Autumn is the season of harvest, bright fall colors, sweaters, and pumpkin spice lattes. It is also a reminder that winter is right around the corner. As the amount of sunlight continues to decrease, one might notice her or his energy decreasing as well. This noticeable drop in energy is not uncommon for us living north of the equator. Many also report an increase in sadness, carbohydrate and sweet cravings, as well as withdrawing from physical and social activities.
If you have noticed a few of these changes, you are not alone. Some may refer to the changes in mood that align with the seasons, seasonal affective disorder (SAD). It is hard to know the prevalence of SAD due to unreported cases, undiagnosed SAD, or the co-occurrence of SAD symptoms with other health conditions; however, an article in 2015 written by Sherri Melrose estimated that 9% of Alaskan residents have a SAD diagnosis compared to 1% of Florida residents. The data reported by this article supports the theory that regions in the northern latitude have a higher prevalence of SAD, and sadly, that includes us Minnesotans.
SAD is not a psychiatric diagnosis in itself, but a recurring major depressive disorder with a seasonal pattern. Although one must meet criteria before a diagnosis can be made, there are those who experience symptoms of SAD who do not meet criteria for a diagnosis. In other words, some people experience milder symptoms of SAD, sometimes referred to as the “winter blues.”
It has been hypothesized that a decrease in sunlight during the winter months affects serotonin levels. Low levels of serotonin have been associated with depression. Serotonin is a chemical produced by nerve cells and it has various functions, one is to regulate mood. Decrease in sunlight also is believed to affect melatonin levels. Melatonin is produced in the brain when it is dark and causes sleepiness. This can lead to someone feeling more lethargic and sleepy as daylight decreases. Less exposure to sunlight can also affect vitamin D levels. Vitamin D affects serotonin activity, which as previously stated, serotonin plays a role in regulating mood. Additionally, symptoms of vitamin D deficiency are closely associated with symptoms of depression. Shorter days and longer nights can have an affect on our bodies and it can in turn affect our moods.
Simply being aware of the changes in one’s mood can be a helpful start to make the transition to winter easier. Staying proactive in scheduling routine activities with others may also be beneficial. Penciling in monthly coffee dates with friends, or a weekly book club meeting can help keep you engaged and active through out the winter months. Also scheduling time for self-care is important. This might include a setting a movie night, 30 minutes a week for yoga, 20 minutes of cardio a day, or 5 minutes a day of mindfulness. Overall, creating a routine, staying active, and having structure can help offset the inclination to hibernate all winter.
For those who are experiencing winter blues, or symptoms of SAD, there are interventions that have been shown to be effective in reducing symptoms. Light therapy, or Bright Light Therapy, mimics sunlight and has shown promising results in decreasing symptoms of SAD. Light boxes can be purchased starting at $38.99. It is recommended that a light box be used in the morning for 20-60 minutes every day. There are some side effects to light therapy, therefore consulting with a health professional is recommended before starting light box therapy.
Another possible intervention is adjusting vitamin D levels if those levels are low. Make an appointment with a primary care provider to evaluate whether vitamin D levels are in the normal range. If vitamin D levels are low, a primary care provider will be able to recommend the appropriate dosage and course of treatment.
You can also consider psychotherapy to help with symptoms of SAD. Psychological interventions such as cognitive behavioral therapy or acceptance and commitment therapy are often helpful in managing and coping with changes in energy, mood, or overeating. Primary care behavioral health (PCBH) is a good alternative to traditional outpatient psychological services for those who are looking for brief, short-term therapy. Many primary care clinics now offer PCBH services in their clinics. To get connected with PCBH services, talk to a primary care provider. Medications may also be helpful to manage symptoms of SAD. It is recommended that anyone interested in medications schedule an appointment with a primary care provider to talk about symptoms and options that best fit them.
It is possible to have SAD symptoms worsen, especially with other life stressors. Reach out to a mental health professional sooner rather than later if symptoms are negatively affecting work, interpersonal relationships, or other important areas in life. If there are thoughts of suicide, there are several resources and support available. Schedule a psychotherapy appointment to speak with a psychologist or mental health professional. Call crisis lines such as COPE (612-596-1223) or use the crisis text line (text MN to 741 741). If there is an emergency, call 911 for immediate assistance. Hennepin Healthcare’s Acute Psychiatric Services is also open 24/7 for mental health emergencies.
If losing sunlight affects your energy level, moods, and eating behaviors, remember you are not alone. There are steps you can take to help your body and mind transition into winter. Create a routine, stay active, and implement some structure during the winter months. There are resources available to meet you where you are – wherever that may be. A good place to start is in your primary care clinic with your primary care provider.
Written by Talee Vang, Psy D., LP., PCBH
Melrose, S. (2015). Seasonal affective disorder: An overview of assessment and treatment approaches. Hindawi Publishing Corporation Depression Research and Treatment, 2015, 1-6. Retrieved from https://www.hindawi.com/journals/drt/2015/178564/
Rohan, K.J., Sigmon, S.T., & Dorhofer, D.M. (2003). Cognitive –behavioral factors in seasonal affective disorder. Journal of Counseling and Clinical Psychology, 71(1), 22-30. Doi: 10.1037/0022-006x.71.1.22