In the summer months, Emily* was energetic, pleasant, and full of life. She was excited about her future, motivated at work, and was a wonderful partner to her new fiance. Right around November, however, just as the first snow of winter came in, the good spirits she had previously found herself in were taken over by a seeming slush. To her fiance, she was not the same person he knew her to be: Her bubbly personality had become flat, her zest for life had all but disappeared, and her joyous attitude quietly eroded, as the nights she so enjoyed, once filled with friends and laughter, now disappeared by her own will, and she sat in silence, night after night, blankly staring at the dimly lit television. It was as if a switch had been turned off: Summer salads became chocolate croissants, motivation became irritability, and feeling too lethargic to get out of bed became the norm. At 26, Emily was now in danger of being let go from her job, losing her fiance, and the having life she had worked so hard to build slip away. No one particular event had occurred which would pinpoint the exact cause of Emily’s sadness. Instead, she was simply S.A.D., suffering from Seasonal Affective Disorder. According to researchers Stuart L. Kurlansik and Annamarie D. Ibay, “S.A.D. is a combination of biologic and mood disturbances with a seasonal pattern, typically occurring in the autumn and winter with remission in the spring or summer. In a given year, about 5 percent of the U.S. population experiences seasonal affective disorder, with symptoms present for about 40 percent of the year.”
“S.A.D. is a combination of biologic and mood disturbances with a seasonal pattern, typically occurring in the autumn and winter with remission in the spring or summer. In a given year, about 5 percent of the U.S. population experiences seasonal affective disorder, with symptoms present for about 40 percent of the year.”
S.A.D, which affects women more than men at a staggering rate of 4:1, tends to be particularly prevalent during a woman’s childbearing years, ages 20-35. Interestingly, in a 2014 study by psychologists Halszka Oginska and Katarzyna Oginska-Bruchal, the disorder has been found to be linked to a certain personality trait, namely openness to experience. Openness, on the ‘Big 5 personality inventory’, (which also looks at conscientiousness, extroversion, agreeableness, and neuroticism as the key components which make up the human personality), is the tendency to be curious about the world and sensitive to it. In other research, this personality trait has been found to be higher for women, in general. A personality high in openness to experience may suffer from a higher rate of depressive affective disorders because if you are more curious about the world around you, you are more likely to be affected by it. Why this personality trait would only cause depressive symptoms during the winter, however, remains unknown. Apart from a personality high in openness, people who are more susceptible to developing S.A.D. generally cope with stressors by avoiding them. For instance, instead of dealing with an issue head on, “avoiders” engage in a range of activities including watching television, sleeping, over-eating, drinking alcohol or drug use. They are thus more prone to S.A.D, because their coping method of avoidance acts almost as a human form of hibernation, as theorized by the researchers. Even though the condition is seasonal, it is nevertheless a serious mental condition with devastating symptoms. As a subtype of major depression, these symptoms, as stated by the Mayo Foundation for Medical Education and Research, include: Feeling depressed most of the day, nearly every day; Feeling hopeless or worthless; Having low energy; Losing interest in activities you once enjoyed; Having problems with sleeping; Experiencing changes in your appetite or weight; Feeling sluggish or agitated; Having difficulty concentrating; Having frequent thoughts of death or suicide.
