By Andy Buchanan
NorthShore University HealthSystem
The coming winter months bring shorter days and colder weather, prompting many people to complain about a lack of energy and negative changes in mood. In short, it’s hard to feel sunny when there’s, you know, not much sun.
But to some people these feelings can manifest themselves in a more serious way, when a dread of the dark winter months becomes debilitating. It’s called Seasonal Affective Disorder, or SAD, and epidemiologists estimate that 4-6% of people in the United States experience it annually.
Robert Farra, Ph.D, Director of the Adult Mood and Anxiety Disorders program called Solutions at NorthShore University HealthSystem, says with SAD individuals experience episodes of mild to moderate depressive symptoms that occur certain times of the year, usually during winter months when there is less natural light. People who live in places with long winter nights are at greater risk for SAD.
“For the last several weeks many of my patients have begun talking about the weather and how they dread the winter. When I ask them if they are new to the area, they say, ‘Oh no, I've lived here all my life,’” Farra says. “And every year they talk about how much they dislike the weather, usually predicting the worst weather scenes in their minds. … They make a whole plan on how they’re going to behave in the winter, which is basically hibernate except for going to work. It’s a miserable time of year for them every year.”
And more than we realize, Farra says, our thoughts influence our feelings and behavior. “I’m already seeing people who by the way they think are setting the stage for a full-blown episode of SAD,” Farra says.
Symptoms of SAD usually begin slowly in the fall and winter months, and include sad mood and often increased irritability; increased appetite and weight gain; increased sleep and daytime sleepiness; decreased energy and ability to concentrate, especially in the afternoon; loss of interest in work or other activities; and sometimes withdrawing from socializing with friends. For reasons researchers don’t understand, more women than men experience SAD.
Treatment can include light therapy using a special lamp with a very bright light (10,000 lux) that mimics light from the sun. Patients are advised to sit for 30-45 minutes twice daily for the treatment. But compliance often isn’t great, Farra says, because some people find it a chore to sit for that long. And light therapy has been shown to work on less than half those that try it.
“It’s not just a lack of light. If it were that simple everybody who got a high intensity light would be cured and that would be that,” says Farra. “There’s a cognitive and behavioral component to SAD.”
That goes back to the feelings of dread that consume some people and lead to behavioral changes. For these people, cognitive behavioral therapy can be helpful. In sessions with a psychiatrist, patients learn to change their negative thoughts and behaviors, and this helps alleviate symptoms.
“Through cognitive behavioral therapy people learn cognitive skills to use in the winter. Once you learn the skills you can practice them on your own,” he says. “It’s a relatively short-term therapy, six sessions on average, and people can learn the important skills necessary to manage this better.”
But in some cases that’s not enough, Farra says, and anti-depressants may also be needed. In addition, people who have had repeated seasonal depression should talk to a mental health care professional about prevention methods and starting treatment during the fall or early winter, before the symptoms of SAD begin, Farra says.
The larger point, he says, is that there are treatment options out there.
“Suffering is optional but you have to take some action. If you take no action to improve your life in these areas, nothing’s going to change,” Farra says.
