My energy is low, my weight is up, and please don’t ask me to go anywhere that requires “real” pants. I am pretty sure I am experiencing the Winter Blues and it doesn’t help that the savviest salesperson I know in the brown vest and pig tails is currently offering online cookie orders -yes, THOSE cookies – and delivery (you know who you are Phoebe). However, while I am definitely experiencing some additional belly fluff and lethargy, these cold, gloomy days are not preventing me from enjoying my life (did I mention the cookies?). Yes, winter can be tough, but for some it is downright debilitating.

Seasonal Affective Disorder 

What does it mean if the winter blues permeate most aspects of your life and interfere with your ability to get through your days, weeks, even months? Seasonal Affective Disorder (SAD) is a type of depression that comes and goes with the seasons, typically starting in the fall and persisting through the winter months. SAD usually goes away in the spring and summer but there are those that experience seasonal depressive episodes in the summer too.

What are the symptoms?

SAD isn’t considered a separate type of disorder, but rather a type of depression that occurs in a seasonal pattern. Those diagnosed with SAD meet the criteria for major depression for at least 2 years and usually experience more frequent non-seasonal episodes of depression. As you can see below, symptoms of major depression and SAD overlap significantly.

• Feeling depressed most of the days, nearly every day
• Feeling hopeless or worthless
• Having low energy
• Losing interest in activities you once enjoyed
• Having problems with sleep
• Experiencing changes in appetite or weight
• Having difficulty concentrating
• Feeling sluggish or agitated
• Having frequent thoughts of death or suicide

Symptoms of the winter pattern of SAD include:

• Having low energy
• Sleeping a lot
• Overeating and weight gain
• Craving carbohydrates
• Social withdrawal (feel like “hibernating”)

Who is at risk for SAD?

SAD is more frequent in people who live far north or south of the equator. About 1 percent of those who live in Florida and 9 percent of those who live in New England or Alaska suffer from SAD. Women are four times more likely to experience SAD and if you have a family history of depression you are also more likely to develop SAD.

What causes SAD?

In a word (or two), we don’t know. However, research has found some biological clues:

• People with SAD may have trouble regulating a key chemical messenger involved in mood.
• People with SAD may overproduce the hormone melatonin, leaving people feeling sleepier and more lethargic.
• People with SAD may also produce less Vitamin D, which when low can be associated with clinical depression.

Treating SAD

The good news is there are effective treatments that can be used alone or in combination including medications (SSRIs), light therapy, and psychotherapy (talk therapy). Light therapy has been a mainstay of treatment for SAD since the 1980’s. The idea behind light therapy is to replace the diminished sunshine of the fall and winter months using daily exposure to bright, artificial light. At present, vitamin D supplementation by itself is not considered an effective SAD treatment, however, the evidence for its use has been mixed. There are some studies that suggest it is as effective as light therapy. What we do know is that checking vitamin D levels can be a helpful step in a thorough evaluation of your symptoms.

If you are suffering with SAD there is help available. Balance Women’s Health specializes in women’s mood disorders and offers comprehensive evaluations to help you find the balance you seek. Call today at (405) 378-2727 to schedule an appointment with one of our providers.

And a note to my fellow Winter Blues traveler: Take heart, dear reader, this too shall pass. Spring is only a short 7 weeks away.

Sources:
American Psychiatric Association. Depressive disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:155-188.

Fava M, Østergaard SD, Cassano P. Mood disorders: depressive disorders (major depressive disorder). In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 29.

National Institute of Mental Health