Winter in the Midwest is as gray as it is long. On average, we receive less than seven days of sunshine per month from November through March. The cloudy sky, strong winds and frigid air is enough to cool off anyone’s fire for life. For those suffering from Seasonal Affective Disorder (SAD) though, winter brings with it more than the occasional bout of the winter blues. The season can be a debilitating time for individuals with the disorder.

An Overview

SAD is a form of depression that occurs during the same season each year, most commonly during the winter months. First diagnosed centuries ago in Scandinavia, the disorder primarily plagues those living in cold weather climates that experience prolonged periods with little to no sunlight. Dr. Mark Smaller (www.markdsmaller.com) notes that individuals with SAD have a particular and sustained negative reaction to the change in season.

Physiologically, the body is responding to a lack of exposure to light, resulting in altered levels of serotonin and melatonin. Smaller says there can also be an historical component in SAD, such as a patient having had a traumatic event or loss during a specific time of year. This historical antecedent can play a role in triggering SAD.

Symptoms

SAD symptoms are akin to other types of depression. Dr. Smaller notes that this can lead to misdiagnosis if a clinician is not well-versed in SAD indicators. Patients may experience:

Lack of motivation or decreased interest in everyday activities

Increase or decrease in appetite

Difficulty concentrating

Change in sleep patterns

Altered energy level

Social withdrawal

Appearance of some or all of the above symptoms at the same time each year

Dr. Nadeem Hussain of Central DuPage Hospital (www.cdh.org) says SAD sufferers often isolate themselves to their homes and avoid social interaction. This isolation only deepens the depression.

Treatment

Dr. Hussain notes there are several forms of SAD treatments. The success rate of each varies from patient to patient, which is why doctors should present a menu of options. Psychotherapy should accompany treatment plans.

Get Outdoors and Exercise

It may be counterintuitive, but getting outdoors even when the sky is gray can help to alleviate SAD symptoms. Patients are encouraged to increase physical activities and do so outside when weather permits. Outdoor activity gives individuals a sense of empowerment over the weather they cannot control. Exercise should be fun, so it becomes something to look forward to each day. Running, walking briskly, ice skating or sledding with children are great ways to soak up the bounties of winter.

Leave Home

This is especially tough for SAD patients because the natural inclination is to stay in and avoid social outings. Patients are encouraged to do the exact opposite of what they feel like doing. If the last thing you wish to do is leave home, do just that. Pick up the phone and make a plan to meet up with a friend or family member. Enjoy dinner out on the town, catch a play or head to a museum. Enjoy the amenities of the city we often ignore during the summer months.

Light Box Treatment

Light therapy has been found to be quite effective for SAD patients. A light therapy box emits light that mimics natural outdoor light. The box is thought to alter one’s circadian rhythms and suppress the body's natural release of melatonin, causing chemical changes in the brain which reduce SAD symptoms. Individuals sit in front of the light equipment for 20-30 minutes daily. The initial investment generally ranges from $200-400 for a light box.

Temporary Anti-Depressant

When a SAD patient does not respond to other treatments, a doctor may prescribe a temporary anti-depressant to be used seasonally. As with any depression, the success of psychotropic medications varies between individuals.

More Than the Winter Blues?

Most of us feel unmotivated or underwhelmed from time to time when winter strikes. SAD patients differ in that they are unable to move past these feelings of depression. If you believe that you or a loved one may need to seek help, find a clinician who specializes in the diagnosis and treatment of SAD.