Moods, emotions, ups and downs are always a challenge in life; the question is, are they temperamental variances or biochemical changes due to the cycle of the seasons? Sometimes the winter blues aren’t just the winter blues.
So many circumstances can bring on mood changes. A situation that pushes you emotionally to your limit—trauma, loss, chronic pain, sustained guilt, or unresolved emotional issues—can bring on a feeling of imbalance or instability. First, become aware of your moods. It’s easy to just ignore feelings, deny them or even maintain a state of numbness, but the first step to healing is real self-awareness. Agitation, daily depression, hopelessness, loss of interest, insomnia, appetite changes, difficulty concentrating, and suicidal thoughts are symptoms of major depression. If these feelings last more than two weeks, you need medical evaluation to assess whether the depression is clinical or situational, and whether it requires medication, counseling, or both.
Depression can run in families. If you have relatives with depression, that predisposition increases the odds that you will, too. If you’ve ever experienced depression in the past, you’re more likely to experience a recurrence. You may deny the depression because of the stigma that still hovers over it, or because you hope you’ll get through it on your own, but this can lead to long-term anguish for you and your loved ones.
If you notice that your symptoms appear in the autumn and resolve when spring arrives, you may have SAD, sometimes called winter depression or Seasonal Affective Disorder. The symptoms are different from those of major depression and include irritability, low energy, heavy feeling, oversleeping, overeating (especially carbs), weight gain, problems getting along with others, and feeling overly sensitive to criticism. These symptoms are not present except during these particular times of the year (There are some who experience Summer Seasonal Affective Disorder, but the majority of episodes happen in the colder months because of shorter days and less ambient lighting).
Research shows that at least 12 million people experience SAD each year, and a small percent actually require hospitalization. In other words, this is more than just the winter blues. Traditional treatments include phototherapy (light therapy) psychotherapy, and medications. Integrative treatments including acupuncture, yoga, meditation, guided imagery, massage therapy, and craniosacral therapy as well as many other modalities are becoming increasingly popular and accepted.
The reasons for Seasonal Affective Disorder are still being researched. Your circadian rhythm, or biological clock, may become disrupted in the winter because of the reduced level of sunlight; this can also cause a drop in serotonin levels, one of the many neurotransmitters that allow your brain to work smoothly. Melatonin levels, the chemical that affects sleep, may also become disturbed, leading to insomnia and depression.
So besides moving closer to the equator (sun and fun), being very mindful of your emotions and addressing them as they arise is the best approach to recognizing SAD. It really is important to seek help and begin treatment before the symptoms become too severe. Suicidal thoughts, social withdrawal, work problems or substance abuse might begin to intensify if SAD remains untreated. See a primary care provider, a psychiatrist or a counselor to address the problem and receive the help you might need.
According to the Mayo Clinic, light therapy is very effective. You sit a few feet from a special light therapy box so that you’re exposed to bright light. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood. Light therapy is one of the first-line treatments for fall-onset SAD. It generally starts working in a few days to two weeks with few side effects. Research on light therapy is limited, but it appears to be effective for most people in relieving SAD symptoms.
Pharmacotherapy is also helpful in that it actually allows your brain to produce the proper amount of serotonin so that you begin to feel like yourself again. An SSRI (Serotonin Reuptake Inhibitor) works in the first dose, but patients don’t usually feel an effect for at least two weeks. Examples of these medications, among others, include Lexapro, Prozac, Paxil, and Zoloft. If you are already on one of these medications and are still experiencing symptoms, speak to your prescriber to possibly increase the dose, add another medication, or change the prescription entirely.
Counseling with the right person can bring great relief as you learn a variety of skills to begin healthy ways of coping, changing negative thoughts and behaviors that may be making you feel worse, and managing stress.
Lifestyle changes can be very helpful as well. Make your environment sunnier and brighter. Sit outside or close to bright windows. Take walks. Dress up warmly and eat lunch out in the sun. Exercising regularly and especially going outside within the first couple of hours after waking up are easy helpful habits to develop.
Alternative medicine routes, although not supported by the FDA, are also options, but you should certainly notify your healthcare provider about any additional supplements you take. Omega-3 fatty acids, vitamin D supplements, probiotics, St John’s Wort, and Sam-E all claim to help mild depression symptoms. They also may or may not combine with other medications you are taking, so be sure to review them with your local pharmacist or prescriber to be sure there won’t be any untoward drug interactions.
The bottom line is, taking care of yourself on every level will always lead to the healthiest results. Self-awareness, rest, relaxation, playtime (some grownups ask “What’s that?”), eating right, limited alcohol, meditation, and socialization are all practices that will help, whether you are sad or have SAD.
If you feel you or someone you know is experiencing this, it’s time to intervene and seek treatment. We all deserve to feel a sense of happiness and peace, so doing whatever it takes to get through difficult times in a healthy way is the best proactive choice we can make. Read more about depression and Seasonal Affective Disorder at http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/basics/definition/con-20021047
By Amy G. Martin, APRN, RhD