Seasonal Affective Disorder

Here, in Denver, it has been feeling very much like the middle of Summer in the middle of September, with temperatures in the 90s on most days. However, there are several telltale signs that fall is underway, such as: football season beginning; kids are back in school; despite the heat, some trees even know it’s time to start shedding their leaves; and perhaps the sign that is felt the most among some of us: fewer minutes of daylight each day.

Some of us feel these signs more than others. Some may even have a love for fall festivities and look forward to the holidays around the corner, but still there is a feeling somewhere inside that can put people on edge. This is likely due to the anticipation of the colder, darker days ahead which can both keep us indoors more, as well as shift our circadian rhythm, changing our sleep habits or making us feel more tired overall. While these feelings may start to occur as we approach the fall season, they typically increase as it becomes winter, when we have the least amount of daylight.

For some people, these feelings may be experienced as “winter blues.” For others, these signs and symptoms may be something more difficult to manage. You may be familiar with the terms Seasonal Depression or Seasonal Affective Disorder (SAD). In the Diagnostic Manual of Mental Disorders (DSM-5), this disorder is identified as a type of depression – Major Depressive Disorder with Seasonal Pattern.” SAD (a very fitting acronym, right?) has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and less sunlight in winter.

Symptoms of Seasonal Affective Disorder

SAD is a type of depression so the symptoms can be similar to and overlap those of depression:

  • Sadness

  • Anxiety

  • Weight gain

  • Increased appetite and carbohydrate cravings

  • Extreme fatigue/lack of energy

  • Feelings of hopelessness or worthlessness

  • Difficulty concentrating

  • Irritability

  • Loss of interest in usual activities and withdrawal from social activities

  • Increased sleep and daytime drowsiness

  • Decreased sex drive

  • Suicidal thoughts

  • Increased headaches

Treatment Options for SAD

  • Try to increase your exposure to sunlight. In Colorado, we are very fortunate to average over 300 days of sunshine which makes this option easier. Get outside to see and feel the sunshine as often as you are able. On increasingly cold days, do some extra bundling in outerwear to make it more tolerable or spend as much time sitting near a window as possible. If you work in an office without windows, it is even more imperative to take as many breaks as possible during which you walk to a part of the building with windows or get outside.

  • For people in other parts of the country, however, sunlight is not often so accessible. In these cases, Light Therapy is something to consider. Light therapy involves sitting near or in front of a therapy light box. The box gives off a bright light that mimics natural outdoor light, rather than the indoor lights we are usually exposed to. Since it is believed that the biochemical imbalance in the brain is prompted by shorter daylight hours and less sunlight, light therapy is thought to affect brain chemicals linked to mood and sleep, easing SAD symptoms. Light therapy is also sometimes referred to as phototherapy.

  • In Psychotherapy, you can work on increasing and improving interpersonal relationships which can be helpful in alleviating some symptoms of SAD such as feelings of hopelessness or worthlessness, withdrawal from social activities, anxiety, sadness and lack of energy in particular. Therapy can also help you to identify stressors and find ways to cope with or eliminate some of them which can help with the overall depressive symptoms. A therapist can help to reduce these difficult symptoms in multiple ways and through various methods of therapy, depending on the person and situation.

  • Antidepressants can alter the chemical imbalance that can lead to depression, including SAD.

  • A Vitamin D Supplement may help to improve some milder symptoms. With less sunlight, our bodies make more melatonin (often associated with improved sleep) which can cause us to sleep too much and our bodies don’t make enough vitamin D.

Tips for Dealing with SAD and “Winter Blues”

  • Get regular exercise. I know. This is what everyone recommends to help with various health-related issues. But how do you get motivated to do regular exercise when your depressive symptoms include feeling exhausted, fatigued, and uninterested? You don’t need to get a gym membership or start working out for extended periods each day. Start slow, do whatever feels manageable. Doing some kind of movement is always going to be better than none at all and increased movement is better than your starting point. Then, gradually increase from there as it feels comfortable. Most importantly, do not push yourself to the point that it will make you feel worse – “Ugh, I sat on the couch and watched TV instead of doing any exercise.” Instead, tell yourself this is okay and you will try again another time. You are human. These things happen to all of us. Rather than dwell on it or judge yourself, get up and grab a post-it note. Write: “Do some exercise while watching.” Stick the note to your TV or remote. The next time you go to sit and watch TV you will have your reminder there waiting for you. And you can still watch TV. Just add in a little movement while you’re doing it. Whatever works for you, even if it’s just doing some stretches. Like anything else, the more you do this, the more it will become a habit and feel more natural.

  • Be kind to yourself! This is a sentiment I share with my clients very regularly. We are all so much more accustomed to being hard on ourselves and judging ourselves than being gentle, kind and accepting. If you are experiencing symptoms of SAD, it’s not easy and it’s not your fault. There is nothing you did to cause it and it takes energy that you often don’t have to try to get relief. The more you allow yourself the space to feel and experience the tough stuff, the easier it will actually become to work through it more effectively.

  • Set realistic goals and expectations. As with exercising, this applies throughout our lives. Allow yourself to take breaks when a task feels overwhelming. Set priorities. Expect that it will take time for your symptoms to feel better rather than immediately and know that depression effects people differently. What may work for a friend may not work for you and while that friend may feel relief more quickly, it may take longer for you – and that’s okay.

  • Avoid drugs, alcohol, nicotine and even caffeine. These can all make symptoms of depression worse, even if it feels like they are helpful in the moment.

  • Eat healthy, well-balanced meals. The more sugar and carbohydrates we eat, the more sugar and carbohydrates we crave. When we gradually consume less sugar, our bodies start to feel more settled without it

  • Try to focus on the positives and create positive experiences. A great way to focus on the positives is to start a gratitude journal and recount three things you are grateful for each day. Find some positive fall/winter/cold weather things that you enjoy or bring you comfort. Some ideas include:

    • Fall, winter or holiday festivals – put them on your calendar and make a plan so you have something to look forward to.

    • If you enjoy winter sports, try to get out there to participate in them when you can.

    • Create an extra cozy atmosphere for yourself at home that you can feel good about – warm drink, cozy blanket, fuzzy slippers, your favorite hoodie, a movie that captures your attention or makes you laugh, and light some candles if you don’t have a fireplace.

    • Pumpkin flavored everything seems to make a lot of people feel good, even if just for a few minutes.

If you have symptoms and think you may be suffering from SAD, talk to your primary care physician or a licensed mental health clinician. To be diagnosed with SAD, a person must meet the following criteria:

  • They must have symptoms of major depression or the more specific symptoms listed above.

  • The depressive episodes must occur during specific seasons for at least 2 consecutive years. However, not all people with SAD do experience symptoms every year.

  • The episodes must be much more frequent than other depressive episodes that the person may have had at other times of the year during their lifetime.

Jenn Kubilus is a psychotherapist and the owner of Birches Counseling, LLC. She is a Licensed Professional Counselor in the state of Colorado and provides online therapy primarily to women working through various emotions related to life transitions, including but not limited to: grief and loss, career changes, infertility and family planning, and relationships.

https://www.birchescounseling.com/meet-jenn

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