If you feel blue during the winter months, it’s not your imagination and it is not that suddenly you are more stressed out.
Seasonal Affective Disorder, also called SAD, is a form of depression that affects up to ten percent of Americans, according to the American Academy of Family Physicians. Up to 20 percent of us have a mild form of SAD that starts when the days get shorter and colder.
SAD is a type of depression that is related to changes in seasons — and usually begins and ends at about the same time every year.
Some rare cases of SAD happen in the spring or early summer but if you’re like most people with SAD, symptoms will appear during late fall or early winter and will go away when the sun comes out again in spring and summer.
What is SAD?
Symptoms of SAD may include:
- Feeling depressed or moody most of the day, nearly every day.
- Losing interest in activities you once enjoyed.
- Tiredness or low energy.
- Weight gain and changes in your appetite, especially a craving for foods high in carbohydrates.
- Feeling sluggish or agitated.
- Having difficulty concentrating.
- Feeling hopeless, worthless, or guilty or even having frequent thoughts of death or suicide.
- Oversleeping or having problems with sleeping.
On the contrary, if you experience spring and summer SAD, symptoms may include:
- Trouble sleeping, more like insomnia.
- Poor appetite.
- Weight loss.
- Agitation or anxiety.
The specific cause of seasonal affective disorder is unknown but some factors have been proposed to play a role:
- Our biological clock called the circadian rhythm is influenced by the effects of sunlight on the suprachiasmatic nucleus, a tiny spot in our brain near your optic nerve that controls our circadian rhythm. When sunlight enters our eyes, it triggers the suprachiasmatic nucleus to turn off the production of melatonin, a hormone that regulates sleep and influences mood. The decreased level of sunlight in fall and winter disrupts our body’s internal clock and this can mess up the normal cycle of light and darkness that keeps our circadian rhythm in sync. This can lead to feelings of depression involved in the winter-onset of SAD.
- Our serotonin levels. Serotonin is a brain chemical produced by the brain to regulate mood and emotions. The reduced sunlight can also cause a drop in serotonin, which may trigger depression and play a role in SAD.
Seasonal affective disorder is diagnosed more often in women than in men and occurs more frequently in younger adults than in older adults.
Factors that may increase your risk of seasonal affective disorder include a family history of depression or a history of major depression or bipolar disorder. And of course, the farther you are from the Equator, the more common is the incidence of SAD due to decreased sunlight during the winter and longer days during the summer months.
I recommend that you take signs and symptoms of SAD very seriously as they can worsen. If not treated they can lead to more serious problems such as social withdrawal, problems at work, substance abuse, increased risk for other mental health disorders such as anxiety or eating disorders or even suicidal thoughts.
Here is what you can do to beat seasonal mood changes
Treatment can help prevent complications and worsening of symptoms.
Treatment for seasonal affective disorder may include different approaches, but I recommend that you consider an approach that is conscious of the importance of mind-body connection and that addresses the problem from all four areas of your self-care: your body, your mind, your brain, and your heart.
Here are some suggestions that might help you overcome the dark season with a smile on your face.
1. Light up your life!
Since SAD is linked to the lack of sunlight during the winter months, many people commute to work in the dark, spend all day inside, then go home when it’s dark again. To counteract these effects, get outside as much as possible to expose yourself to natural light, leave your curtains open and sit close to windows where possible.
A study from McGill University in Montreal has shown that by spending at least 30 minutes a day outdoors—even during the cold winter months—you should be able to offset your seasonal drops in serotonin.
You could also invest in a SAD lightbox for light therapy.
Light therapy, also called phototherapy, is one of the first lines of treatments for SAD.
According to research from UBC Hospital in Vancouver, Canada, light therapy is effective at combating seasonal affective disorder by elevating the levels of serotonin in your brain.
It consists of the use of a special light box that mimics natural outdoor light.
During light therapy, you sit or work near the light therapy box for several minutes per day.
It generally starts working in a few days to a few weeks and it is relatively safe.
