A look at Seasonal Affective Disorder and tips to help reduce symptoms of wintertime darkness and depression
Our Bay Area weather is shifting to colder and darker mornings and we are starting to hear conversations from Mind Therapy Clinic clients about how difficult it is to get up when it’s darker. Some are beginning to talk about mood changes.
We Californians are blessed with very moderate winter temperatures but no matter how intense, the shift into fall and winter can create a real physiological and psychological condition called Seasonal Affective Disorder, SAD, which is a type of depression that occurs in winter. Cold weather can be uncomfortable and possibly depressing but it is actually shorter hours of daylight that prompts SAD.
"Our hormones are sensitive to sunlight,” said Mark Schiller, MD, medical director and founder of Mind Therapy Clinic psychiatric outpatient services. “Hormones regulate our moods and sleep.” If you or a client is affected by SAD, then you can expect the disorder to reoccur every winter, he noted.
Because it is hormonally-based, SAD is probably not completely preventable, but there are many actions you or clients can take to lessen SAD’s effects.
Catch an early breakfasts & early light
One way to prepare for SAD is to set your internal clock earlier each morning, in an action called “phase shifting." Starting near the end of October, think about preparing and eating your breakfast under bright light," Dr. Schiller said. The optimum timing, he said, is at 7 AM for one half-hour.
If you wake up to a bright, sunny morning, get outside for 30 minutes. Midday provides peak winter sunlight, so an early afternoon walk can be beneficial. Open up your home’s window coverings to let in maximum morning light.
Phase shifting with indoor artificial bright light is a substitute for natural sunlight to counteract SAD. A light of 10,000 lux brightness shifts our hormones. SAD symptoms - one or more the following: sadness, hopelessness, lack of energy, irritability, and social withdrawal - often respond to light-box or lamp therapy. There are plenty of lamp and light-box option available online, from utilitarian to stylish. If an earlier breakfast isn’t feasible, you can phase shift for 30 minutes every morning with a lamp/light box. Turning on the light-box in fall or early winter may lessen or prevent symptoms. Even after SAD symptoms have begun, a few weeks of light therapy will address them.
"Regular exercise can help shift any type of depression, including SAD," Dr. Schiller noted. A consistent exercise commitment year-round is a wonderful health goal but if you or your clients get SAD, a focus on regular exercise before winter begins will be a double bonus.
There is a large amount of research on depression and the effect of exercise. In a 2013 study published in The Cochrane Review, which reviewed 30 clinical trials on exercise and depression, the conclusion was that exercise improves symptoms of depression.
Good sleep hygiene
"Probably one of the best ways to address Seasonal Affective Disorder is to understand and regulate your own body rhythms. If you cultivate awareness of your body rhythm, you can learn to control is your sleep cycle," said Dr. Schiller. A focus on creating good sleep hygiene, or habits, for SAD would include rising (early) with the sun, going to bed at the same time every night and getting at least 8 hours of sleep. One suggestion Dr. Schiller gives for setting your sleep cycle is to keep one clock set to summer time when daylight savings time ends Sunday, November 3, set your sleep cycle according to summer time.
Heart-healthy food plan
A heart-healthy food plan diet makes sense whether you or your clients have SAD or not. A study in the American Journal of Psychiatry concluded that a heart-healthy food plan may also address depression and anxiety. The study included more than 1,000 women, ages 20 to 93. Women whose diets were high in fruits, vegetables, whole grains and plant-based proteins had a lower risk for depression than did those whose diets were high in fried foods, added sugars, refined grains, and processed foods.
Get away from wintertime SAD. "Seasonal Affective Disorder is probably genetic and the most effective escape its effect is to move south," Dr. Schiller said. Some SAD-effected individuals may experience a fading of the SAD symptoms as they age but if you don't want to wait until retirement to escape SAD, plan a winter vacation in a locale with long sunny days.
See Your Doctor Before Winter Depression
"If you know you experience seasonal symptoms of depression, make an appointment with your doctor to create a depression management plan," Dr. Schiller suggested. "Some individuals with significant SAD symptoms respond well to bupropion,” he said, spanning fall through early spring. Other treatments that may help include vitamin D, omega-3 fatty acid supplements, and the hormone melatonin. If you or your clients get SAD in the winter, talk to your doctor to prevent winter depression.
Do you or your clients experience Seasonal Affective Disorder?