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Seasonal Affective Disorder: More Than Winter Blues

The holidays are behind us and a new year is before us. This is the time of year when we are expected to feel joyful and hopeful as we celebrate the past and plan for the future. Yet, many people experience the “winter blues” during this time of year.

Sometimes, it is just a lack of energy or motivation with a sense of sadness lingering in the background. Some say they don’t feel like their normal selves and their joy is shadowed by an underlying sadness for which they just can’t pinpoint the reason. For others, these feelings are exaggerated and can become debilitating.

When people experience an exaggerated form of the blues during certain months for no apparent reason at all, it is known as Seasonal Affective Disorder or SAD (an appropriate acronym).
Seasonal Affective Disorder is a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms at the same time each year, most commonly, in the winter.

The most challenging months for SAD sufferers are January and February, but can begin as the holidays arrive. Of the nearly 10 million American cases, 70 to 80 percent of them are women.

Typical symptoms of SAD include depression, lack of energy, increased need for sleep, craving for starchy foods and weight gain. Symptoms often begin in the fall, peak in the winter and resolve in spring.

Less Light Means More SADness

The incidence of SAD intensifies with increasing latitude and suggests a connection with the degree of light exposure. Sunlight enters the brain through the eyes and the light stimulates the production of serotonin, a neurotransmitter that supports nerve cell functions including one’s “mood.”

Sunlight increases serotonin, which in turn increases energy, decreases appetite and brings a sense of empowerment and engagement. Less sunlight results in lower levels of serotonin, which means less energy and motivation and a desire to eat and sleep more.

On the flip side, darkness stimulates the production of melatonin, which promotes sleep. Melatonin is produced at increased levels when a person is not exposed to light. When winter days are shorter and nights are longer, the production of this hormone increases.

Additionally, as seasons change, there is a shift in our “biological internal clocks” or circadian rhythm, partly because of changes in sunlight patterns and changing temperatures. This can cause our biological clocks to be out of sync with our daily schedules.

Decreased light means less serotonin and more melatonin. The combination of less serotonin (which helps nerve cells cooperate) and increased amounts of melatonin (which puts a body to sleep) causes SAD. Research has shown that melatonin may cause symptoms of depression. Consequently, increased levels of melatonin during winter months could cause SAD.

More Light Means Less SADness

Spending time outdoors during the day or arranging home and workplaces to receive more sunlight is helpful. Outdoor light, even when the sky is overcast, produces adequate amounts of light to increase serotonin production.
When going outdoors or enjoying sunlight indoors is not possible, a lightbox can be beneficial. A light therapy box mimics outdoor light. Light therapy has been shown to suppress secretion of melatonin in the brain and increase serotonin production, causing a chemical change in the brain that lifts the mood and eases other symptoms of SAD.
Lightboxes are designed to be safe and effective, but they are not approved or regulated by the FDA for SAD treatments. It is important to talk with your healthcare provider before purchasing a light box to ensure it is the best treatment option and that you are getting the correct type of lightbox. For instance, some light therapy lamps are designed for skin disorders – not for SAD. Lamps used for skin disorders primarily emit ultraviolet (UV) light and could damage the eyes if used incorrectly. Lightboxes used to treat SAD should filter out most, or all, UV light.

Daily exercise also can be useful to relieve symptoms of SAD, especially if done outdoors. Eating a balanced diet can prevent weight gain and may help one’s mood. Psychotherapy also can help relieve depression. Some individuals benefit from a combination of medication, light therapy and psychotherapy treatments.

Don’t let the winter months be blue, keep them bright and white. If you experience any of the symptoms of SAD, talk with a friend or family member and let them know how you feel. Be sure to get outside, eat well, drink plenty of water and surround yourself with people and things that make you feel good.

If the feelings linger and increase, call your healthcare provider. Embrace the light and enjoy the season, whatever it may be. FBN

By Richard Holt, D.O.

Richard Holt, D.O., is the medical director at the Rehabilitation Hospital of Northern Arizona. He specializes in helping patients recover from injury or disease and live the highest quality of life possible. For more information, visit RHNA.ernesthealth.com or call 928-774-7070. 1851 N. Gemini Dr., Flagstaff, AZ  86001

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