Seasonal Affective Disorder (SAD)
by Virginia Duffy, Ph.D.
What is it about winter?
That time of the year is here again when many people feel down. Some call that down feeling Seasonal Affective Disorder (SAD), cabin fever, or just the winter blahs. These are types of depression or blues that occur during winter months. Persons with Post-Traumatic Stress Disorder (PTSD) may be especially susceptible to these moods. We are not sure of the cause of these problems, but many think they are related to decreased exposure to light.
SAD is the most serious. It is more than the blues — actually a depressive disorder, although perhaps less severe than some others. Symptoms of SAD (and any depression) include feeling overwhelmed, frequent crying, and irritability (being easily annoyed). Sleep disturbance may be experienced as either sleeping too much or having trouble sleeping. Appetite disturbances can also go either way — that is, losing your appetite and weight loss, or increased appetite and weight gain.
Cabin fever and winter blahs are terms that usually refer to boredom and restlessness that occur with decreased activity and spending humdrum days and evenings in a limited space.
Treating Seasonal Affective Disorder
For SAD, the most successful treatments are light therapy and antidepressant medications (one or both). Light therapy allows the brain to receive the light it needs to decrease the nighttime hormone of melatonin and increase serotonin and other neurotransmitters in the brain. This relieves depression in the same way that antidepressants do.
Light therapy can be had for free by going outside before noon for 30 minutes every day without sunglasses. This works even on cloudy days. Do not look directly at any bright light (including the sun); instead, read or complete some other activity in the reflected light. Keep your eyes open. Thirty minutes in the a.m. should help, but this needs to be done daily, and before noon.
To use artificial light, you can buy a light box for about two to four hundred dollars, or if you are handy, you can make one. You can do a search online for plans; there are a number of sites with this information.
In some cases, SAD may need to be treated with antidepressants. If you have the symptoms described above and think you may need antidepressants, talk with your doctor. SSRIs (selective serotonin uptake inhibitors) are most commonly used for depression. These include medications such as Prozac, Zoloft, Paxil, Celexa, and Lexapro. Research with fish oil indicates that 3,000–4,000 mg a day may work as well as prescription antidepressants. Fish oil is also good for many other areas of your health.
Another alternative that has been used successfully for depression, especially in Europe, is SAM-e (S-adenosylmethionine). SAM-e is not an herb or a hormone. It’s a molecule that is present in all living cells. It aids in a process that helps regulate the action of various hormones and neurotransmitters, including serotonin, melatonin, dopamine and adrenaline. It seems to work well, but is expensive. It can be found in any health food store. Ask your doctor before trying this.
Avoiding and Managing Cabin Fever
Cabin fever and winter blahs usually can be easily managed with changes in routine. For post-holiday blues and to avoid cabin fever, I suggest you gather family or friends around you. If you can tolerate onlyone or two, that is okay. Have a comforting supper (chili or soup and bread), watch an upbeat movie, or play a few games.
Going outside is great if you can participate in an activity to keep you warm, such as walking, snowshoeing, or skiing. Even short walks in the light can be helpful.
If you just can’t bring yourself to get outside, find a place inside with lots of light. It can be a spare room or basement — I like my garage. Set up a table to do crafts or other projects: refinish furniture, sew, paint, draw, anything you like to do. Make sure this a place you can leave things lying around, so you can go back to it any time you have a few minutes without having to set up.
Even small changes in your routine can help. With a little planning and effort, you can avoid the blues and even enjoy yourself this winter. And remember: spring is not far off.
About the Author: Virginia J. Duffy Ph.D., Psychiatric Nurse Practitioner, is the author of Behavioral First Aid: Managing Emotions During Crises.