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If your mood seems to be sinking into darkness and gloom along with the freezing cold temperatures, you are not alone.

Along with the cold and snow, winter can bring changes to our health and well-being. The winter blues are estimated to affect about 1 in 5 Canadians. Of those, 25 per cent have Seasonal Affective Disorder (SAD), a condition in which severe mood disturbances recur over at least two consecutive winters followed by non-depressed periods in the spring and summer.

The winter doldrums are often accompanied by fatigue, an increased need for sleep, carb cravings, weight gain, loss of libido and withdrawal from loved ones. But individuals with SAD face more severe symptoms, often sleeping an extra two to four hours daily, experiencing intense food cravings and weight gain, and having difficulty functioning because of extreme lethargy and depression.

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SAD tends to occur in adulthood and affects eight times more women than men. The further north you travel from the equator, the greater the risk of experiencing the winter blues or depression. This geographic pattern is thought to arise with the seasonal shortening of the light-dark cycle known as the photoperiod.

The hormone melatonin is the master timekeeper of our internal clock. It is released in response to darkness and turned off by light. Shortening of the winter photoperiod causes melatonin secretion to fall out of sync, resulting in a phase delay or disconnect between our internal circadian rhythm and the external light-dark cycle. Increased melatonin production may deplete brain stores of the feel-good neurotransmitter serotonin, which is a precursor to melatonin and plays a pivotal role in regulating mood, satiety and feeding behaviours. Seasonal disruption of the serotonin-melatonin pathway contributes to wintertime problems with sleep, mood and weight gain.

SAD tends to run in families and is more likely to occur in individuals who are experiencing high levels of stress, have limited social supports and have a history of early childhood trauma.

As we gain a deeper understanding of how circadian and seasonal rhythms are at play within our bodies, we will be better equipped to help patients combat the wintertime blues and SAD. Here are five steps to get started.

1. Let in the light

Research has shown that exposure to bright light upon awakening in the morning is more effective than evening light in treating winter depression. Morning light causes a circadian phase advance to offset the effects of shortened winter daylight hours on melatonin. So let in the morning sunshine for a better sleep and mood during the winter months.

2. Move more

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Regular aerobic exercise has significant antidepressant effects. Unlike non-seasonal depression, the timing of exercise may matter more in SAD. While evening exercise can exaggerate the phase delay and worsen symptoms of SAD, a morning exercise routine, especially one that includes outdoor activity, can provide synergistic benefits. So pick up a new winter sport like snowshoeing, skiing or ice fishing to add flavour to your winter workout regimen.

3. Cuddle up with someone

While SAD is associated more closely with changes in light than temperatures, staying warm by cuddling close to someone you care about can help ward off winter blues. Keeping socially connected provides a safety net to prevent early symptoms from escalating into bigger problems, and boosting intimacy with your partner can help lift a languishing wintertime libido.

4. Follow the snowbirds

The tendency of snowbirds to migrate south may be explained by the science of SAD. Floridians are significantly less likely to experience SAD than those living in the North. Even a short escape to climates closer to the equator with longer photoperiods can help. Sun travel provides more than a break from routine – it can reduce the toll wintertime takes on our health.

5. Get help

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If morning light, exercise and a sunny getaway are not adequately addressing winter blues or sadness, there may be something else at play. Antidepressant therapy has been shown to be beneficial when symptoms are severe and debilitating, and cognitive behavioural therapy may hold promise in treating SAD. Speak to your physician and get help if wintertime blues are dragging you down.

Health Advisor contributors share their knowledge in fields ranging from fitness to psychology, pediatrics to aging.

Dr. Jennifer Pearlman is a physician focused on women's health and wellness, a staff physician at the Menopause Clinic at Mount Sinai Hospital in Toronto and Medical Director of PearlMD Rejuvenation, a women's health and wellness facility. You can follow her on Twitter @drjpearlman.

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