In Eastern Ontario, this has been a winter for the record books: long periods of deep cold alternating with difficult periods of precipitation and very few days of temperatures that make for a pleasant walk. Just this past week the temperature fell 30 degrees within 12 hours and the precipitation turned from rain, to freezing rain to snow. I find that whenever there is a difficult period of winter weather, more patients will ask, “Do you think I have Seasonal Affective Disorder?” Because of the weather, there are many more people asking that question this year so a brief primer and some references might be helpful for some of you.
Norman Rosenthal is the psychiatrist who, with his research team, first described Seasonal Affective Disorder (SAD) and his book, Winter Blues: Everything You Need To Know To Beat Seasonal Affective Disorder, is still one of the best references on the condition. It is available now in its fourth edition. The book is easy to read and still provides some of the most authoritative information with respect to SAD. He even has a blog and short video about what you need to know about SAD.
Since I see youth and young adults in my practice, I should point out that this group has a higher rate of Seasonal Affective Disorder. It is interesting that, in his blog about SAD in college students, Rosenthal suggests that parents can have a protective effect on youth vulnerable to SAD since they will remind them to get enough sleep and to care for themselves. When one is away from home for the first time, it takes awhile to learn selfcare and so these students might be more vulnerable to a condition that causes decreased energy and a sleep disturbance. This is Rosenthal’s contention so it follows from this that if you, or a family member, suffers from Seasonal Affective Disorder, a good way to support them is by helping them to maintain a reasonable schedule, especially with respect to getting enough sleep.
The symptoms of Seasonal Affective Disorder include:
1. Difficulty waking
2. Decreased energy
3. Difficulty concentrating
4. Increased appetite especially for sweets and starches
5. Weight gain
7. Decreased interest in socializing
These symptoms can interfere with a person’s capacity to manage their regular work or academic schedule and if you’re experiencing these, there are some things you can do that may be able to help.
First, look up the material I’ve included and consider whether you might have Seasonal Affective Disorder. Even if you’re not certain, there are some health measures you can take that have no risk and that could be helpful. Start with getting more light: go for a walk, especially a morning walk and find ways to let the sunshine into your home or workspace. You can use a timer or a dawn light at your bedside table to “start” the daylight a bit earlier. You can also get a specific light for Seasonal Affective Disorder. These are available in medical supply stores and some insurance plans even cover the cost.
You can also develop some basic Cognitive Behaviour Therapy techniques. Learn to recognize and manage negative thoughts and find some things to do that always help you to feel better. This last suggestion seems to be very hard for many people for whom depressed mood can be problematic. When there is a depressed young person on the inpatient unit, one of the most enjoyable and rewarding things to do is to help them find activities that always help them to feel better.
Finally, when should you see a doctor if you think you might have SAD? If your functioning at work or in school becomes affected, it’s time to discuss with your family doctor whether more treatment is required. Some cases of Seasonal Affective Disorder can be so severe that antidepressant medication will be needed.
All of this does not address whether a winter such as we’re having in Central Canada results in more cases of Seasonal Affective Disorder. Well, this does not seem to be supported by research. I cannot quite believe it myself. When I get ready to leave for work in the morning and I can’t quite face the 10-minute walk because it’s -30 degrees centigrade and there’s a wind chill factor on top, it would be great to feel justified in worrying about an increased risk of SAD. But it’s not the case. In fact, the short walk in the bright morning is likely just what I need to prevent the condition.