How to Cope With Seasonal Affective Disorder

It's that time of the year again. The leaves are dropping from the trees, the clouds are rolling in with more frequency, and the days are dramatically shorter and colder.

Most reading this have a good sense of what Seasonal Affective Disorder (SAD) is and how it can wreak havoc on many of us this time of the year.

For those unfamiliar, wikipedia defines SAD as "a mood disorder subset in which people who have normal mental health throughout most of the year exhibit depressive symptoms at the same time each year, most commonly in winter."

Dr. Norman E. Rosenthal, author of Winter Blues, is the world-renowned researcher and psychiatrist who led the team that first described Seasonal Affective Disorder (SAD) and pioneered light therapy to treat it. Dr. Rosenthal has found that about 1 in 20 people in the U.S. has SAD.

Turns out some people need more light than others. For those, the darker and shorter days adversely affects mood and behavior. One can better manage SAD by being aware of circadian rhythms, as well as by trying to maintain healthy sleeping and eating habits that guide your body through it's natural rhythms.

One of Rosenthal's patients described themselves as feeling like a bear in the winter and wanting to hibernate. "So if you feel any identification with a hibernating bear, you might well have SAD," he says. Women are about four times more vulnerable than men, and the condition is more common in the Northern Hemisphere. (via NPR)

The Mayo Clinic lists the following as symptoms specific to winter-onset SAD.

• Oversleeping
• Appetite changes, especially a craving for foods high in carbohydrates
• Weight gain
• Tiredness or low energy

Other symptoms can include:

• Having problems with sleeping
• Experiencing changes in your appetite or weight
• Feeling sluggish or agitated
• Having difficulty concentrating
• Feeling hopeless, worthless or guilty
• Having frequent thoughts of death or suicide (National Suicide Prevention Lifeline — 800-273-8255)

Treatment options for SAD include light therapy, medications and psychotherapy. Though increasingly the number one recommendation is to start your day with a morning walk outside.

Why Does SAD Occur

It is believed that a change in photoperiod, which is the number of daylight hours, is at the root of SAD. According to Kelly Rohan, a professor of psychological science at the University of Vermont, photoperiod is believed to have more of an influence on mood than the overcast skies we see in the northwest, or the colder temperatures. Fewer hours of light is believed to affect the circadian clocks of people with SAD, leaving them out of sync with their natural rhythms. Light therapy, most often delivered first thing in the morning, is believed to kick those circadian rhythms back into a normal cycle.

That’s why going out for a walk first thing in the morning after sunrise can help — it’s an organic way for the body to get sunlight and resynchronize its internal clock, offers Kelly Rohan, a psychology professor at the University of Vermont. via Today

Current consensus is that light therapy is most effective in the early morning (based on the fact that most cases of SAD have a phase delay) and that an intensity as close to 10000 lux as possible should be used for a minimum of 30 minutes at a time. Time to response is usually between two to four days and three weeks and the specifics of duration and intensity can be adjusted depending on response and side-effects. (via Progress in Neurology and Psychiatry)

References:
'Tis The Season: Coping With SAD, Or Seasonal Affective Disorder / NPR
The Double Whammy of Seasonal Affective Disorder in a Season of Covid / NY Times
Light therapy lamps can ease seasonal depression. / Washington Post
Pathogenesis and management of seasonal affective disorder
The Best Light Therapy Lamp / Wirecutter
10 Top-Rated Light Therapy Boxes To Use While You're Stuck Inside All Day / Health.com
5 Lamps to Help You Feel Like You’re at the Beach All Winter Long / The Cut

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