Seasonal Affective Disorder Treatment Options

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Seasonal affective disorder is a type of depression that is associated with changes in the seasons. It also has the clever acronym SAD, or it’s called the winter blues. These symptoms often start in the fall and persist into the winter. With winter SAD, people feel less energetic and more moody, with symptoms similar to depression.

Happy Winter Solstice everybody! In the northern hemisphere, December 21st is the darkest day of the year; the sun shines for the least amount of time and the night is the longest. And every day from here on out is going to have about 90 more seconds of daylight. Little by little the northern hemisphere is going to get lighter and brighter, and before you know it, summer will have arrived!
 
I like to think of that as an analogy to our lives. Little changes like that, one new skill or a new way of thinking, can make a big difference over time in our lives.
 
Now, let’s leave that optimism behind and talk about how crappy winter is.
 
In the clinic I work at, we see some interesting trends. One of them is the fact that in June through August we have a relatively lower number of clients, and in January through March we see a lot more people who are really struggling.
 
In this post you’re going to learn all about seasonal affective disorder, how the seasons impact mood, and what you can do about it. And we’re also going to talk about how SAD can surprisingly impact you during the spring and summer as well.

What Is Seasonal Affective Disorder?

Seasonal affective disorder is a type of depression that is associated with changes in the seasons. It also has the clever acronym SAD or is called the winter blues. These symptoms often start in the fall and persist into the winter. With winter SAD, people feel less energetic and more moody, with symptoms similar to depression.
 
It can look like:
  • Losing interest in activities you once enjoyed 
  • Feeling sluggish, tired, or low in energy 
  • Having problems with sleep 
  • Feeling hopeless 
  • Gaining weight
  • Experiencing changes in appetite
  • Craving more food, especially high-carb food

Around 20% of Americans (that’s like 65 million people) experience seasonal affective disorder. This disorder impacts people who are closer to the poles because the amount of sunlight varies more dramatically with the seasons there than it does near the equator.

I’m from Cache Valley, Utah, where we only get about nine hours of daylight on winter solstice. That means that if you work indoors and go to work at 8 and get home at 5, you won’t even see the sun peeking out behind the mountains. Temperatures often hover in the negatives for weeks, and air quality gets atrocious. 

Long story short, winter can be pretty miserable. And that’s not just for me. In one study, 85% of people with mood disorders like depression said their symptoms got worse during the winter months.

What Is Spring/Summer SAD?

Most people don’t know that seasonal affective disorder also impacts some people in the spring. Some people feel depressed, have trouble sleeping, lose weight, or feel agitated or anxious. This is more likely to happen with bipolar disorder, where spring and summer can bring on mania and fall and winter can be a time of depression.
In the book Educated by Tara Westover, the author talks about her father who showed symptoms of bipolar disorder. Her family lives about 40 miles north of where I grew up, and my mom occasionally runs into her mom in town.
 
In the book, Tara twice recounts her father slipping into a deep depression during the cold Idaho winters. To manage that, their family drove down to Arizona, where he basked in the sun for hours every day. and then eventually got his energy back. At this point they would drive back to Idaho.
 
But on their drives back to Idaho, the father would be impatient, reckless, and irritable. Possibly he even felt invincible. These are all symptoms of mania, and on both of those drives back, they got into bad car crashes.
 
Both the depression during the dark winter, and the intense energy he felt after exposure to sunlight are probably due to how light exposure changes brain chemistry.

How Does Light Exposure Impact Mood?

The light that enters our eyes triggers our brain to produce melatonin and serotonin. Serotonin is a neurotransmitter associated with happiness, sleep, digestion, sex, and a bunch of other things.
 
Our skin also has the ability to produce serotonin when sunlight hits it. I think that’s got to be one reason why taking a trip to the beach in the middle of winter feels amazing. During the horrid winters in Cache Valley, I used to always travel south in February for a sunny climbing trip, and the 50-degree days and sunshine felt amazing.
 
If you want to learn more about how light impacts the brain, mood, and serotonin production, check out my other video on light therapy for non-seasonal depression.
 
So in the winter, when there is less light, people tend to feel depressed, down, and low in energy. But in the spring, some people tend to feel more energetic and agitated.
 
Spring seasonal affective disorder is often overlooked as a contributing factor to mental health. Suicide rates are at the highest right at that transition from winter to spring, when people have been at their lowest and then start feeling more energy and agitation. This is similar to what we see when people start antidepressants.

How Does Modern Culture Mess With Natural Patterns?

Sometimes we get this idea that our bodies and minds are out to get us, that we are just screwed up people and that we have to fight all the negative impulses and instincts that we have in order to overcome them.
 
In my experience however, I have found that it is generally more helpful to work with our drives, instincts, and emotions, and to channel them into positive directions. I genuinely believe that we, and our bodies and minds, are inherently good, and that the things that stem from them are functional at their core. We just tend to get in the way sometimes.
 
