Some people look forward to the leaves changing color, sweater weather and brisk temperatures. For others, the shorter days, colder temperatures and gray skies bring on the start of the winter blues.
While feeling sluggish in the dark, cold months of late fall and winter is not uncommon, some people experience a more severe downward spiral called seasonal affective disorder, or SAD. Whereas the terms "winter blues" generally describe how many of us can feel around this season of shorter days and stressful holidays (and reflect a feeling that is relatively easy for most of us to move past), SAD is a type of seasonal clinical depression. With Seattle's frequent overcast skies and dreary weather, SAD is a common challenge for residents.
What Causes Seasonal Affective Disorder?
Experts believe this seasonal depression is linked to shorter days, which means fewer daylight hours and sun exposure. The shorter hours of daylight may create a chemical change in the brain, interfering with the body's production of serotonin and melatonin, two important hormones, as well as the body's biological internal clock.
During these days of little sunlight, it is thought that your body reduces its production of serotonin (also known as the "feel-good" hormone), leading to feelings of depression. Inversely, during these times, your body normally releases melatonin (the sleep hormone) at night, signaling to your body that it's time to rest. With increased darkness, your body may produce too much melatonin.
The combination of these two hormone production malfunctions can lead to a disrupted internal clock, where your body is out of sync with its normal sleep and wake cycles. When your body is out of sync, your brain may follow.
Who Gets SAD?
Those who live in the northern portions of the country must contend with shorter days and fewer hours of sun, and they are at higher risk. Seattle, for example, gets an average of 152 days of rain a year, a much higher amount than other cities. As residents know all too well, the rainy season in Seattle runs from October through April — and November is the rainiest month of the year. That's a lot of gloomy days.
According to the American Psychiatric Association, about 5% of adults in the U.S. experience SAD. In Washington state, that percentage doubles, with 10% of residents reporting symptoms of SAD.
SAD is more prevalent among women and usually affects adults. In fact, the risk of SAD increases with age and rarely affects teens and children.
People who suffer from depression are more prone to SAD, and the two conditions can and often do coexist. Additionally, those with other mental health disorders such as ADHD, anxiety, panic attacks and eating disorders are at higher risk of developing SAD.
What Are the Symptoms of SAD?
How do you know if you have SAD or are slightly down and lethargic because of the colder temperatures and dark days? First, SAD symptoms are more debilitating than a simple "low" mood. SAD symptoms are similar to symptoms of general depression, but they are tied to the fall and winter seasons and usually subside in the spring.
Symptoms include:
- Low energy, fatigue or sluggishness
- Insomnia or an increased need for sleep
- Difficulty concentrating
- Feelings of worthlessness or hopelessness
- Changes in weight, appetite or increased cravings for carbohydrates (sugary, comfort foods)
- Loss of interest in activities that are normally enjoyable
- Consistent sadness or irritability
- Social withdrawal
- Thoughts of suicide
If you're experiencing any of these symptoms or suspect you have SAD, you should see a mental health specialist for a diagnosis and treatment plan.
What Are Seasonal Affective Disorder Treatments?
While Seattle's long and gray winters may contribute to the prevalence of seasonal depression, understanding this condition and its treatments can empower residents to combat SAD and enjoy the vitality of the Emerald City again.
There are a variety of treatments and therapies available to help.
Lifestyle Modifications
Practicing good sleep hygiene, exercising regularly and watching your diet can help improve your mood. To help improve your sleep habits, sleep and wake up at the same time every day, skip naps, and try not to eat or drink alcohol too close to bedtime.
Additionally, getting natural light, if and when it's available, can help. At work, sit by a window and go for a walk outside during your break or lunch hour. Lastly, mind-body practices such as yoga and meditation are accessible and effective treatment options to help relieve symptoms of depression and anxiety.
Light Therapy
One way to treat a disorder likely triggered by reduced hours of sunlight is with light therapy. Light therapy involves sitting for 20 to 30 minutes a day, usually in the morning, in front of a light box that emits light much brighter than typical indoor lighting. It is an artificial substitute for natural sunlight. The box filters out damaging ultraviolet (UV) light, so you don't have to worry about harmful UV exposure. People who experience SAD every year discuss light therapy with their healthcare provider, If appropriate, therapy generally begins in the early fall and continues throughout the winter.
Research shows that light therapy effectively relieves symptoms of SAD in about 70% of patients. However, it's not an effective treatment option for everyone — nor is it always effective on its own.
Talk Therapy
Talk therapy, especially cognitive behavioral therapy, can be effective in treating SAD. Trained therapists can help those with SAD identify negative thoughts and patterns and work with them to reframe those thoughts into positive or neutral concepts.
Additionally, a therapist can help encourage positive behaviors overall, supporting a healthier life.
Medication
Antidepressant medications that treat other types of depression may be prescribed to those with SAD. Because SAD is associated with serotonin production, a class of drugs called selective serotonin reuptake inhibitors can be especially beneficial.
Talk with your physician to determine if a prescription medication may be right for you.
Vitamin D
According to the National Institute of Mental Health, vitamin D can be a treatment option for winter-pattern SAD. With fewer hours of daylight in the wintertime, many people with SAD have diminished vitamin D levels. As a result, vitamin D supplements may help to improve symptoms.
That said, studies have had mixed results as to its effectiveness. Some studies have found that using vitamin D as a treatment for SAD was as effective as light therapy; others reported no effect.
Make sure to consult with your healthcare provider about any potential interactions between your supplements and medications.
Finding Support for SAD
If you're experiencing feelings of depression and despair as the winter approaches, you're not alone. There are a variety of support services and resources in Seattle. At the National Alliance on Mental Illness Seattle, you can find:
- A crisis hotline.
- Peer support groups.
- Family support groups.
- A resource handbook.
The good news is that although SAD is common in the Seattle area, there are many effective treatment options, accessible services and support groups. These resources can help you not only understand the condition, but find peace during the winter.
These articles are intended for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment and are not intended to treat or cure any disease. Never disregard professional medical advice or delay in seeking it because of something you have read in these articles. Advances in medicine may cause this information to become outdated, invalid, or subject to debate. Professional opinions and interpretations of scientific literature may vary. Consult your healthcare professional before making changes to your diet, exercise or medication regimen.