The season got you down? Struggling with the motivation to get moving, even though you know it will help? Do you find the color red mildly depressing?
You may have a serious case of righteous indignation with the superficiality of life, or perhaps just the winter blues. While we don’t specialize in existential funks, we know something about depression and its cousin, colorfully named Seasonal Affective Disorder (SAD).
Our brains are immersed in a neurochemical and hormonal stew that is dauntingly complex, but a lot of work in the last decade has given us understanding of at least the broad strokes. It’s pretty complicated up in the head.
It is completely normal to slow down some in the fall; your body is conserving energy to get you through the cold winter.
For up to 10% of people, this is much more than simply banking the fires; it is a life changing and unwelcome annual ordeal. An affective disorder is a fancy way of saying a mood problem. The namesake symptom of SAD is depression.
Depression is usually associated with varying degrees of fatigue, increased need for food and sleep, weight gain and difficulty concentrating.
This occurring during the holidays is particularly irksome – when the need for energy is greater than normal. The increased appetite when the house is full of Christmas cookies is torture to anyone trying to maintain an ideal body weight.
An additional 10% of people have a milder form of the condition that may only have fatigue as a symptom.
The scientists tell us that the decrease in daylight triggers a decrease in brain serotonin and increase in daytime melatonin levels. You probably remember serotonin; that is the brain chemical that Prozac increases. Serotonin is good.
You would be right in deciding that medications like Prozac would be helpful in Seasonal Affective Disorder.
For those inclined toward more natural cures, we just need to trick your body into thinking it’s summer.
Your body mostly wants a sunbeam, like a cat. That is something we know how to do. Light therapy is essentially a portable sunbeam. The UV light is filtered out so you won’t get skin cancer, or unfortunately, a suntan. Light therapy with the intensity of 10,000 Lux seems to work the best, with 30 minutes every morning commonly recommended. Sitting in your sunbeam after work can also help, but occasionally causes insomnia. This treatment actually can work in as little as a week. That is three times faster than is usually seen with medical pill treatment.
Melatonin is also commonly used to treat Seasonal Affective Disorder. Melatonin is a hormone that is produced by your body in dim light. Taking supplemental melatonin in the afternoon can reset the hormonal clock.
Light therapy isn’t the only unusual treatment for SAD. Use of a negative ion generator in the bedroom at night shows a 50% response in patients with SAD.
Medications of the SSRI class work well but take a few weeks to become effective. Prozac is the best known SSRI, but any of them are effective.
The seasonal nature of Seasonal Affective Disorder favors the non-drug approach to the disorder. In people with SAD it usually returns each winter. Light therapy can be started in the fall before symptoms occur and can be useful in preventing the onset of SAD. Many find this more palatable than starting and stopping medications every year.
Seasonal affective disorder is often the cause of winter blues. A variety of treatments are usually well tolerated and effective. In the meantime, have a Christmas Cookie, can’t hurt.
Take care,
Dr. B
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.
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