Why is it that we get so blue in the winter time? If you live north of the 50th parallel North (or south of the 50th parallel south), then the reason could have less to do with your dismal life situation and more to do with your body’s reaction to the reduction in daily light that comes with every winter season. Seasonal Affective Disorder (with the apt acronym of SAD) was described as a feature of the Scandinavian people as early as the 6th century CE. Due to their latitude, it is estimated that 20% of Scandinavian people suffer from the disorder.
SAD was first proposed as a bona fide disorder in North America in the 1980s, and is now recognized by the American Psychiatric Association as an affective disorder. Population in the United States is affected to varying degrees, depending on where they live in the country, with those further south experiencing a rate of about 2% of the population, and further north experiencing up to a rate of 10% of the population. In Canada and toward the Arctic Circle, rates can soar higher.
While only about 20-30% of those people suffering from SAD are men, one can surmise that the men in the lives of the other 70-80% of the population suffering (women) are suffering right along with them in their inability to predict and understand their partners’ mood swings. There is an even larger per cent of the population who suffer from a lower degree of SAD, or “winter blues,” but their symptoms are less debilitating than those with fully symptomatic SAD.
Causes
While the cold temperatures of the winter in the north are a pretty good reason to get a little demoralized, it is actually the reduced sun exposure during the winter months that really affect mood. In the far north, where hours of daylight can plummet to just a few hours per day, the disorder is obviously more keenly felt. Studies have also shown that, aside form geography, there is also a strong hereditary link among sufferers of SAD, meaning if your one or both of your parents suffer from SAD, there is a stronger chance that you will.
While it was once assumed that the trigger for SAD was in the ocular system (that is, sensors in the eye taking in the sunlight), new studies show that it is your whole body that reacts to the effects of light. Recent studies have shown that light being applied to the back of a person’s knee can shift their internal clocks, fooling the body (perhaps through the blood stream). In the same way that light can trick the body into believing it is on a different clock, a lack of light can bring about change sin one’s mood and ability to cope.
Symptoms
The symptoms of SAD are very similar to those of depression. They can include disrupted sleep patterns (usually overtiredness, oversleeping and lethargy, but can sometimes be the opposite: disturbed or shortened periods of restful sleep); elevated anxiety, sometimes in social situations, leading a person to become more isolated socially;scravings for sweets and carbohydrates, leading to overeating; loss of sex drive or desire for emotional intimacy; and a weakened immune system.
SAD is an affective disorder, meaning that it affects primarily one’s moods. Feelings of depression, including sadness, guilt, low self-esteem, despair and an inability to cope with stress or situations that usually would not phase an individual are all markers of depression. SAD sufferers can also experience abrupt mood swings. Notable especially right before the change in season (in the late summer, early autumn) or when the sunlight returns in the spring, these mood swings can change so quickly that they can mimic the highs and low of bipolar disorder. SAD sufferers can experience an euphoric upswing in their mood that can cause different symptoms, such as insomnia and hyperactivity.
The timetable of affective changes depend on the length of the winter season, and when the hours of daylight start becoming shorter, usually beginning between September and November and ending in March or April. Doctors are usually hesitant to diagnose SAD until a patient has experienced symptoms for at least three winter seasons.
Treatment
If you are someone who suffers from the winter blues, as opposed to full-blown SAD, then there are several strategies you can try before turning to professional care. Studies have shown that being outside in the sunlight for even an hour of the day (preferably at noon) will help alleviate minor symptoms. Of course, if the sky is completely overcast for several weeks at a time, this will not help. Regular exercise will also help to raise seratonin levels in the brain, as well as fight off the urge to lay around moaning and gorging on carbs and sugar.
For those who suffer more severe bouts of SAD, there are three major treatments in mainstream medicine. These three can be used effectively in their own or in tandem with each other. The first treatment is the use of a light box. Though what the body is craving is light, household or office lights are not powerful enough to make a difference. In fact, if you spend a large part of your day in a windowless office, and are susceptible to SAD, you can experience its effects all year long. The average indoor light emits an intensity of 250 lux, while light boxes range from 2,500 to 10,000 lux.
The light box can be used in several fashions (and light visors can be fitted for those who cannot take the time to sit in front of the light box). The light box is designed to emit enough light to supplement what the body is missing out on. A person suffering from SAD will generally spend 30-60 minutes per day (depending on the intensity of the light) in front of the light box with their eyes unshielded, but not looking directly at the light. Effects can be noted within the first week of use, but consistent use over the length of the winter months is important for long-term relief of symptoms. While the light boxes can be expensive (between $500 and $1,000), there are many associations that lend them out for a patient to try, to make sure it is a suitable treatment before they invest.
Another treatment option to be used in conjunction with, or in lieu of, a light box is pharmaceutical. Tricyclic antidepressants are not effective in treating SAD, but non-sedative SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine (Prozac), sertraline (Zoloft or Lustral), paroxetine (Paxil) and bupropion (Wellbutrin XL) can be effective tools in relieving symptoms. If you suffer from exceptional mood swings (from depression to mania), your doctor may want to try a mood-stabilizer like Lithium.
Finally, in conjunction with the other two treatments, it is believed that cognitive psychotherapy can also help to alleviate or work through some of the issues of anxiety or pressures to cope with other stressors in life that SAD makes difficult to handle.
With so many therapies and a recognition that SAD is not “all in your head” or a natural reaction to the Winter Blues, more people are recognizing SAD for what it is--a recognized affective disorder—and are therefore able to seek and find the help they need to make it through those long winter months with their short, short days.
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