Lifestyle Corner
Take Control of Those Winter Blues!
Feeling blue and depressed this winter? These feelings may be symptoms of Seasonal Affective Disorder (SAD). SAD is a medical condition--like other types of depression, SAD is a mood disorder.
SAD is associated with the lack of available sunlight during the winter months. Most people feel more energetic and happier when the sun is out. However, some individuals are significantly affected by the darker days of winter. These "winter blues" for them interfere with daily functions, like getting up on time for work, staying focused throughout the day, and maintaining relationships.
Women are more affected by SAD than are men. The prime time for SAD to occur is between the ages of 20 and 40. Scientists also have found that SAD often affects more than one family member. At least two genetic variations associated with SAD have been discovered.
In the animal kingdom, the levels of sunlight profoundly affect the seasonal activities of most warm-blooded mammals (i.e., reproductive cycles and hibernation). Human beings also react to the seasons with changes in mood and behavior. As the days get shorter and stay darker for longer in winter, you may find you eat and sleep more, or dislike the dark mornings and shorter days. For some, these symptoms are severe enough to cause depression, feelings of hopelessness and considerable stress and they struggle through each winter day.
Norman Rosenthal, MD, a former NIH scientist, is credited with discovering SAD and developing the criteria for its diagnosis. The following is a list of the main criteria for SAD. Study this list and see if this condition applies to you:
A pattern of winter depressions, at least two that occur during consecutive winters, alternating with non-depressed periods in the spring and summer.
At least one of these depressions was severe enough to meet the criteria of major depression.
No other major psychiatric disorder is present.
No clear-cut recurring social or psychological reasons to account for the recurrent winter depression.
Here are some specific SAD symptoms:
Bad/sad moods. People with SAD have symptoms of depression, such as despair, misery, guilt, and anxiety.
A positive response to sunlight or light therapy. Depression disappears in the spring and summer, for example.
Craving for sugary and/or starchy foods when depressed, often resulting in weight gain over the winter months.
Oversleeping, not feeling refreshed after sleeping, feeling like you can't get out of bed, and having low- to no- energy when you do.
Physical symptoms such as joint pain, stomach problems, and lowered resistance to infection.
What causes SAD? Researchers aren't exactly clear what causes this condition. One theory is that serotonin, a chemical in the brain widely believed to play a major role in depression, falls to its lowest level during the winter months. If you are affected by SAD, you may have less serotonin available or your body may be less able to handle the decreased levels than those unaffected by the disorder.
SAD may also be associated with melatonin production. Melatonin, a hormone secreted by the pineal gland, is produced at increased levels in the dark. When days are darker more melatonin is produced. Also, there may be intrinsic problems with specific hormones, such as the stress hormone cortisol as well as secretion of growth hormone. How is SAD treated? Many people with SAD respond to "phototherapy" or bright light therapy, which has been shown to suppress the brain's secretion of melatonin and affect serotonin levels. The device most often used today is a bank of white fluorescent lights on a metal reflector and shield with a plastic screen. The amount of light you receive is noted in lux, a measurement of light intensity. A wintery morning sunrise, just before the sun crests the horizon, emits about 10,000 lux. A summer sky delivers over 100,000 lux. A classic fluorescent ceiling light in an office emits 300-500 lux, and the phototherapy sunboxes emit from 3,000-10,000 lux, which is considered to be therapeutic for most individuals. Most people with SAD can experience significant relief with approximately 30-45 minutes a day of exposure to the light box.
For mild symptoms, spending time outdoors or arranging your home or office to receive more sunlight may help. One study found that an hour's walk in winter sunlight was just as effective as two and a half hours of phototherapy. Powerful stuff, that sun! For more information about SAD, call the Society for Light Therapy, Biological, and Rhythm, at (303) 424-3697. For information about depression, click on "Depression" in the Health Center at this web site. I would also highly recommend Dr. Rosenthal's excellent book Winter Blues (Guildford 1998) for great practical advice about managing SAD. For more specific treatment, discuss your symptoms thoroughly with your doctor or mental health professional.
Pamela M. Peeke MD, MPH, Pew Foundation Scholar in Nutrition and Metabolism, is Medical Advisor to the NWHRC; she also is an Assistant Clinical Professor of Medicine at the University of Maryland, Baltimore, and author of the best selling book Fight Fat After Forty (Viking Press, 2000).
Click www.drpeeke.com, Dr. Peeke's Web site featuring health and wellness issues for women.
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