It's not uncommon to feel a little blue at this time of year. As one reader, who complained of feeling down, wrote: "I'm not sure if it is just the winter blahs or it's something more. Part of it, I am sure, has to do with the winter weight I always pack on, but the blues just seem to make me eat even more. Any ideas?"
As many as one out of two Canadians report changes in sleep patterns and mood at this time year, as well as low energy levels, signs of what many call the winter blues.
This is also the time of year when we hear the phrase "Seasonal Affective Disorder" bandied about. But what is SAD, and how does it differ from the everyday winter blues?
SAD is a form of depression known to be caused by the low light levels of winter days, and is much more severe than what most of us complain about. It manifests in the fall and winter, clears in the spring, and is more common in northern climes. It depends not only on latitude but also on weather patterns -- though it is unclear if it is the length of the day, cloud coverage, barometric pressure, temperature or the amount of precipitation that contributes to the disorder. (It has also been reported that some people who work in windowless buildings may experience SAD-type symptoms any time of the year.)
People diagnosed with SAD report a prolonged sense of sadness, low mood levels, profound fatigue, and a tendency to sleep more than usual, as well as eat more than usual. They report marked carbohydrate cravings and can gain up to 20 or 30 pounds. There seems to be a gender bias, with about four times more women affected than men. (Interestingly, other depressions do not show this gender bias.)
It usually strikes people in the 20-to-40 age group, although it has been reported in children, and might have a genetic component. Some patients also have a history of alcoholism. Research shows that about half the people who develop SAD will experience this seasonal depression over the next five to 10 years. Another 10 to 25 per cent will go on to have generalized depression.
About 600,000 Canadians are thought to suffer from SAD. Canada may have a higher incidence of SAD because of our more northern location.
Before starting any treatment for SAD, it is important to have a complete physical evaluation. Sometimes another illness can show up as depression.
There are some simple first steps to treat SAD (and to shake off winter blues in general). Try to work near a window so you are exposed to natural light. Avoid closed rooms. Try to get outdoors more. Make a habit of going outside at lunch, no matter how lethargic you feel. Try to balance your diet, eat healthy foods and limit carbohydrates. Avoid simple sugars such as cookies and chocolate.
Your doctor might also prescribe an antidepressant. This medication might only be used on a seasonal basis during the risk period for developing SAD.
Another treatment option utilizes light-therapy lamps, which have been around for about 20 years. One theory is that exposure to light can lift depression; it is believed that the brain's response to the bright light sends out a signal to suppress melatonin, the hormone that makes us sleepy.
Light therapy is effective in about 65 per cent of cases. It can be administered at home for 30 minutes at a time; some people use it twice daily. Light therapy may not be suitable, however, for people with certain eye problems. So it is imperative to consult your doctor before using such a machine.
In any case, let's make the best of the climate we live in. Find a winter activity that takes you outdoors, such as hiking, skiing or skating; it will get you exercising and exposed to natural sunlight. I recently took up snowshoeing. The learning curve was small -- all I have to do is put one foot in front of the other, and I'm already an expert! -- and the benefits are many.
Dr. Marla Shapiro can be seen daily on Balance: Television for Living Well on CTV. Questions about general health issues can be sent to her at: health@globeandmail.ca (Please direct queries about personal health issues to your doctor.)