Getting Through the Winter with SAD (Seasonal Affective Disorder)

Many of us can notice a change in our mood and behaviour patterns as the seasons change and the long, bright, warm summer days give way to the grey, cold, shorter days of winter. If you think about it, it makes perfect sense – most animals act differently during autumn, whether that is storing food to get through the months when supplies are more meagre, growing thicker coats for the colder weather or eating extra ready to hibernate, there aren’t many animals in the cooler climates that don’t adjust their behaviour to the seasons. As humans we often forget that we are, basically, animals, and therefore our bodies also notice the changes in temperature and light levels.

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What does SAD feel like?

In the winter we may find that we eat more, sleep more, feel more lethargic and our mood may dip. This is known as the winter blues and is fairly common. However, for some of us the effects are felt far more greatly and this can lead to a diagnosis of Seasonal Affective Disorder. Symptoms of SAD include:

  • Symptoms of depression such as; persistent low mood, feeling guilty, tearful, despair, hopelessness, worthlessness, difficulty concentrating, apathy
  • Anxiety symptoms such as; tenseness and inability to cope with normal/everyday tasks
  • Social issues such as; irritability, lower sex drive, avoiding company
  • Sleep issues such as; feeling lethargic and sleepy during the day, oversleeping, insomnia, disturbed sleep patterns
  • Increased appetite (particularly for carbohydrates) which can lead to weight gain
  • Physical symptoms such as joint pain and lower immune system leading to more colds and infections

By understanding why we feel these symptoms we can start to find ways to alleviate them. For many the day we put the clocks back in the UK has become a day to dread, when we know the SAD symptoms will start to kick in and we will have to put all our reserves into getting through the winter months.

But why?

The main cause of SAD is the lack of light. Two chemicals in our brains really come into play here; Serotonin and Melatonin. During the winter months we are exposed to less natural light, both because the days are shorter and greyer, and also because we spend less time outside due to the inclement weather.

Light plays a huge role in our moods and daily rhythms. When night falls our bodies react to the lack of natural light entering through our eyes and the pineal gland in our brain produces a chemical called Melatonin. Melatonin makes us feel sleepy and lethargic and prepares us for going to sleep for the night. In the morning bright daylight entering our eyes signals to the gland to stop producing melatonin which helps to wake us up and make us feel refreshed. At the same time, the light boosts production of the chemical Serotonin which is our ‘feel good’ hormone.

During the winter we receive less light all day, which means we are producing extra melatonin leading to feelings of sleepiness and lethargy. Everyday tasks become much harder to cope with and we feel irritable and grumpy – just as we would do if we hadn’t had enough sleep. At the same time, the lack of light slows our production of Serotonin. This makes us feel depressed and leads to feelings of sadness, guilt, anxiety and apathy.

Alongside this our bodies start to prepare us for winter as they would have done in our cave man days; by altering our metabolism and appetites so we crave starchy, energy producing food such as carbohydrates to help ‘fatten us up’ for the cold winter months.

Not everyone experiences SAD. It is thought that some of us are more sensitive to light levels than others – leading to symptoms of winter blues. Those of us who have previously suffered from depression are more likely to get SAD and women are around four times more likely than men to experience it (http://patient.info/doctor/seasonal-affective-disorder-pro). People living further from the equator also have a higher chance of developing symptoms with around 6% of adults in the UK apparently reporting severe seasonal changes in their moods (although many suspect this figure is much higher).

So now we know why, what can we do?

Light Therapy

As SAD symptoms are mainly triggered by light, it makes sense to use light to help alleviate them. The easiest way to do this is with light therapy which usually comes in the form of a light box. Light therapy works by using a powerful light to deliver light right to the back of the eye. This then lowers your Melatonin levels and increases your Serotonin production which will lessen the symptoms of SAD.