For example, check out the symptoms of SAD: oversleeping, craving food, gaining weight. These are all perfectly functional drives and behaviors if you are a caveman. If survival of the species (or your family) is important, then for our ancestors, the way to survive the scarcity of winter was to build up a fat reserve; sleep through the long, cold nights; and hang out in your tiny hut during the short, cold days.
 
If you had tons of energy and excitement during those months of confinement, you would drive yourself and others crazy, not to mention burning tons of calories that you didn’t have the food reserves to replace.
 
Spring SAD can also serve a function: it’s a time to have tons of energy (agitation), not sleep well (so you can get up early and get those seeds in the ground), and lose appetite/weight (get rid of that hibernation store you were keeping in your midsection). All of these “symptoms” served an excellent survival function before the days of indoor heating, 9-5 work days year-round, and indoor lighting.
 
Basically if we were allowed to hibernate during the winter and live outdoors and work and sleep following a more natural schedule, then we may not have as big of a problem with seasonal mood disorders. But our modern society and work and school schedules don’t really allow for that.
 
Since most of us either can’t afford a trip to the beach right now or are stuck at home during a global pandemic, one of the ways we can treat SAD is through light therapy.

What Is Bright Light Therapy for SAD?

Bright light therapy is when you use an artificial light to mimic the sun. This helps your brain and body produce more serotonin and melatonin. Light therapy can help people fall asleep more easily at night and feel happier and more energized during the day.
 
Light therapy has been shown through rigorous research to be very effective. In fact, it’s been shown to be as effective at treating non-seasonal depression as antidepressants. And it’s been consistently shown to be effective at treating SAD. It’s relatively inexpensive, but it’s often not covered by insurance. I’ve been doing light therapy this winter, and I’ve actually noticed a huge difference in my mood and energy levels.
 
What to look for in a therapy light:
  • Cooler tones, very bright
  • 10,000 Lux at a comfortable distance
  • Very large area
  • Angle above the eyes
There are a lot of very inexpensive lamps on Amazon, but they are generally small, and the light enters your eyes from below. If you want best results, use a larger lamp with a downward angle.
How to do Light Therapy
I encourage you to work with your doctor before trying light therapy, but it is something you can do from home. It’s best to start light therapy right after you wake up and use the lamp for 20 to 30 minutes each morning or as recommended by your doctor. Start your sessions at the same time each morning. Consistency will help your body and internal clock adapt to seeing the light at your chosen specific time each day.
 
I recommend that you track your treatment each day with a simple chart and record your mood and how long you did treatment.
 
Generally light therapy has very few, if any, side effects. If you use it too much your eyes may get tired or you may get headaches, and for some people too much light therapy can cause agitation or mania. So if you’ve experienced mania or bipolar in the past, you may want to be more cautious about light therapy.

What Are Other Treatments for Seasonal Affective Disorder?

You should combine light therapy with other treatments for best results. And light therapy isn’t the only treatment for SAD. Building a healthy lifestyle is essential to managing your mood anytime, but especially during the winter. Other treatments for SAD include:

  • Medications, including SSRI’s.
  • Exercise, which is always good for the mood and the body.
  • Therapy to explore how your thoughts and actions may be contributing to your low mood and to learn new skills to combat mood disorders. This has been shown to be effective at treating SAD, even with just a few sessions.
  • Socialization. Plan in some way to get together, whether it’s doing playgroup with other moms, having Zoom meetings with friends, gaming together, whatever. I know it’s hard right now during the pandemic, but it’s still really important to see friends.
  • Schedule adjustment. See if you can adjust your schedule a little to get outside when the sun is shining. Maybe you can start work later, get outside in the morning, or take a short walk during your lunch break.
  • Dressing for the winter so you can still get outside. People who move from warmer climates to colder ones, like my husband, often just need a little knowledge about gear to make their experience so much better. Good boots, socks, a hat, and thermal underwear can make a world of difference. Wearing layers when outside can make almost any weather accessible. If you wear the right clothes you can do almost any activity outside in most types of weather. My dad goes biking even in the freezing Logan winters.

Another thing to consider is that most Americans have low vitamin D levels, and that is associated with depression. Your body uses sunlight to metabolize vitamin D, and those levels tend to drop in the winter. But there are mixed results about whether supplementing with vitamin D is effective or not. I recommend working with your doctor to explore that option.

So again, when it comes to managing seasonal affective disorder, some simple changes like light therapy, exercise, and learning how to dress for the cold weather can make a huge difference.
Okay, I hope that’s helpful. I hope you all have a lovely winter and find a way to make it a good one. Thank you for watching, and take care.
 
For more help with Depression, check out my course, Change your Brain, below. 

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