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Anxiety and Stress Management

with Patricia A. Farrell, PhD

This blog has been retired. We appreciate all the wisdom and support Dr. Farrell has brought to the WebMD community.

Monday, November 17, 2008

SAD: The Demon Beast of Winter

Winter comes this year with a promise of holidays that may not be as bright as we would like. In the middle of a pounding economic downturn with job loss and belt tightening all around, there is another spectre that is there whether the economy is good or bad and it’s Seasonal Affective Disorder, originally called the Winter Blues. Imagine how difficult it is for people with this disorder (SAD) and then add on top of that the problem of lack of money and the stress that brings. It’s a one-two punch no one wants, especially with reduced economic and psychological resources. An estimated 25% of the population suffers from a mild form of SAD and around 5% has a more severe winter depression.

SAD often affects groups who live above certain latitudes. So, it would seem, people often referred to as ‘snow birds’ know what they’re doing when they head south for the winter. It may not be just the cold they’re escaping, it may be depression. The shift that takes place in our biological clocks happens in response to the light that hits our eyes and affects our internal settings.

A small structure in our brains, the pineal gland, produces a substance which can be both problematic and helpful. The substance is melatonin and it has been linked to both SAD and sleep. During the winter months, the decreased exposure to sunlight may stimulate the production of this hormone.

How do you know you have SAD and what can you do about it? First, let’s look at the usual symptoms we see with this winter variety of the disorder. Yes, there’s a summer disorder, too, for some people.

SAD Symptoms

  • January to February is the prime time of year in most Northern climes and we see:
  • Changes in sleeping and eating habits
  • Persistent sad, anxious or “empty” mood
  • Loss of pleasure in activities once enjoyed
  • Depression subsides in the spring and summer months.
  • Symptoms have occurred in the past two years, with no non-seasonal depression episodes
  • Seasonal episodes substantially outnumber non-seasonal depression episodes
  • The individual craves sugary or starchy foods probably because this increases the availability of serotonin which fights depression

As a result of the dietary changes seen, there is weight gain and that further increases depression by lowering self-esteem and intensifying feelings of helplessness. Your clothes don’t fit, you can’t buy new ones and you feel self-conscious. Double whammy there.

Steps You Can Take

  • Light box or visor treatments
  • Dawn simulation devices for morning awakening
  • Antidepressant medications
  • Outdoor or even indoor exercise such as walking for as little as 15 minutes a day

Our thinking about how to treat SAD has changed since 1984 when Dr. Norman Rosenthal first described the disorder. Light boxes aren’t seen as necessary because we’ve discovered that light, from any source, may be beneficial. The most interesting results have come from just plain old exercise several times a week and it can be indoors or outdoors. Walking is one of the exercises that has been found to be both useful and to involve no cost. Leave the car a few blocks away from where you’ve going shopping or at the edge of the parking lot, walk to the stores, take a walk around your neighborhood or in front of the TV. You can probably, if you have a high-tech home, use TV exercise programs such as the virtual tennis, yoga and other programs. This way, you avoid the cold weather and still get your anti-depression exercise fix. In the office, get up and walk things over to your colleagues, walk to the water cooler a few times a day and walk up and down stairs.

You do have resources and you can overcome this disorder, so get walking.

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Posted by: Patricia Farrell, PhD at 12:30 pm

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