Wisconsin Community Mental Health Counseling Centers, Inc.

Scientists estimate that more than 30 million Americans suffer from some degree of winter depression. Although the gloomy, gray days of winter can dampen anyone’s spirits, individuals with SAD feel more than the slight feelings of depression known as the "winter blues." Those who suffer SAD tend to experience an onset of depression with the shortening of available daylight during the fall or winter months. SAD tends to be recurrent, in that it returns year after year. The depression tends to lift or diminish in the spring.

Some common symptoms include: fatigue, hypersomnia, weight gain, a craving for surgery foods, and of course, depressive feelings. There is a tendency for the person to feel more and more down as the day progresses. The latter tends to be the opposite of what is seen in major depressions. For individuals who suffer year round depression a seasonal component can mean a worsening of symptoms during the fall and winter.

Recognized by the medical community within the last decade, SAD is a condition reported more frequently in the northern United States. Younger people are at a higher risk for the disorder and there is some suggestion that greater numbers of females vs. Males are afflicted. The disorder seems to occur more in the elderly. SAD is not related to seasonal factors such as unemployment, the start of school or unhappiness about the weather. The cause of SAD is felt to be due to chemical changes which occur in the brain as a result of reduced light stimulation to the retina of the eye.

A key to SAD may be found in the hormone melatonin. Because our bodies function in 24-hour cycles, the loss of sunlight in the winter may decrease the release of melatonin, which governs our sleep-wake cycles. This hormone causes some people to experience increased lethargy.

If your lethargy or depression interferes with your job or personal relationships, or if you have thoughts of suicide, seek professional help. Treatment of SAD involves utilizing interventions which attempt to reverse the chemical changes that lowered daylight cause in the brain. The most common interventions for mild cases of the disorder involve lifestyle changes which allow more opportunity for light to stimulate the eyes. Antidepressant drugs are also being studied in SAD. An open study showed that bupropion was effective in the treatment of SAD.

Another study suggested that citalorprim, a selective serotonin reuptake inhibitor was as effective as light therapy. Fluoxetine was reported to be as effective as light therapy in another study. What remains a question is whether a combination of medications and light therapy is more effective than either alone.

In addition to treatment, some simple adjustments to your lifestyle can make it easier to cope with SAD. Among those many adjustments:
* Try to maintain a regular schedule. Keep a weekly or daily planner, and follow through on activities by considering them as "commitments" to yourself. Plan activities in advance, no matter how lethargic you feel. Inactivity can lead to increased lethargy.
* Exercise regularly. A program of exercise is known to increase metabolism, which can help you to feel better. If you don’t already have a favorite indoor winter activity, such as racquetball, curling or swimming, consider adopting one. Even walking can help, walking in small malls is one way to exercise when bad weather prevents walking outdoors.
* Allow natural light into your home or office by keeping curtains and blinds open as much as possible during the daytime hours.
* Use moderation in your diet. Try to eat the same kinds of foods in the same portions as you did before you became depressed.
* Limit your use of alcohol, a natural depressant.

Although this disorder can be debilitating, it is treatable. If you experience SAD, you must seek treatment and make adjustments to your lifestyle that will help alleviate its effects.

Anne purchased a specially designed light box, which she set up in her kitchen next to the table where she prepared her daily lesson plans in the early morning. At school, she rearranged her classroom so that her seat was closer to the window. She took daily walks to get the benefit of whatever sunlight there was. She felt lighter, more energetic and her food cravings diminished. And although she still waited eagerly for the first flowers of spring, she felt relieved that winter had lost its terrible hold on her spirits.

Peggy Dennison is a psychotherapist and author. Call her at 414-367-5570, or write her at 155 E. Capitol Dr., Suite 5, Hartland, WI 53029