Research on light therapy is limited, but it appears to be effective for most people in relieving SAD symptoms by changing the brain chemistry linked to mood and sleep.
Most people with seasonal affective disorder begin treatment with light therapy in the early fall when days typically become shorter and darker. Treatment usually continues until spring, when outdoor light alone is sufficient to sustain a good mood and higher levels of energy.
To be effective, light from the lightbox must enter your eyes indirectly so make sure your eyes are open but don’t look directly at the lightbox, because the bright light can damage your eyes.
The three key elements for effectiveness are a combination of light intensity, duration, and timing.
For most people, light therapy is most effective when it’s done early in the morning after you first wake up so that you’re exposed to bright light within the first hour of waking up each day. Alternatively, you can set your lightbox on a table or desk in your home or office. That way you can read, use a computer, write, watch TV, talk on the phone or eating while having light therapy.
As for every ritual of self-care, be consistent and try to develop a daily routine around it.
Stick to your routine and if you skip a day or two, monitor your mood and your symptoms and see if changing it to a daily schedule helps.
2. Strengthen your mind-body connection.
The second approach to treat SAD is to practice activities that strengthen your mind-body connection.
You can choose among many, but these are the ones that have been shown to give the best results with SAD.
1. Practicing relaxation techniques such as yoga, tai chi, guided imagery or simply meditation. According to a 2014 review of 47 studies published in the journal JAMA Internal Medicine, mindfulness meditation was effective in reducing depression, anxiety, and pain. You can start by using one of my rituals of wellbeing in the free audio training that is called the Orient Express or just find your own way.
2. Developing an exercise routine that you can stick to and that is fun. Think outside the box! You might start the winter with big fitness plans, but when it comes down to it, how many of us are guilty of choosing the sofa over the treadmill? To prevent yourself from falling into this trap, find an exercise class that you actually want to do during the winter. There’s a growing body of evidence—including a recent study from Princeton University—that suggests that physical activity boosts your brain’s serotonin level whatever the time of year, and it elevates levels of this feel-good hormone for hours after your workout. Exercise also releases endorphins which will make you feel happy!
3. Get an indoor hobby. When the winter months roll in, it doesn’t mean that you have to give up on your interests and park yourself in front of the TV for months on end. To keep yourself occupied, take up a new hobby that you can complete indoors, such as writing, reading, painting, learning a new language or cooking. You could decorate your home or just rearrange your space in a way that is as functional and enjoyable as possible.
4. Make smiling and laughing your new mindset! Make someone smile with random acts of kindness. A scientific study found that people who practiced daily acts of kindness, like charity work or volunteering, experienced a significant happiness boost in 10 days.
And laugh more often! Laughter is one of the best medicines out there, particularly when it comes to the winter blues, as it releases endorphins and serotonin, helping to raise your mood and reduce stress. A study from the University of Montreal found that by laughing with friends, watching a funny movie, or even faking a smile, you can literally alter your brain chemistry and insulate yourself against the winter blues. Apparently even the anticipation of laughter can help to reduce stress levels and lift your spirits.
5. Make sure you get plenty of sleep! Having a structured bedtime can have a great effect on your emotional and mental health. A lack of sleep can contribute towards feelings of sadness and could be part of the reason why you are experiencing the winter blues. To give yourself the best chance of getting to sleep, put away your phone at least an hour before you go to bed as the blue light emitted from electronic devices can mess with your sleeping pattern and keep your brain alert. Try unwinding with a book instead, as this will relax and prepare your body for sleep. Try to go to bed early or simply nap more during the day.
Sadly, we can’t hibernate until April but we can nap! According to sleep experts Arianna Huffington and Sara Mednick, sleep bathes your brain in serotonin, beating back feelings of anxiety and depression and aiding a more positive outlook. Twenty to 30 minutes may be the ideal length for a nap, but even a few minutes here and there can have benefits.
3. Nutrition
A third approach to beat SAD is to improve your nutritional status.