Light therapy tips:

  • When using light therapy make sure you have a light box with a high LUX level (the unit used to measure light). It needs to be at least 2000lux and preferably 10,000lux (around 10x the brightness of a normal office). The higher the level the less time you need to spend with the light box. (Daylight bulbs and normal lighting won’t work.)
  • You will need to use the light box for between 30 minutes and 2 hours per day depending on the lux level of the bulbs.
  • Use the light box in the morning to ensure you don’t mess up your circadian rhythms and body clock.
  • Ensure you follow the directions that come with the light box – you need to have the light box angled so the light can get right to the back of the eye. As long as you are doing this you are free to read, watch TV or do whatever you want during this time.

Something else many people find helps is a dawn simulation alarm clock which uses light to gradually wake you. Some of these will also use a fading light to help you drop off to sleep. These do not replace light boxes but used alongside one they can help keep our body clocks on track.

Light therapy is not available on the NHS however when used to treat SAD symptoms it is VAT free.

Lifestyle Changes

Light therapy has been shown to be very effective for a lot of people with SAD, however, it can be expensive and therefore isn’t always an option. Thankfully there is a lot we can do to help decrease symptoms without light boxes.

Routine: It can be easy to get out of routine when we are feeling lethargic and our sleep pattern is disrupted. By ensuring you go to sleep and wake up at roughly the same time every day you avoid disturbing your body clock.

Electronics:Try to limit the use of phones, tablets and TVs just before bed. These will put artificial light into the eye and can mess up the delicate chemical balances making it harder for you to fall asleep at night.

Get outdoors: Try and spend some time outside every day. It can be hard to motivate yourself to get out but by exposing yourself to natural light you will naturally boost your Serotonin levels which will have a big effect on your mood.

Exercise: Studies have shown that exercising regularly is a great way of naturally boosting production of Serotonin. Exercise will also help wear you out so you feel more sleepy at night time, which will also help regulate your body clock.

Eat healthily: The food your body craves during winter can actually leave you feeling lethargic and tired. Plus they can lead you to gain weight which can lead to feelings of frustration and depression. Try to counter this with lots of fruit and vegetables (and make sure you treat yourself to what you enjoy too!). Some people find taking a Vitamin B12 or a Vitamin D supplement can help as well.

Reduce stress: Try to avoid planning stressful life events for the winter months if you know you naturally find this time of year harder. Things like changing jobs or moving home, where possible, should be planned for the summer. Winter can be a stressful time anyway; the holiday period can lead to financial strain and difficult family events so try to do your Christmas shopping ahead of time and don’t put yourself under pressure to go to every party you are invited to.

Ramp up the self-care: Pamper yourself with a massage, sit down with some craft activities, learn relaxation techniques such as mindfulness or meditation – find what works best for you.

Book a holiday: A more expensive option but some people with SAD book their ‘summer holiday’ during winter, while others will go somewhere closer to the equator for the whole of the winter period. However, some people do report a real slump in their mood when they return to the UK so bear this in mind when considering this option.

Support: Speak to your friends and family in advance. Ask them to read this so they understand what you are going through and why. It will help them be more understanding and supportive. Having people to talk to who are going through the same thing can also be invaluable – many ‘general’ depression support groups will also have people who suffer from SAD, for example, our own Peer Support Group would be a good place to turn.

Medication and Therapy

Talking treatments, such as counselling or cognitive behavioural therapy (CBT) can be very useful to help you manage the symptoms of SAD and recognise other factors that may be adding to your feelings of depression.

St John’s Wort is a herbal remedy that has been shown to be helpful for some in coping with the symptoms of winter blues. Be careful when using alongside light therapy as it can make you sensitive to bright light and make sure you speak to your GP if you are using any other medication before trying.

SSRI (selective serotonin reuptake inhibitor) antidepressants work partly by increasing the levels of Serotonin available in the brain. Because we know a lack of Serotonin is one of the causes of SAD, antidepressants can be effective in helping treat SAD. Speak to your GP to see if this option is suitable for you.

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