How to avoid getting SAD this winter

Aside from the benefit of an extra hour in bed, the clocks going back – signaling shorter days and longer evenings ahead – can bring impending doom. Blue skies in Britain can dampen anyone’s mood, but for those suffering from Seasonal Affective Disorder (SAD), winter can be especially painful.

SAD can lead to depression, fatigue, irritability and sleep problems. The medically recognized condition affects 1 in 20 of us in the UK. But instead of dreading the next six months, know that there are practical ways to stay positive.

What is seasonal affective disorder?

“SAD is a type of depression caused by seasonal changes,” says Dr. Safia Debar, a medical doctor at the Mayo Clinic in London. “It’s sometimes known as ‘winter depression’ because that’s when the symptoms are more visible and severe and can be debilitating.”

Usually, the onset of SAD begins in autumn or winter and gradually improves from the end of spring or summer, since we have more daylight hours. Although it is not possible for SAD to cause depression, sad feelings and low energy can last as long as spring or early summer.

Although it’s a well-known medical problem, it’s sometimes been historically underestimated by people who don’t understand the condition, explains Dr. Norman Rosenthal, a psychiatrist whose landmark 1984 study was first defined SAD as a distinct mood disorder. “I think there is a tendency to minimize someone else’s suffering if we don’t experience it ourselves”.

Signs and Symptoms of Seasonal Affective Disorder

• Feeling worthless, sad, or depressed most of the day, almost every day
• Loss of interest in activities you once enjoyed
• Having less energy and feeling sluggish
• Having a lot of trouble sleeping
• Carbohydrate cravings, overeating and weight gain
• Having trouble concentrating
• Feeling hopeless, worthless or guilty

In fact, symptoms include all that we associate with depression.

Dr Rosenthal explains: “It is a feeling of powerlessness, of not being able to do things, of wanting to withdraw from friends and family so that as a result, you lose the powerful effects of having good friendships.” “Now, because you don’t want to move your body and go outside, you stay inside feeling down, and you may start overeating, especially sweets and starches, and then you get fat.

“For most people, carbohydrates have a calming effect, but for those of us with SAD it has a energizing effect, so we crave it because naturally we will want to do anything to boost our energy. .But eating carbohydrates leads to weight gain which can be another reason for feeling sluggish and weak.”

Dr Debar also points out that sleep disturbance, anhedonia (loss of interest in previously enjoyable activities), lethargy and fatigue “can all feel like a cycle that is hard to break”.

What causes SAD?

The exact cause of SAD is not fully understood, but since it is linked to the seasons, the main hypothesis is that a lack of sunlight can prevent a part of the brain called the hypothalamus from working properly. This has several implications, explains Dr Debar, including:

• Melatonin production
• Serotonin production
• Our circadian rhythm

“Melatonin is a hormone that makes you feel sleepy; in people with SAD, the body can produce it at higher levels than normal,” says Debar. “Meanwhile, serotonin is a hormone that affects your mood, appetite and sleep, so a lack of sunlight can lead to a decrease in serotonin, which is associated with depression.”

In addition, our bodies have an internal clock that uses sunlight to perform many important functions, explains Debar, such as when we wake up. So low light levels during winter can disrupt our circadian rhythms, leading to SAD symptoms.

Who is at risk for SAD?

• People who live in the coldest regions of the northern hemisphere
• Those who live or work in areas with little natural light
• People who have relatives who are suffering
• Women

SAD is more common in areas with long, dark winters. “In general, the further north you go, the shorter your days are in the winter and the more likely you are to suffer,” says Dr. Rosenthal.

But there may be genetic differences at play. For example, research done in Iceland, shows that it is rarely experienced as you would expect there (even though it is much further north) while it is very common in Britain. It is thought that Iceland has a population with almost the same genes, and maybe those people who could not stand the North moved to the south, while those who succeeded stayed there, and that is how the genes were properly influenced. ”

“Women are also more likely to get it – especially during their childbearing years,” says Dr Rosenthal. “After menopause (the beginning of menstruation) growth in girls and women increases, and it stops until after menopause. So there seems to be something about sex hormones that puts women in this situation,” he says.

