So Sad: For people with Seasonal Affective Disorder.
Winter brings on a lot more than the blues.
Story Robyn Griggs Lawrence
You know you need to exercise and socialize, but it’s all you can do to drag yourself to work in the dark, try to focus while you’re there, then drag yourself back home in the dark.
Maybe you rely a little too much on your favorite substance to numb your aggro. Maybe you binge on pretzel crisps, then beat yourself up because you should be eating kale chips—or no chips at all.
You wonder why you’re even on this cold, bleak planet. Every morning you want to pull the covers over your head and pretend your life isn’t happening. Some days you do.
For about five percent of Americans, this nightmare is a recurring reality. Seasonal Affective Disorder (SAD) settles in just as winter does and doesn’t lift until spring. It’s been plaguing humans for centuries—French physician Philippe Pinel noted the onset of mental deterioration in psychiatric patients in his 1806 Treatise on Insanity—but it wasn’t included in the American Psychiatric Association’s official manual until 1987.
While studying the impact of light on mental health in the early 1980s, National Institute of Mental Health researcher Norman Rosenthal discovered Seasonal Affective Disorder, a recurrent annual depression characterized by hypersomnia, social withdrawal, overeating and carbohydrate cravings, and a lack of sexual energy that seems to respond to changes in climate and latitude. About 1.5 percent of Floridians have SAD, Rosenthal found, compared with nearly 10 percent of New Hampshirites.
No one knows why some people get SAD and others don’t. There seems to be a link to alcoholism as well as a genetic history of depression and bipolar disorder. Numerous studies have shown a correlation between SAD and the reduced ability to transport the mood-regulating neurotransmitter serotonin. According to the National Institute of Mental Health (NIMH), people with SAD produce too much serotonin transporter protein in winter, leaving less of the “feel good” hormone available.
Rosenthal suggests lack of sunlight throws off circadian rhythm and interferes with the hypothalamus, the part of the brain responsible for hormones. This causes abnormalities in the genes responsible for both serotonin transmission and retinal light sensitivity. Just recently, Johns Hopkins researchers discovered a third photo receptor in the eye that syncs our internal clocks with daylight and provides a direct pathway to the areas of the brain that affect mood—backing up the ocular part of Rosenthal’s theory.
When your brain stops producing serotonin, it starts pumping out melatonin, the sleep hormone that responds to darkness, instead. This naturally makes you lethargic and groggy, and your brain’s instinct to correct serotonin deficiency could be the cause of your monster carb cravings, according to NIMH.
Studies have also found a link between vitamin D, which the skin produces after sunlight exposure, and serotonin production. In northern climates, rays aren’t strong enough to trigger vitamin D production during winter months. This suggests that vitamin D supplements might help with SAD, but studies have been inconclusive.
There is no cure, per se, for SAD. The most prominent treatment is light therapy to replace sunlight with bright artificial light. You need to sit for about 30 minutes in the morning in front of a light box (readily available online) that exposes you to at least 10,000 lux of UV-free cool-white fluorescent or full-spectrum light—20 times more than regular indoor lighting. (You get 50,000 lux on a sunny day.)
The treatment is not unlike indoor tanning beds (but without the tan), and researchers speculate that frequent tanners might be self-medicating for SAD as much as getting their tans on. (Excessive indoor tanning is now recognized as a psychological disorder.) Red River College in Manitoba, Canada, offers light therapy stations for students who are suffering and also loans out portable SAD lamps.
Response to light therapy generally begins within a week or two, and its effectiveness seems to depend on how severe your SAD is. Studies have found that light treatment in the morning causes remission in two-thirds of patients with mild episodes but less than half with moderate to severe cases.
Light therapy is also being studied as a treatment for other types of depression, sleep disorders, and dementia, among other conditions. It’s not safe for people with diabetes and retinopathies and may contraindicate with certain medications.
Greens and Goals
Experts will try to tell you that your best bet for dealing with SAD is to get yourself up and out there, living your best life. This is clearly easier said than done when your serotonin-deprived, melatonin-drenched brain is begging for a long winter nap. You need outside help.
Lean on a good therapist or coach, in person or online, and let your inner circle know you need a little extra attention. Tell them not to take no for an answer when you try to weasel out of the Mardi Gras party. Find a workout buddy.
No matter what, succumbing to the urge to sink back under the covers will only make things worse. Sunlight is most effective against SAD in the morning, so that’s the time to get out there. An intense morning workout can do a lot—but again, be nice to yourself if you can’t make that happen. Taking a brisk walk whenever you can—even on cloudy days, sunlight filters through—is powerful medicine.
Moving your body, whether running or practicing yoga, and eating a diet rich in protein and greens are helpful when SAD is hovering. It also can’t hurt to give yourself something to live for as the dreary months drag along. Set short-term goals and see yourself reaping the benefits in the spring. This could be as simple as knitting an afghan, reading a classic, or trimming your fall harvest—anything you find worth getting out of bed for.
Those instincts to pull the duvet over your head and sleep the winter away aren’t wrong, by the way. Humans evolved to be less active in winter because they needed to save energy when food was scarce, but modern Type A culture never cuts us any slack—even when we’re going to and coming home from work in the dark.