As the worst of winter sets in, some folks notice their tempers may match the days: short, dark, and icy. Winter blahs are pretty common this time of year. Some people even grow to hate holidays. Others feel let down once the Christmas tree is out by the curb. Still, others get ground down by month after month of gray skies and grayer slush. Even Wall Street isn’t immune: indeed, the price of IPOs has been found to vary with the season.
As mentioned in previous newsletters, most psychological disorders are the extreme end of normal experiences. Winter blues are a problem, but a relatively minor one—you feel blah, you eat more Girl Scout cookies in the recliner than usual, but you manage to function.
By contrast, Seasonal Affective Disorder, or SAD, is more serious. In the most current version of the Diagnostic Statistical Manual (5th Edition), SAD is a specifier associated with Major Depressive Disorder. More often than not, a SAD sufferer feels like a hibernating bear who’s been disturbed: grouchy, lethargic, and exhausted. You also may feel sad, guilty, hopeless, pessimistic, unmotivated, and self-critical. Symptoms that are different from a non-seasonal depression include craving for carbs, resulting in weight gain, and sleeping too much. Also, unlike typical depression, which can occur regardless of the season, SAD lifts like a hemline once warmer weather hits. Those carb cravings, by the way, are your body’s attempt to boost serotonin. Serotonin release can be influenced by high-carbohydrate food, as anyone who has ever reached for a donut to soothe a bad mood can attest. Indeed, it’s not just a phenomenon unique to SAD—ask anyone who’s ever tried to quit smoking, had PMS or battled emotional eating.
What Causes Seasonal Affective Disorder (SAD)?
No one is exactly sure, but the shorter daylight hours of winter seem to be the main cause of SAD. No wonder then Idaho was ranked as the second most saddest states in the union by Mental Health America, a nonprofit devoted to positive mental health. If you are wondering, Oregon was the number 1 saddest state on Mental America’s top 50 countdown.
Light is the pacemaker to our pacemaker—it cues our circadian rhythms or internal body clock. Shortened daylight hours can trigger a cascade of problems: our out-of-whack circadian rhythms throw off associated neurotransmitters and hormones such as serotonin and melatonin, which in turn throws off our appetite, sleep, and mood. SAD affects about 1-5% of Americans in the lower 48 states, with numbers increasing as we move to northern latitudes, shorter days, and longer winters. In Alaska, numbers can top 10%. Women in their childbearing years are most affected, with a 4:1 ratio of women to men. As with most other observations concerning the human race attempting to generalize an observation to individuals or cultures is a “fool’s errand.” This is particularly true when we attempt to attribute the lack of winter time sunlight to the cause of SAD. There are a number of cultures that seem to have adapted to the longer winters and long periods without sunlight. The most researched group are the native Icelandic peoples. Iceland located at latitude (63.4°) has one of the lowest rates of SAD in the world. Studies comparing Icelanders who have immigrated to Manatoba, Canada, located at latitude (50° to 50.5°N) reveals a markedly higher rate of SAD (9.1%%) among non-Icelanders as compared to the Icelander population (4.8%). Additional factors like climate, and even the sensitivity of your retinas combine to create the perfect (winter) storm for SAD.
So what can you do to beat winter blues and SAD? Well, instead of curling up in a fetal position with a stack of cinnamon rolls until spring, try my 5 tips for beating mild winter blues. And if your struggle is with full-blown SAD, I have 3 tips on how to combat that too.
Tip #1: See the light.
Serotonin production is related to light; the neurotransmitter gets pumped out more quickly as the days get longer and brighter. Likewise, the production of melatonin—the sleep hormone—is also regulated by light.
To treat winter blues with light, getting some winter sun may be enough. Standing indoors by a closed window or getting some sunlight through a windshield while commuting isn’t sufficient. But a walk around the neighborhood with your dog or a trek to a deliberately distant coffee shop during bright, midday work hours might be a satisfactory way to soak in some sunlight.
Tip #2: Exercise.
A long line of studies touts the benefits of exercise on mood. How exercise might work in the context of SAD isn’t exactly clear. Some studies say exercise somehow increases one’s sensitivity to light and can help restore circadian rhythms. Others say it jump-starts the circadian pacemaker—a cluster of neurons in the pineal gland. Regardless, a good workout may help you achieve a good mood, despite an impending polar vortex.
Tip #3: Drink coffee.
One study followed 51,000 American women for 24 years and found, among many other things, that as coffee consumption went up, the risk of depression went down. The women who drank the most coffee—4 or more cups a day—had the lowest risk of depression Lucas, et al., 2011). The researchers were careful to say that the research was too preliminary to start recommending caffeine as a protector against depression, but in the dead of winter, the stimulation (and warmth) of a tasty latte can’t be a bad thing.
Tip #4: Wash your hands.
This seems an odd way to improve your mood. Still, you’re more susceptible to depressive symptoms after a viral illness, and we all know hand-washing is the best way to avoid the cold or flu (besides a flu shot, which I recommend).
Tip #5: Socialize.
Social support is one of the best buffers to all kinds of mood problems, and yes, I know when you have the winter blahs, the last thing you feel like doing is hanging out. If nothing else, throw a Winter Doldrums party, wear your best Snuggie, and make your friends come to you.
3 Tips to Beat SAD
In addition to all of the above, here are 3 extra, supercharged tips to battle true SAD:
Tip #1: Talk to your doctor about a lightbox
For SAD sufferers, a lightbox (sometimes called the “happy box”) is the treatment of choice and works for about 80% of patients. Not just any lightbox. Research suggest that a white fluorescent light box fitted with an ultraviolet filter and rated at 10,000 lux provides the best results. The optimal dosage is obtained by sitting at a distance of 14 inches from screen to cornea for 30 minutes as soon as possible after awakening. One study even showed improvements after just one hour of treatment—near-immediate effect. Simply sitting in front of the light will trigger a cascade of changes in your brain and re-set your body clock. Talk to your doctor about a possible prescription and Lightboxes are expensive but with a prescription insurance may pick up part of the costs.
Note also, LED units, full spectrum lights, and tanning booths are not effective. And never look directly at the light.
Tip #2: Negative air ionization.
I admit, I was skeptical about this one at first, but it checks out. A negative ion is an atom or molecule that has gained an electron. Negative air ions are generated naturally by moving water—there’s a higher concentration at waterfalls, the beach, and even in your shower. Germane to our topic, summer air, but not winter air, has a high concentration of negative ions. A study in the prestigious American Journal of Psychiatry found that high-density negative air ionization during sleep led to a 50% improvement in SAD symptoms in about half the participants—not as many as with bright light, but a breakthrough non-drug treatment nonetheless.
One thing worth your skepticism is the resulting avalanche of negative air ionization products out there—bracelets, air purifiers, even lightboxes with negative ionization built-in. Unfortunately, most negative air ionizers emit too few ions to do anything for your mood. The generators in the study had a flow rate of 450 trillion per second, much higher than most products on the market. Machines that match the ones used in the study are out there, though; just read the fine print.
Tip #3: Consider traditional depression treatments: medication and therapy.
The only medication I am aware of that has been approved by the FDA for the treatment of SAD is Wellbutrin. Talk to your general practitioner or psychiatrist about this option.
On the therapy front, Acceptance Commitment Therapy (ACT; Hayes 1999) and Cognitive Behavioral Therapy (CBT; Beck, 1967) can address the unhelpful beliefs and habits—like withdrawing from a winter social life—that may go along with SAD, and may act as inoculation for future winters.