How to beat the winter blues

Doctors recommend treatments for seasonal affective disorder

By: Caitlin Heidbrink

Posted: 2/25/08

Trudging through the frigid, snow-packed UW-Eau Claire campus on a daily basis may not be a student's idea of a good time. Enduring early darkness for months of winter can be annoying. Most admit to hoping for spring to come or dreaming of a sunny vacation.

But feeling trapped in the doldrums of winter could be more serious than a general dislike for the cold season.

Seasonal affective disorder is a form of depression directly linked to seasonal changes. According to a Nov. 2006 study by the American Family Physician, SAD is not a mood disorder, but a sign of serious depression.

"There are many people who experience winter blues," said Dr. William Weggel, psychiatrist at Luther Midelfort Hospital, 1221 Whipple St, in an e-mail to The Spectator. "I see those who are experiencing more serious symptoms of seasonal affective disorder."

Stacy Duran, a junior at Luther College (Iowa), said she feels down in the winter months because it is cold, dark and dry. This constant climate puts her in a bad mood for extended periods of time, she said.

"It can be pretty debilitating," said Mary Joe Sorenson, licensed marriage and family therapist at L.E Phillip-Libertas Center in Chippewa Falls "It's not something you can wait through and bounce back."

As far as symptoms, she said, SAD is similar to other forms of depression. Fatigue, loss of interest in things previously enjoyed, a tendency to isolate socially, weight gain or loss, and an overall feeling of hopelessness are all common characteristics of the disorder.

In addition, people simply feel bad about coping with it, Sorenson said.

"Frankly, they can have low self-esteem because they think they should just buck up and deal with it," she said.

The main difference between SAD and regular depression is what causes it in the brain.

Sorensen said people in the northern hemisphere are more prone to struggling with the disorder because of what triggers it.

Sunlight enters the brain through our eyes stimulating the production of a neurotransmitter, serotonin, which supports nerve cell function including mood, according to Weggel, who added less light results in lower levels of serotonin. The combination of less serotonin, which helps nerve cells cooperate, and increased amounts of melatonin, which puts a body to sleep, causes SAD, according to Weggel.

The onset of an individual's depression is an important factor in determining whether or not it is SAD, Sorensen said. She added if a patient's depression is linked to a seasonal pattern for at least two years, then they meet the criterion for SAD. Typically, she said, onset runs from late October through the winter months.

"In most cases, we are able to find a treatment plan for the patient that helps them cope with the winter months as well as all year long," Weggel said.

There are three main treatments for SAD. Light therapy, medication and cognitive behavioral therapy are all viable options, Sorensen said, adding while all three may help the depression, it is something that must be dealt with each year.

Light therapy involves literally exposing the eyes to special, more intense lamps on a regular basis, Sorensen said, adding these lamps can be purchased for this form of treatment.

According to the American Family Physician study, early morning light therapy regulates the circadian pattern of melatonin secretion.

Anti-depressant medication given for normal depression can also be used to ease symptoms of SAD. Like any medication, Sorensen said, patients must try different brands to see which works best for them.

Cognitive behavioral therapy simply involves talking with a therapist about strategies to cope with SAD.

Weggel suggested other treatment options including increased exposure to light by getting outside during daylight hours, using full spectrum bulbs at work and home, getting more exercise - preferably outdoors - eating fewer carbohydrates and more protein, fruit, vegetables or taking a vacation in a sunny, warm location.

Duran has her own method of treatment.

"I lay in a tanning booth for five to eight minutes every few days, and the heat and brightness of the lamps helps me relax and get in a better mood, and when I do that, I feel a lot better for the next couple of days," she said.

There are also behaviors that can make SAD worse. Sorensen said it may become full-blown depression if an individual does not monitor signs such as overeating or isolating oneself. What is already bad can become worse and create a vicious cycle, she said.

She said using other depressants, such as drugs and alcohol, can also worsen SAD.

"Anytime you're abusing alcohol or using anything like that to cope, you're going to exacerbate it and make it worse," Sorensen said.

Over ten million people are susceptible to SAD in the United States alone, she said. However, Sorensen said she doesn't think many people actually address the fact that they might have SAD and that it is something people think they have to deal with on their own. In addition, she added, there might be shame in acknowledging a struggle with depression.

"When people realize they have SAD, it takes a lot of the unknown and shame away," Sorensen said, "They can learn to use strategies to deal with it."