Seasonal affective disorder (SAD)?

Dear Melancholy Baby,

Somebody must've been feeling a bit clever when they christened the wintertime blues with the acronym, SAD. Cleverness aside, seasonal affective disorder (SAD) is a subtype of mood disorder (like major depressive disorder or bipolar disorder) that comes and goes according to the seasons. About four to six percent of Americans are diagnosed with SAD, and the vast majority of these cases — about 90 percent of them — are winter-onset, as opposed to summer-onset. The shorter days and colder weather in winter can be enough to dim anyone's mood, but for some, it triggers depression symptoms. Some of the symptoms are very similar to what you describe, including tiredness. However, it may be helpful to visit with a mental health professional as they can help you figure out if you have a true SAD diagnosis.

But, you might be wondering, what exactly causes this SADness to take place? For those with the condition, symptoms of SAD typically start when they're between 20 to 30 years old and frequently recur year after year. Some research indicates women may be more likely to be diagnosed with SAD. Changes in the amount of sunlight lead to changes in the body's circadian rhythms, which may lead to feelings of SAD for some. Researchers don't quite know the biological reason(s) for these seasonal swings, but living in a location with long and dreary winters or more dramatic seasonal changes can also be a risk factor. One thought is that it has to do with the disruption in brain chemicals that occur in response to the different patterns of light and darkness — like those short, dark winter days you mentioned. Two chemicals in particular, melatonin and serotonin, are especially sensitive to light variation across seasons and play a significant role in regulating your sleep-wake cycles and your mood. Because SAD is a seasonal pattern of what might otherwise be diagnosed as depression or bipolar disorder (I or II), a mental health professional would look for the symptoms of these conditions and then determine whether they were historically triggered by seasonal changes and had occurred at least two years in a row. For those who experience winter-onset SAD, some of these symptoms may include:

• A drop in energy level or lack of interest in activities you used to enjoy
• Increased fatigue
• Increased sensitivity to social rejection or avoidance of social situations
• Difficulty concentrating
• Irritability and anxiety
• Feelings of guilt or hopelessness
• Physical problems, such as headaches
• Cravings for carbohydrates
• Weight gain
• A tendency to oversleep

Those with summer-onset SAD may experience:

• A loss of appetite
• Weight loss
• Inability to sleep (insomnia)
• Agitation
• Anxiety

Lists adapted from the American Academy of Family Physicians. 

If you think you might have SAD, or a milder form of seasonal depression, a first step to consider is consulting a mental health professional for an evaluation. The most common treatment for winter-onset SAD is actually to simply expose the person to more light through light therapy. This is often done using special devices, such as a light box or light visor, that mimic that cherished fiery ball in the sky. However, it's good to note that tanning beds aren't a recommended alternative for getting your light fix. About 30 to 45 minutes of light therapy per day often does the trick for many people with winter-onset SAD. Alternative treatments for winter- or summer-onset SAD could include behavioral or "talk" therapy to alter negative thought patterns, or standard antidepressant medications, which a mental health professional might prescribe.

Whether you have a diagnosable case of SAD or you just feel as though winter is dragging you down from time to time, there are a few do-it-yourself ways that you might consider trying to beat the winter blues:

• You could make your house, apartment, or room bright. Keep the curtains open. Use bright colors on walls, upholstery, and bedding.
• If you work inside during the day, ask if you can work near a window.
• If circumstances allow, consider planning a little winter getaway to somewhere sunny and warm.
• If possible, try being physically active outdoors. If you're active indoors, try to do so near a window.
• Eat a balanced diet with lots of vibrant fruits and vegetables, and try to avoid sugary snacks.
• To the best of your ability, be patient with yourself and your symptoms, and ask your friends, family, and health care providers for extra support during the months you feel down.
• Try to stick to a regular sleep routine year round so that the seasonal changes in daylight hours won't affect you as much.

Mr. Golden Sun may like to play tricks on your mood, but rest assured that with some patience, perhaps the advice of a mental health professional, and a little more light (natural or artificial), that seasonal frown has a chance of being turned upside down.