Seasonal blues in spring

People often joke that they get the ‘winter blues’ but for some people the cold, dark days of winter are no laughing matter.

Seasonal Affective Disorder (SAD) is considered a variant of depression that occurs in the autumn and winter months but gets better in spring and summer. SAD can cause mild to severe symptoms that can be quite debilitating for some sufferers.

Symptoms

The symptoms are the same as depression, but the key difference is that people with SAD have stable mental health in the warmer seasons. Because of this seasonality, it can take a few years for you and your GP to figure out that this affects you. People with SAD may have any of the following symptoms:

• low mood most of the time (feeling flat, low, sad, numb, “just not quite right”)
• finding it hard to follow normal routines
• over- or under-sleeping
• over- or under-eating
• trouble concentrating
• avoiding social interactions
• feeling guilty or worthless
• moving and thinking more slowly than usual
• irritability, feeling anxious
• lethargy and daytime drowsiness
• carb-craving and weight gain

People with SAD can spend up to 40% of their year struggling with these depressive symptoms. SAD can be so severe in some people that they have suicidal thoughts.

Causes

It seems that vulnerability to SAD increases the further from the equator you are. In these places, winter days are very short and nights are very long. The later sunrises and earlier sunsets of winter disrupt the body’s internal body clock leading to changes in brain chemistry. Scientists think that lack of sunlight during the colder months affects a part of the brain called the hypothalamus. The hypothalamus is involved in the control and production of hormones that regulate sleep, mood, appetite and circadian rhythm (the body’s internal clock).

Treatment

Treatment of SAD may involve medication, psychological therapy, light therapy or a combination of all three.

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, citalopram and sertraline are anti-depressants that increase serotonin levels in the brain, improving mood. It can take four to six weeks for mood to improve and it is common to trial a few different types of anti-depressants or serotonin supplements before finding the medication that works for you with the least amount of side effects.

Light therapy uses a light box to expose people to bright light for 30 to 60 minutes after they wake up. This mimics natural light and is thought to change the brain chemicals linked to mood. Symptoms can improve quite quickly, in around a week. Another form of light therapy is “dawn simulation” where light is used to gradually brighten a room, like the sun at sunrise.

Psychological treatments such as Cognitive Behavioural Therapy (CBT) use talk therapy to change negative patterns of thought and are effective for SAD.

Self-care

Regular exercise, spending time outside each day, maintaining stable blood sugar levels through healthy eating, winter hobbies, and staying connected with friends and family are important elements of self-care for SAD. Speak to your GP or pharmacist if you think SAD may be something you are experiencing.

Disclaimer: This article provides general information only. It is not intended as medical or health advice and should not be relied on as a substitute for consultation with a qualified healthcare professional who understands your individual medical needs.