Gaba Telepsychiatry

Seasonal Affective Disorder – How To Get Over The Winter Blues

Many of us have noticed a change in mood during the winter months, a lowered level of motivation, a mild sluggishness, craving fatty foods, sleeping more, and just a little less excited about everything. This collection of symptoms during the winter is called ‘Seasonal Affective Disorder’ or ‘Winter Blues.’ There are many factors which can contribute to this:

  1. Cyclical/Idiopathic – Bears hibernate, why shouldn’t we? Are we all large two-legged mammals after all? Homo sapiens are thought to come from coastal Sub Saharan Africa where they lived for hundreds of thousands of years before migrating to southern Europe, and eventually the NorthernHemispheres. Hibernation is a method of conserving energy and essential nutrients as the food was traditionally scarce during the winter months.
  2. Although we are technically ‘warm-blooded,’ our metabolism does decrease during the winter months, which means reduced blood flow to the brain.
  3. We spend less time outdoors during the winter months – exposure to sunlight can stimulate our metabolism.
  4. Shorter daylight hours can mean it is dark when we go to work, and dark when we come home. Loss of exposure to sunlight can cause vitamin D deficiency.
  5. Direct exposure of bare skin to sunlight can stimulate the production of serotonin which elevates mood.

Seasonal Affective Disorder is now a DSM diagnosis and is accepted as a medical condition. Diagnostic criteria include persistent low mood during the winter months, with significant improvement in mood during the summer months for three consecutive years. The question is, what should you do if you have a seasonal affective disorder and how can it be treated? Treatment strategies for seasonal affective disorder include:

  • Exposure to sunlight – try to take your vacations during the winter months rather than during the summer if you suffer from the seasonal affective disorder. Luckily winter is considered ‘offseason,’ at many tropical resorts and vacation packages can be purchased at heavily discounted rates.
  • Sunbathing is an effective treatment, but care must be taken not to burn. Use sunblock, avoid the midday sun, and exposing as much skin as possible for shorter periods is more effective and safer than intense exposure to packages of skin.
  • Spend time outdoors – it is easy to huddle in front of the fireplace during the cold weather, but as the Russians say ‘There is no such thing as bad weather, only bad clothes.’ Wrap up warm and take brisk walks outside.
  • White Light Lamps or SAD lamps for Seasonal Affective Disorder – Certain lamps have been found to combat depressive symptoms in those suffering seasonal affective disorder. Seasonal affective disorder lamps emit white light which is supposed to imitate sunlight and have been found in clinical trials to be useful for the treatment of Seasonal Affective Disorder. White light lamps used in clinical trials emit white light, are at least one-foot square and emit at least 10000 lux. A standard daylight bulb is not an effective treatment for Seasonal Affective Disorder.
  • Vitamin D – Some studies say that vitamin D is more effective than the SAD lamp in treating the seasonal affective disorder. Some doctors believe that seasonal affective disorder does not exist and is just vitamin D deficiency. It is accepted that vitamin D deficiency can make Seasonal Affective Disorder symptoms worse, and it is worth trying supplementation. Standard multivitamins contain 800 IU of vitamin D, while some doctors prescribe 5000 IU daily during the winter months, especially in darker skinned individuals.
  • Avoid oversleeping – Sleeping more than ten hours per day can exacerbate symptoms of depression, and people tend to sleep more during the winter.
  • Avoid drinking more alcohol, indoor activities which include going out for dinner, and going to bars – Harsh weather conditions can also mean staying at home and opening a bottle of wine. People do tend to drink more when drinking at home, as alcohol is significantly cheaper when purchased at the liquor store, and it is easy to keep drinking without hurting your bank balance.
  • Treatments for Major Depressive Disorder such as ‘Serotonin Reuptake Inhibitors,’ can be effective for Seasonal Affective Disorder.
  • Any form of regular, intense exercise can improve symptoms of Seasonal Affective Disorder, possibly by improving metabolism and increasing the production of Growth Hormone, Noradrenalin, and Serotonin.
  • One strategy for treating low mood is filling your day with enjoyable activities. Extra care should be taken to fill your day with activities that you enjoy during the winter months if you suffer from Seasonal Affective Disorder.

Differential Diagnosis of Seasonal Affective Disorder includes Major Depressive Disorder, Dysthymic disorder, Atypical Depression, Mood Disorder due to a General Medical Condition (Vitamin D deficiency), and Bipolar Disorder. The seasonal affective disorder is treatable, and with careful evaluation and adherence to symptom management the ‘ Winter Blues,’ could be a thing of the past.

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