By Dr. Michael Jacobson, D.O., M.P.H., CHM Medical Director
*Editor’s note: This information was published in the December 2022 issue of Heartfelt Magazine, CHM’s monthly magazine that provides CHM membership-related tips and tricks, medical advice from doctors, testimonies from CHM members, and more. Please refer to the CHM Guidelines and applicable web pages for the most up-to-date information regarding CHM membership, sharing eligibility, and ministry news.*
For many, as the days get shorter and nights get longer, it seems like our mood experiences a similar decline, sometimes to the point of seasonal depression. Seasonal Affective Disorder (appropriately termed “SAD” or referred to as the “winter blues” or winter depression) is a depression related to seasonal changes. According to the National Institutes of Health (NIH), SAD is not really a distinct disorder but major depressive disorder (MDD) manifesting itself in a particular pattern.
Seasonal affective disorder symptoms
Typical symptoms may include:
- feeling depressed most of the day on most days
- losing interest in activities one used to enjoy
- changes in appetite or weight
- sleep problems
- low energy
- feeling hopeless or worthless
- difficulty concentrating
- thoughts of self-harm
In SAD, these symptoms tend to increase late in the fall, be associated with greater social withdrawal (literally feeling like ‘hibernating’), and remain so until the spring and summer months emerge.
What causes seasonal affective disorder, and who is at risk?
Many experts believe SAD’s cause is unknown. However, by understanding some basic brain chemistry, we can gain insight into what we can do to help alleviate the symptoms of SAD.
Fundamentally, SAD is associated with the reduction in light from the sun. The brain senses this through chemicals directly impacted by the presence or absence of sunlight.
For example, during a sunny day, light transmitted through the eye to the retina inhibits the release of melatonin from a tiny gland deep within the brain. As darkness emerges, these retinal impulses ‘remove the brake’ from the pineal gland, resulting a melatonin release. Known as the ‘sleep hormone,’ melatonin induces drowsiness and causes sluggishness and depression if we remain awake. Reduced sunlight also causes a drop in serotonin, a brain neurotransmitter that affects our mood.
People at increased risk of SAD include those with a personal or family history of depression, living far from the equator (in Alaska, SAD is known as “cabin fever”), and low levels of vitamin D.
Anyone who suffers from depression to the point that they have thoughts about harming themselves or others should seek help immediately.
For less extreme symptoms, there are several practical steps that nearly anyone can take to improve SAD-related symptoms.
- Boost exposure to sunlight. Get outside during sunny periods and allow your body the benefit of appropriate exposure. When natural sunlight is insufficient, man-made artificial light therapy lamps are now widely available and much less expensive than when they first appeared. In general, 10,000 lux (a measure of light intensity) for at least 30 minutes daily is recommended as a substitute for or to augment natural sunlight.
- Vitamin D. A precursor to vitamin D is activated when sunlight strikes human skin. Thus, when sun exposure is less, people can be at greater risk for vitamin D deficiency. This may play a role in serotonin function and is important for building strong bones as well as reducing infection, inflammation and cancer. Natural sources of D3 are few, but include egg yolk as well as the flesh and oils of fatty fish, such as cod, salmon, tuna and sardines. Additional sources include fortified foods and supplementation.
- Cognitive Behavior Therapy (CBT) is an effective form of psychological treatment.
- Antidepressants, the most common of which include Selective Serotonin Reuptake Inhibitors (SSRIs).
Focus on the positive
Finally, don’t forget the value of intentionally focusing on the positive. Recently, I noticed that my granddaughter was upset. When I asked her why, she told me that she wanted to ride in the truck with her daddy. After commending her on the good desire to be with her dad (validating feelings is important here), I explained her dad needed to have a private talk with someone, which was why she had to travel in the other vehicle.
Nearby, I saw a cup half full of a beverage. Taking it into my hand, I said, “Look inside. Is this cup half full or half empty?”
“Empty,” she replied.
Then I asked her if it was also true that it was half full.
“Yes,” she replied.
I explained to her that while both perspectives were true, the one she chose would determine how she processed the event, and thus her feelings. As the meaning of this dawned on her, a smile came across her face, and once again she returned to joy. Note that nothing had changed outwardly, only her focus and thus how she processed those circumstances.
In one of my favorite passages, David wrote of where we find true joy: “You will show me the path of life; In Your presence is fullness of joy; At Your right hand are pleasures forevermore” (Psalms 16:11).
Editor’s note: Per the CHM Guidelines, psychological or psychiatric treatment, testing, or counseling is ineligible for sharing. Through HealthiestYou™, members have access to mental health services at fair market value to the member.
- Cleveland Clinic Seasonal Depression (Seasonal Affective Disorder)
- NIH Seasonal Affective Disorder
- Mayo Clinic Seasonal Affective Disorder (SAD)
- VeryWellMind: “...Best Light Therapy Lamps (no endorsement intended)
- Chicago Tribune: Best Light Therapy Lamps (no endorsement intended)
- Harvard School of Public Health: Vitamin D