While S.A.D is best known for being a winter condition, there is a summer- onset variety which differs slightly in its symptomology. Similar to Emily’s description above, symptoms that are specific to the winter variety include: Irritability, tiredness or low energy; problems getting along with other people; hypersensitivity to rejection; heavy, “leaden” feeling in the arms or legs; oversleeping; appetite changes, especially a craving for foods high in carbohydrates; and weight gain. The summer-onset symptoms, include, conversely, trouble sleeping, a loss of appetite, and weight loss. As a recognizable disorder named in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, S.A.D. is diagnosable by a doctor, who assesses whether the disorder occurs in a seasonal pattern and there is major depression only at a certain time of the year, with no or very few and mild symptoms at other times of the year. Further, there must have been at least two major depressive episodes occurring in the past two years, and depressive episodes during a specific season must outnumber the amount of depressive episodes that may have occurred during the off-season over a person’s lifetime. Lastly, psychosocial stressors, which include tragic events like the death of a family member, divorce, of an unexpected event like suddenly becoming unemployed, would have to be ruled out as potentially causes for a depressive mood. There are three general ways that S.A.D has been traditionally treated: light therapy, pharmacotherapy (taking antidepressants), and cognitive behavior therapy (CBT):
Classically known as ‘heliotherapy’, light therapy involves just that: light! In this treatment option, a special device, which can be purchased, stimulates the light of dawn. According to the Canadian Consensus Guidelines for the Treatment of Seasonal Affective Disorder, “patients should be positioned about 12 to 18 inches from a white, fluorescent light source at a standard dosage of 10,000 lux for 30 minutes per day in the early morning. They must be awake with their eyes open, but are not required to look directly into the light (i.e., eating or reading during the treatment is acceptable as long as the light enters the pupil).” The reason why light therapy has been shown to be as effective as anti-depressants is because, according to one theory, it resets the body’s internal clock and makes up for the lost sunlight we in the northern hemispheres experience more heavily. Cognitive behavioral therapy has also shown comparable results: Recent research published in the American Journal of Psychiatry found that a program of CBT tailored for S.A.D. had better long-term outcomes than light therapy alone. This may be because the therapy involves teaching skills and strategies to change negative thinking patterns that might give way to depressive thoughts. The Centre for Addiction and Mental Health, which runs programs of CBT, describes it as follows: The CBT model is built on a two-way relationship between thoughts (“cognitions”) and behaviours. Each can influence the other. There are three levels of cognition: (a) Conscious thoughts: rational thoughts and choices that are made with full awareness; (b) Automatic thoughts: thoughts that flow rapidly, so that you may not be fully aware of them. This may mean you can’t check them for accuracy or relevance. In a person with a mental health problem, these thoughts may not be logical; and (c) Schemas: core beliefs and personal rules for processing information. Schemas are shaped by influences in childhood and other life experiences. “In CBT, clients learn to identify, question and change the thoughts, attitudes and beliefs related to the emotional and behavioural reactions that cause them difficulty. By monitoring and recording thoughts during upsetting situations, people learn that how they think can contribute to emotional problems such as depression and anxiety. CBT helps to reduce these emotional problems by teaching clients to identify distortions in their thinking, see thoughts as ideas about what is going on, rather than as facts, and stand back from their thinking to consider situations from different viewpoints.”
In other words, by first becoming aware of the negative thoughts you have, then catching yourself every time the thought occurs and neutralizing it, over time, with persistence and patience, the very thought which gave way to depressive spirals can be altered, thus creating new neural networks and ‘schemas’ in the brain. Eventually, the idea is that with enough practice, the healthier, more realistic, and emotionally stable thought pattern will become automatic. The key to success in CBT is tied around the each person’s individual desire to change and confront uncomfortable thoughts.
While these three methods are tried and true, according to Carolyn C. Ross, M.D., there are four supplements which can also help stave off “the winter blues”: B-complex vitamins, Vitamin D, St. John’s Worst and Fish Oil: B-complex vitamins, including vitamin B6, B9 (folic acid) and B12, help convert proteins into specific neurotransmitters such as serotonin and dopamine, which are needed for mood and energy. Often, people who choose a strict vegetarian diet risk having insufficient vitamin B12, which can not be found in vegetables. Vitamin D has also been found in a recent research study to help reduce S.A.D. According to Dr. Ross, the suggested upper limit for adults is 2,000 IU per day of vitamin D3. St. John’s Wort has also been shown to have an antidepressant effect, with most research studies using a dosage of 300mg of an extract three times daily. Lastly, the effects of fish oil have been found to be pervasive, from benefiting heart disease to reducing suicide risk, and the symptoms of depression and bipolar disorder. In many research studies, a diet low in fish consumption has been linked to an increase in depressive symptoms – one study in particular found this was true at an alarming rate of 31% in comparison to participants who ate high amounts of seafood. Nevertheless, any supplements should be taken as advised by a medical professional, who can appropriately assess dosage by your individual need.
While having the occasional day feeling ‘down in the dumps’ is normal for everyone, feeling sad for a prolonged period of time for no apparent reason is not. Actively engaging in rewarding activities, seeking help to change negative thought patterns and avoidance-related coping mechanisms, and speaking to a medical professional will help you beat ‘the winter blues’
By: Mariana Bockarova