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Feeling gloomy? Tips for coping with SAD



“Daylight can mean sunshine, or it can be eight hours of rain. They’re not equal.”

SHUTTERSTOCK

Why, what’s the matter,

That you have such a February face,

So full of frost, of storm and cloudiness?

    — Much Ado About Nothing, William Shakespeare

 

With the holidays a distant memory and the days blurring into a monotony of slate-colored skies and relentless drizzle, it’s easy to feel lethargic. But anyone who is persistently feeling fatigued, having difficulty focusing, sleeping poorly (or too much) or feeling hopeless could be suffering from something more serious.

According to the American Psychiatric Association, seasonal affective disorder, or SAD, is a form of clinical depression that occurs at a particular time of year and affects about 5 percent of the American population. Although the onset of SAD often coincides with the fall and winter seasons, it can also be triggered in the spring and summertime. Fall-winter-onset SAD is thought to be caused by numerous factors, including changes in brain biochemicals and the internal body clock falling out of sync due to the decrease in the number of daylight hours.

Some deny the existence of SAD and cite certain published studies, such as one that did not find a correlation between reduced daylight hours and the incidence of depression. Clinical psychologist Laura Macleod, Ph.D., with the Everett Clinic Shoreline Center for Behavioral Health, notes that evaluating daylight hours may not be specific enough. “Daylight can mean sunshine, or it can be eight hours of rain,” Macleod says. “They’re not equal.”

But how do you know if you have SAD, or if what you’re feeling is simply winter doldrums? “If symptoms persist or interfere with day-to-day activities, work or personal relationships,” then you know it’s something more serious, says Macleod.

Waiting for symptoms to pass or ignoring them is not the answer. “Depression creates more depression,” Macleod says, meaning that sad feelings or losing interest in once-enjoyable activities may cause one to retreat from the world, leading to a worsening of depressive symptoms.

Behaviors that might ease SAD symptoms include good sleep hygiene (such as going to bed and rising at the same time every day), maintaining social relationships with friends and family, and exercising regularly, especially taking a daily half-hour midday walk outside. If after making these adjustments you aren’t feeling better, see your primary care doctor or mental health professional to discuss other options. Dr. Macleod partners with her patients, and their preferences are paramount in decision making. Commonly used treatments include antidepressant medication, talk therapy and bright light therapy.

Light therapy was first used in the 1980s to make up for fewer daylight hours during the winter months. Amanda Focht, M.D., Medical Director of Outpatient Psychiatry with UW Medicine, cites the advantages of using light boxes: easy availability from retail outlets, few side effects when used appropriately and a relatively fast response rate.

“Light therapy can have effects within one week,” says Dr. Focht. “But it can take up to four weeks” in some cases.

Make sure your light box delivers 10,000 lux of illumination, and that it’s positioned slightly above the eyes, about 16 to 24 inches from the face. Morning use of light therapy is best. Those with eye diseases (e.g., cataracts, glaucoma and others) should check with their doctor before starting light therapy.

Maintaining open communication with your primary care doctor or mental health specialist is important in ensuring treatment is achieving your goals. There’s no reason to suffer in silence or to try to slog through the winter on your own. Dr. Focht says that someone feeling sluggish in the winter could, even without a diagnosis of SAD, benefit from bright light therapy. Anyone with thoughts of suicide should contact the National Suicide Hotline at 1-800-273-8255.

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