By Christian Steiner, MD
Psychiatric Center of Northwest Ohio
For the characters in the “Game of Thrones,” the phrase “Winter is Coming” meant that bad things were about to happen. For us in northern Ohio, the phrase “winter is coming” also can hold a bad omen, as many of us suffer from seasonal depression.
What exactly is seasonal depression and is it real? It is very real, and The American Psychiatric Association officially calls it “Seasonal Affective Disorder” (SAD). Individuals with SAD experience mood changes and symptoms similar to depression. The symptoms usually occur during the fall and winter months when there is less sunlight and usually improve with the arrival of spring.
The most difficult months for people with SAD, in the United States, tend to be January and February. In clinical practice, I have seen a direct correlation between the end of daylight savings time and the onset of SAD. Not only is there a natural shortening of the days but the abrupt loss of our precious evening hours of sunlight disappear. We get up and go to work when it is dark and, all too often, leave when it is dark. Fortunately, there is a bill in the senate that has a “sunshine protection act,” which may make daylight savings time permanent and could be of benefit to everyone’s mental health.
Individuals with SAD have many of the classic symptoms of depression, with feelings of sadness, loss of interest, changes in appetite (with an increase in craving carbohydrates), loss of energy and an increase in the need for sleep. It may even turn over into feelings of worthlessness or guilt and difficulty concentrating or making decisions. The difference between SAD and a formal depression diagnosis is that of permanency. SAD will come and go with the seasons, while Major Depressive disorder remains despite the changes of the season.
What can be done about this? There are a few options including light therapy, antidepressants or talk therapy. Heading somewhere sunny and warm for a vacation can also be a good boost to morale, in late winter, as well.
What is light therapy? Light therapy involves sitting in front of a light therapy box that emits a very bright light (and filters out harmful ultraviolet rays). It usually requires 20 minutes or more per day, typically first thing in the morning, during the winter months. Most people see some improvements from light therapy within one or two weeks of beginning treatment. To maintain the benefits and prevent relapse, treatment is usually continued through the winter. Because of the anticipated return of symptoms in late fall, some people may begin light therapy in early fall to prevent symptoms. For some people, increased exposure to sunlight can help improve symptoms of SAD. For example, spending time outside or arranging your home or office so that you are exposed to a window during the day. Studies have also shown that those who participate in outdoor activities in the winter months also have a reduced rate of SAD.
If you ever feel that life is not worth living any time of year, please immediately seek help through the national 988 suicide hotline, our local ADAMHS number (888.936.7116) or report to the nearest emergency room. If this is more of an annoyance, perhaps talking with your doctor about treatment options could provide some relief. Unfortunately, we can’t prescribe vacations to Maui, but we do have other options.
