We all think of the physical ailments that come with winter: colds, the flu and various other respiratory illnesses. We don’t, however, always give enough attention to the mental illnesses that arrive with winter, such as seasonal affective disorder (SAD).
SAD isn’t always taken seriously since it’s easily confused with winter blues. If February gets you down, you’re in good company. According to a 2023 poll by YouGov, a research data and analytics technology group, the only month Americans dislike more is January.
While winter blues can be frustrating, SAD is a form of depression. This illness affects 5% of the population, who experience symptoms such as increased hunger for carbohydrates, lack of energy, difficulty with focus and oversleeping. Those with SAD may also experience sadness or hopelessness so overwhelming that it can interfere with their enjoyment of and willingness to participate in everyday activities. SAD can occur at different times of year, but it is most common in winter. If you think you may be experiencing SAD, please do not wait to get help.
The exact cause of SAD has not been determined, but it is thought to be connected to seasonal changes to the biological clock and brain chemistry, both of which are tied to our amount of exposure to daylight. Some treatments target those possible causes, while others are more focused on therapies used for other forms of depression. Some common treatments are as follows:
• Bright light therapy — Typically, someone will be exposed to a light box for about 30 minutes in the mornings for SAD. According to the Mayo Clinic, this method, which is meant to imitate being outside, is thought to “cause a chemical change in the brain that lifts your mood and eases other symptoms of SAD.” Keep in mind that this is no everyday light source; the standard is for the light box to provide 10,000 lux of light, many times the brightness of an ordinary lamp. Consult with your doctor before purchasing a light box and use credible sources to identify effective ones.
• Cognitive behavioral therapy (CBT-SAD) — CBT is a form of talk therapy, focused on helping the patient change patterns of thinking and behavior. It is a type of therapy you may have heard of before since it is used for insomnia, substance use disorders, eating disorders, relationship issues, etc. CBT and light therapy have both proven to be effective for treating SAD in research studies and are sometimes used together.
• Antidepressants, vitamins and supplements — Antidepressants are another common treatment for SAD and may be the method your provider recommends. Both vitamin D and melatonin levels are thought to be connected to SAD. Be careful about assuming that altering the amounts you take of either will help your condition. For example, if you have SAD in winter, you are likely getting too much melatonin rather than too little. While vitamin D levels can be lower for those with SAD, studies have not been very conclusive about its effectiveness in treating the illness. Before taking any new supplements or vitamins or increasing their dosage, talk to your provider, especially since some combinations of medications, supplements and vitamins can do more harm than good.
Before you start any treatment, be sure to consult with your primary care doctor. If you have already discussed your symptoms with your provider and want to begin talk therapy, please call the Sandra Eskenazi Mental Health Center access line at 317-880-8491 to schedule an appointment. For emergency assistance with your mental health, please contact the 988 Lifeline (just dial or text those three digits) or call the Sandra Eskenazi Mental Health Center emergency line at 317-880-8485.
In addition to the treatment for SAD you choose with your doctor’s assistance, don’t forget the benefits of simple lifestyle measures. Regular physical activity (weather permitting, outside) and social connections can improve your mood when you are experiencing SAD.
Ananda Kannappan, M.D., primary care physician and Lifestyle Medicine practitioner with Eskenazi Health Center Grande