Combating the Winter Blues

February 16, 2018

 

The northwest has been my home my whole life. I recently moved back to Spokane after living in Seattle for 15 years. For many reasons, I was ready to move back to the east side of the mountains – to be closer to my family, to slow down the fast-paced way I was living my life, and to hopefully reduce the stress that came along with living in a big city.

 

One of the major reasons I moved east was to escape the gloom and doom that descends over Seattle in the winters, springs, and sometimes summers! That gray, dark, constant drizzle that not only leaves you soaking wet and chilled to the bone, but also tired, run down, irritable, and depressed. I thought to myself, “Maybe moving east will give me a little more of that light and brightness I was missing in Seattle…”

 

Unfortunately, I miscalculated the differences between Spokane and Seattle, forgetting that distance from the equator is the major determining factor impacting light in the winter.

 

Seasonal affective disorder (SAD) is a clinical diagnosis that affects many during the late-fall and winter, especially in climates similar to ours in the northwest. The farther from the equator, the higher the incidence in the general population. In sunny states like Florida, the rate is as low as 1.5% of the population.  However, across our state, we experience up to a 7-times higher occurrence of the clinical disorder. Furthermore, up to 25% of the population experiences some weather-related “blues.” While sub-clinical, these symptoms are still frustrating to say the least, and should not go unchecked.

 

Common symptoms of SAD include but are not limited to:

 

✓   Feeling depressed most of the day, nearly everyday

✓   Losing interest in activities that you once enjoyed

✓   Challenges with sleep

✓   Major changes in appetite

✓   Feeling sluggish or irritated

✓   Challenges with focus or concentration

✓   Feelings of hopelessness, worthlessness, or guilt

✓   Thoughts of death and/or suicide

 

When looking at all of the research, it is clear that lack of sunlight impacts the human body by changing three major physical processes, all of which contribute to the mood and physical changes we see during the winter months. These factors include changes in circadian rhythms due to lack of sunlight (our bodies use sunlight to determine when to wake and when to head to bed), a drop in serotonin levels (which is the most important neurotransmitter for combating depression), and a disruption in the levels of melatonin produced in the body (a hormone that aids in preparing the brain to fall asleep). Climates like we experience in the northwest also leave most people deficient in vitamin D. Vitamin D deficiencies can lead to serious medical problems including increased risk of heart disease, certain types of cancer, asthma in young children, cognitive deficits in older adults, and contributes to the development of multiple sclerosis. Vitamin D deficiencies not only affect our physical health, but also our mental health, as insufficient levels have been linked to a higher likelihood of depression.

 

 

I have experienced the effects of SAD since I was a teen. Around the end of October, I begin feeling tired all day long, yawning and fighting heavy eyelids each afternoon, even when I have had enough sleep the previous night. I feel like going to bed every night at 7:30 PM and sleeping until 10 AM.  If left unchecked, around November, I begin to feel symptoms of depression including hopelessness, sadness for no particular reason, and increased irritability. Food becomes a comfort, making it increasingly difficult to make healthy food choices. I’m left feeling too low on energy to exercise or even leave the house. The good news is there are some relatively straightforward interventions to address these symptoms.

 

First and foremost, if you are experiencing any of these symptoms for several days, please make an appointment to see your physician to discuss some of the treatment options. They will also need to determine if there is any underlying medical condition that might be causing your symptoms (e.g. hypothyroidism). SAD is a serious condition that, if left unchecked, may lead to suicidal ideation or action. There are three evidence-based interventions suggested for individuals experiencing SAD or symptoms related to SAD:

 

  • Psychotherapy: Working with a mental health provider, psychologist, counselor, or social worker can help the individual build skills to manage the symptoms of depression that are associated with SAD. This may include aspects of cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT), where the therapist helps the individual learn about depression triggers, identify coping strategies, and evaluate the effectiveness of those strategies.
     

  • Light Therapy: Light therapy provides individuals with synthetic sunlight. The individual is instructed to sit within one or two feet from a specialized light box, as they are waking up for the day for 15 to 30 minutes. This mock sunlight helps engage important brain chemicals, similar to spending time in the sun during the summer. (Fun fact: It also gives you the excuse to lay in bed for an extra half hour each day!) It is important to consult your doctor to find out which light box will be best, not all light boxes are therapeutic, and, in many cases, your insurance will pay for this device if you have a SAD diagnosis and a prescription from your doctor.
     

  • Psychopharmaceutical Intervention: In addition to psychotherapy, medications can help support individuals with SAD. Medications like selective serotonin re-uptake inhibitors (SSRI) help individuals who have lowered levels of serotonin due to lower levels of sunlight. Research indicates that medications are most effective when paired with psychotherapy.
     

Other things that are helpful include a number of self-care strategies:
 

  • Mindfulness Meditation: Mindfulness is a term that refers to the practice of bringing one’s attention to the present moment and focusing on things like breathing, physical sensations, and sensory stimuli. Mindfulness has a number of psychological benefits and can help train your brain to manage depression and anxiety. Studies have found that individuals who used mindfulness practices sustain mental health better than individuals who only use medication.
     

  • Vitamin D Supplements: As stated earlier, vitamin D deficiencies can greatly impact both physical and mental health. Many studies indicate that anyone living in climates like ours is at increased risk of this deficiency. It is important to check with your doctor, who can determine your needs.
     

  • Signing Up for a Yoga or Exercise Class: Moving your body is a wonderful tool to help combat the blues and help boost energy. Exercise helps the body create endorphins, which are linked to feelings of euphoria, and also provides opportunities for mindfulness by taking your mind off of anxious or negative thoughts. In some cases, signing up for a class or gym membership can provide a social outlet for people who are struggling to connect with others. Registering for class also provides some accountability, so you are less tempted to skip or delay going.
     

  • Connecting with Friends and Family: Oftentimes, when people are feeling down or depressed, there is a tendency to internalize thoughts, feelings, emotions and disconnect from friends and family because they do not feel like they have the energy to manage interactions. However, connection is vital when dealing with depression, as humans are social beings. If this is the case, consider less-social interactions like going to a movie or watching a show together. Simply being in the same room as someone else has been proven to benefit the brain.  
     

  • Keeping a Gratitude Journal: Many studies have indicated that one tool for treating depression involves noticing the things one is thankful for in their lives. When experiencing depression, it is often difficult to find things that are going well or that you enjoy. However, researchers have found that even the act of searching for things that you are grateful for boosts our production of the feel-good neurotransmitters in our brains. Simple exercises include:
     

  1. Writing a letter or email to someone you are grateful for and thank them appropriately.
     

  2. Brainstorm three things each day that you are thankful for or that have gone well. Write them down, along with the reason those things happened to you.
     

  3.  Write down something that didn’t go as planned, and the positive consequences that resulted from it.

 

  • Warm Weather Vacation: Because the lack of sun has such an impact on our mood throughout the winter, many people find it helpful to seek out the sun. Places like Southern California, Arizona, Hawaii, and Florida provide a generally sunny climate. A tropical vacation allows you to soak up higher levels of vitamin D and gives you a break from the dark, gray monotony of winter months.

 

If you or a loved one is experiencing these symptoms or struggling in these winter months, please do not hesitate to contact your physician to gather more information and set up an appointment to get help. Remember that this is not a weakness or something to be ashamed of, but a medical condition that, left untreated, can have devastating consequences.

 

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