Research shows that women are four times more likely to be affected, says Dr Debar. Interestingly though, men may have more severe symptoms when they have it. People with a history of major depression are at higher risk for SAD, as are those with bipolar disorder, or other mood-related conditions. getting worse during the seasonal changes,” he says.

Some research also suggests a genetic component, and SAD appears to run in families, experts say.

Analysis

The best way to determine whether it is SAD or depression, says Dr Rosenthal, is to consider the history of when it occurs. I ask how they felt last Christmas as people will remember how they felt and it’s easy to see progress. There is a unique set of signs, and people often tell me that in the summer it is the life and spirit of the party and the big crowd, but in the winter it is a sleeping bear.

Dr. Rosenthal first noticed the condition after moving from a warm to a cold environment. “When this happened three times in a row I started to see a pattern.”

There is no blood test available for SAD – but don’t let this put you off.

“For almost any mental illness, whether it’s chronic depression, anxiety, or schizophrenia, blood tests won’t reveal anything,” says Rosenthal.

Dr Debar explains that a diagnosis of SAD can be confirmed if your depression occurs at the same time every year for at least two years, and the periods of depression are followed by other periods without and depression, for example, when people are in a state of complete depression. a certain season, usually spring or summer.

Dr Debar says: “Because we see the winter blues as so much, it’s often not easy and people tend to tolerate the symptoms. Catching it early means SAD can be managed well before symptoms start.” ”

Treatment options for SAD

There are many different ways you can treat Seasonal Affective Disorder from changing your diet and lifestyle to prescription drugs. Here are some of the most effective ones below.

Non-drug therapies

“The most effective way is to get sunlight early in the morning – even on a cloudy day, even just for five minutes – as this resets the circadian rhythm and being outside in nature boosts mood, ” says Dr Debar.

He explains to his patients that on bright, sunny days, the light outside can range from ** 50,000 to 100,000 lux (how light is measured). On cloudy days, outdoor lighting is still around 1,000 to 5,000 lux, which is more than normal indoor lighting (around 300-500 lux).

“If this is not feasible or possible, then light therapy – which mimics sunlight – is one of the best-researched treatments for SAD,” says Dr Debar.

Clinical studies have shown that simple therapy significantly reduces depressive symptoms in people with SAD, and the results are similar to taking antidepressants.

Most SAD boxes provide 10,000 lumens of artificial light and allow for controlled and consistent daily exposure to bright light (and possibly more than outdoor exposure in winter).

Dr. Rosenthal recommends buying a lamp from a reputable supplier (he uses his own Lumie ones, which he keeps on his desk).

Methods of treatment with drugs

Antidepressants, such as selective serotonin reuptake inhibitors (SSRI) can be taken part of the year, and can be used as a prevention, says Dr Rosenthal.

But Debar warns that although drugs are useful if other methods have failed, antidepressants should not be relied on as a “quick fix”. She suggests that psychotherapy can help often there are other issues that need to be worked on and resolved, and talk therapy provides symptom relief and support. It is also important to address other hormonal processes including insulin, thyroid, cortisol and lifestyle.

Prevention and coping strategies

Know that you are not alone and that it is not your fault. Taking action before your mood drops too low will make it easier.

• Make strategies to increase exposure to natural light
• Invest in, and make heavy use of, a good SAD lamp
• Stay physically active
• Maintain consistent sleep
• Eat a balanced diet
• A complete checkup to ensure there is no vitamin D deficiency, thyroid or diabetes in the blood
• Use mental and stress management techniques
• Fight isolation by gathering support and raising awareness among friends
• Continuous reviews of pharmacists

Debar suggests having a general check-up to make sure everything like thyroid and vitamin D are normal and making dietary changes to include more plants, protein and healthy fats – to help control emotions.

“Reduce sugar and processed carbohydrates, which can cause rise and loss of energy, and avoid other disruptions of the circadian rhythm, such as excessive use of the screen at night, alcohol and heavy meals in the evening.’ And practicing mindfulness or other stress management techniques can improve stability and help us stay grounded and calm in the face of seasonal changes.”

Dr. Rosenthal says it’s important not to give in to symptoms. “Don’t sleep on the bed under the blankets. Humans are social animals and getting out will help. ”

Support and Resources for People with SAD

Don’t suffer in silence. Some useful websites are: