Winter is coming or it is already here depending on your perspective. As the days gets shorter and the evenings get the longer, we adjust to spending a significant portion of our time in darkness. As well as this, the changing of the seasons brings with it the cold, the rain and generally less favourable conditions that we have become accustomed to over recent months. It is of little surprise that this transition can be a real downer for people. In recent years the terms Seasonal Affective Disorder or SAD for short, has become synonymous with decreases in mood and overall well-being. This notion of the “winter blues” has garnered some controversy with experts suggesting that SAD as a whole is misunderstood and that the term is significantly overused.
So what is SAD and what sets it aside from the everyday “winter blues” that many of us experience as we transition into the winter months?
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) which is the guide most frequently used by mental health professionals for diagnosing psychological disorders, now refers to Seasonal Affective Disorder as Depression with a Seasonal Pattern. This guide recognizes SAD as a very real and extremely debilitating form of mental illness. According to this guide, a number of specific symptoms are required for a diagnosis of SAD or Depression with a Seasonal Pattern. Many of these are similar to Major Depression such as feeling depressed most of the day almost every day, decreases in energy levels, changes in interests, eating and sleeping habits, feelings of hopelessness, difficulty concentrating, and having frequent thoughts of death and suicide.
The main differentiating factor here is that the episode of depression begins and ends during a specific season every year with no episodes occurring in between these time periods. Usually SAD emerges during the transition into winter and recedes during the transition into summer but the opposite can be true also. What exactly causes a person to develop SAD still remains unclear. Research exploring the cause of SAD suggests that a lack or excess of sunlight may upset our “biological clocks”. This “biological clock” is responsible for regulating our sleeping patterns. Such an upset may contribute to experiencing symptoms of depression. Additionally research suggests that a lack or excess of light may impact on serotonin levels. As serotonin is a “feel good” chemical, this may also contribute the emergence of SAD.
Regardless of what causes SAD or depression with seasonal patterns, the evidence supporting its existence is a lot more convincing. One recent study carried out in China has even demonstrated that the condition can be induced and treated in animals. In this particular study the researchers manipulated the photoperiod (or the time that the animals received light) over an extended period. The animals in question were rhesus macaque monkeys. When the photoperiod was shorter, the animals began to develop depressive-like symptoms consistent with SAD. These symptoms were swiftly treated and receded following antidepressant treatment. What this study highlights is that SAD is most likely related to a decrease in the amount of light that an animal or person receives. It also further illustrates the distinctiveness of SAD as a psychological disorder in comparison to other depressive disorders.
Currently figures suggest that SAD occurs in between 1-10% of North Americans. Unsurprisingly figures are highest in northern regions where light is most restricted in the winter months (Alaska has the highest rate of Winter-induced SAD while Florida has the highest rate of summer-induced SAD). Thankfully research has demonstrated SAD as being quite a treatable form of mental illness. The most prominent treatment options include medication (such as antidepressants) and psychotherapy. Psychotherapy can take several forms, the most promising of which for SAD have been shown to be Cognitive Behaviour Therapy (CBT) and Acceptance and Commitment Therapy (ACT).
The basis of both CBT and ACT is that they involve developing skills that help you to think and behave differently. This in turn impacts on how you feel and can thus break the cycle that maintains your depressive symptoms. ACT is distinguished from regular CBT by its incorporation of mindfulness and acceptance elements.
One form of treatment for SAD that has garnered significant attention for not all of the right reasons is light therapy. Light therapy involves exposure to an artificial light (called a light therapy box) which is supposed to mimic the effects of natural light and thus stave off the symptoms of SAD. The evidence for light therapy is patchy at best. Many studies have found that light therapy is ineffective in curing SAD. Nevertheless there have been some positive findings. One such study carried out by psychologist Kelly Rohan and her team at the University of Vermont in the United States found light therapy to be as effective as CBT. This evidence suggests that light therapy may have some promise in relieving some of the symptoms of SAD and should therefore not be written off entirely.
Whether you suffer from full blown SAD or just struggle to maintain an elevated mood during the winter (or summer) months, there are several things that you can do yourself to help to alleviate your difficulties. Exercising regularly, sleeping and eating well are paramount to maintaining our overall mental health and well-being. Additionally it can help to include activities in your life that make the most of the time that you can be outdoors in natural sunlight.
If you feel that you may be experiencing SAD, the best thing that you can do is consult with your doctor or a medical professional. The following link may also be of use to you:
http://www.heretohelp.bc.ca/factsheet/seasonal-affective-disorder