While it can be tempting to indulge in comfort foods in the winter, research published in the Public Health Nutrition journal found that people who consumed fast food or excess of sugar were 51 percent more likely to develop depression.
Look at ways to include more nutritious food options in your diet, particularly those containing vitamin B such as chicken, soya beans and fruit. Vitamin B helps the brain produce serotonin.
Other superfoods are beets and asparagus. They are both the top plant-based sources of tryptophan, which supports serotonin production in the brain and a potent source of folic acid, which stabilizes emotional and mental health. Research shows that up to 50 percent of people with depression have low folic acid levels. So maintaining healthy folic acid levels is a priority during winter.
You might also want to supplement your diet with Vitamin D and SAM-E. During the winter months, many of us spend less time outdoors, which results in a drop in Vitamin D levels. To counteract this problem you can increase the amount of foods that contain the sunshine vitamin in your diet, such as oily fish, mushrooms, and eggs, or take a daily supplement of vitamin D. Alongside this, make sure you try to get outside at every possible opportunity to increase your vitamin D intake naturally.
As reported in a 2014 issue of the journal Medical Hypotheses, research has shown that low levels of vitamin D, per se can cause SAD. Whereas another 2014 study published by the journal Nutrients found that people who took vitamin D supplements saw significant improvement in their depression.
Other foods that can help you fight SAD are
Dark chocolate, which contains high levels of cocoa, has natural chemicals to help improve blood flow to the brain, causing a boost in mood and concentration and making you feel more vibrant and energized.
Coconut is also full of a specific type of fat that keeps your brain healthy and fuel better moods.
Chamomile tea, research shows that chamomile not only brings on better sleep but improves your cognitive functioning during the day as well.
4. Self-Love
Finally, practice some good self-love and add some TLC to your life.
1. Pamper yourself with a massage. According to a review of studies by the University of Miami School of Medicine, massage appears to increase your brain and body’s levels of serotonin.
2. Schedule in something to look forward to. It might be a weekend away, a night out with friends or something ongoing like training for a marathon. Whatever you decide, make sure it’s something you can look forward to. A research study from the Netherlands has shown that people get the most happiness from planning and anticipating their vacations.
3. Ensure you’re budgeting plenty of time for social interaction with friends and family or cozy time with your loved one in the winter months. In a famous Harvard study, scientists observed the well-being of 1,600 undergrads over 30 years. They found that the happiest ten percent of students were the ones who had the strongest social relationships—and that was a more accurate predictor of happiness than GPA, income, SAT scores, gender or race.
Or you can do like in Denmark and practice what Danes call “hygge”, a coping strategy that translates to “coziness” in English. Build a fire in the hearth, get into your sweats and lose yourself in an atmospheric book. The long winter evenings make perfect conditions for tackling all the books you’ve been meaning to read. A 2009 University of Maryland study showed that reading is something that happy people tend to have in common. Happy people also watch less TV, so books are a better entertainment option if you’re feeling sad in winter. If books aren’t your thing and you prefer personal interaction, make sure to include some intimate time with your partner at least once a week. A 2015 study of more than 25,000 U.S. adults found that, for those in couples, more intimacy correlated with more happiness.
5. Medications & Therapy
Finally, some people with SAD benefit from medications like antidepressant treatment, especially if symptoms are severe.
Your doctor will be able to sort out whether you have SAD or some other form of depression and may recommend starting treatment with an antidepressant before your symptoms typically begin each year.
Keep in mind that it may take several weeks to notice the full benefits from an antidepressant and also that you may have to try different medications before you find one that works well for you.
Psychotherapy can also help.
A type of psychotherapy known as cognitive behavioral therapy can help you identify and change negative thoughts and behaviors and learn healthy ways to cope with SAD and manage stress. For a start, you can try my ritual based on cognitive restructuring that I called Tame Your Brain. You can find the ritual in the free audio training downloadable on the main page of my website.
Whatever your approach will be, remember that you have the power to transform your stress and challenges into health, growth, and happiness!
Take good care of yourself and keep smiling!
Dr. MB