rosenthal says the best way to tell whether it’s SAD or depression is to consider the history of when it’s happened. “I ask people how they felt last Christmas because people remember how they felt and it’s easier to spot progress. There’s a very characteristic set of symptoms, and in the summer They are often said to be the life and soul of parties and wonderful companions, yet in winter they become hibernating bears.”
Dr. Rosenthal first diagnosed himself with the disease after moving from a warm climate to a cold one. “Once this happened three times in a row, we started to see a pattern.”
There is no blood test available for SAD, but don’t let this worsen your symptoms.
“For almost all mental illnesses, including regular depression, anxiety, and schizophrenia, blood tests won’t reveal anything,” Rosenthal says.
Dr. Dever explains that a diagnosis of SAD is usually made when depression occurs at the same time every year for at least two years, and periods of depression are followed by periods of no depression, such as one year of complete remission. It explains that you can check if A specific season, usually spring or summer.
“Because we think of winter blues as a spectrum, mild symptoms are often overlooked and people often tolerate them,” Dr. Dever says. Recognizing SAD early means it can be properly managed before symptoms appear. ”
Treatment options for SAD
There are many ways to treat seasonal affective disorder, from dietary and lifestyle changes to prescription medications. Here are some of the most effective ones.
Non-drug treatment options
“The most effective intervention is getting just five minutes of early morning sunlight, even on cloudy days. This resets your circadian rhythm and naturally boosts your mood when you’re outdoors.” says Dr. Dever.
She explains to her patients that light outside on a bright, sunny day ranges from **50,000 to 100,000 lux (how light is measured). Even on cloudy days, outdoor light can be about 1,000 to 5,000 lux, which is significantly higher than standard indoor lighting (about 300 to 500 lux).
“When this is not possible or practical, light therapy, which mimics natural sunlight, is one of the most well-studied treatments for SAD,” says Dr. Dever.
Clinical studies have demonstrated that light therapy significantly reduces depressive symptoms in SAD patients, with results similar to those seen when taking antidepressants.
Most SAD light boxes provide 10,000 lux of artificial light, allowing for controlled and consistent daily bright light exposure (more achievable than outdoor exposure in the winter).
Dr. Rosenthal recommends purchasing lamps from reputable providers (he himself uses Lumie’s and keeps them on his desk).
Medication treatment options
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), can be taken for part of the year and can also be used prophylactically, Dr. Rosenthal says.
But Dever cautions that antidepressants should not be relied on as a “quick fix,” although drugs can be helpful when other options fail. She suggests that psychotherapy may be helpful, as there are often other factors that need to be processed and addressed, and that talk therapy may provide validation and support for symptoms. Masu. “It is also important to address other hormonal pathways such as insulin, thyroid, cortisol and lifestyle factors.
Prevention and coping strategies
Know that you are not alone and that it is not your fault. You’ll feel better if you take steps before you feel too depressed.
- Strategize to maximize exposure to natural light
- Invest in a good SAD lamp and use it aggressively
- stay physically active
- maintain consistent sleep
- eat a balanced diet
- Complete medical checkup to check for vitamin D deficiency, thyroid, and blood sugar regulation abnormalities
- Use mindfulness and stress management techniques
- Combat isolation by rallying support and telling friends
- Ongoing review by pharmaceutical experts
Dr. Dever undergoes general tests to make sure everything else is normal, including her thyroid and vitamin D, and makes sure her diet includes more plants, protein, and good fats to help regulate her mood. I’m proposing to change it.
“Reduce sugar and processed carbohydrates, which can cause energy spikes and dips, and avoid factors that further disrupt your circadian rhythm, such as excessive screen use at night, alcohol, and heavy meals at night. And , practicing mindfulness and other stress management techniques can improve your resilience and help you stay grounded and calm in the face of seasonal changes.”
Dr. Rosenthal says it’s important to not give in to your symptoms. “Don’t lie in bed with the covers over your head. Humans are social animals, so getting outside can help.”
Support and resources for individuals with SAD
Don’t suffer in silence. Here are some more useful websites.
Norman E. Rosenthal is a psychiatrist, author, and coach who first described Seasonal Affective Disorder (SAD). His latest book is Defeating SAD: A Guide to Health and Happiness Through All Seasons. Dr. Safia Dever is a health care physician, speaker and stress expert at Mayo Healthcare London.
