I am not a fan of fall and winter. Fall makes me sad and gives me a feeling of things coming to an end. Winter is the season other people call the “comfy season” to snuggle up and light candles. I really do not find anything comfortable about winter. In fact, all it does is making me feel trapped inside. The past few years I was lucky enough to be in sunny regions over winter, at least for a few weeks. Not this year. This year I am spending winter in Germany. I do not like the cold, but I may be able to cope with it. What I can not cope with is the darkness. This is because I suffer from winter depression, also called seasonal affective disorder, or short: SAD.
Why this topic is so important to me.
No one has ever given me the diagnosis of SAD. A lot of the symptoms that come along with winter depression can have entirely different causes. However, if you get the same depression symptoms every year and they start and end at around the same time of the year, you can be pretty sure that you are affected by SAD.
With the next information coming up I am hoping not to trigger you. However, I would like to include it in my post. It is the main reason I am very much aware of my disorder: When I was 15 years old, my father committed suicide. At this time, all I felt was the pain of losing him because we were very close. Later on, when I was trying to understand I started reading up on the topic of depression. Not all forms of depression can be treated easily, but in the case of SAD, there is a lot we can do about it. I do not want anyone, not myself or anyone else, to go through this alone and unnoticed. Let’s raise more awareness for SAD being a serious disorder.
What exactly is a winter depression?
Seasonal affective disorder is a type of depressive disorder with a seasonal pattern. It generally has a predictable onset in fall, continuing into the winter months. Symptoms usually disappear when spring is coming up. Even though there are various studies around winter depression, causes and treatments are mainly suggested. It has been widely agreed that SAD is a complex disorder. There are several vulnerability factors acting at different levels, various genetic mechanisms that underlie them, and it is greatly influenced by the physical environment.
Statistics have shown that the typical person suffering from SAD is a premenopausal woman. People most at risk are younger, female, live far from the equator, have a family history of winter depression and other types of depression, as well as bipolar disorder.
As with any kind of depression, SAD should not be taken lightly. According to the World Health Organisation around 800.000 people die from suicide each year. Over 60% of those have suffered from major depression (that does not include bipolar depression).
How do you know you may have SAD?
If you observe any of these symptoms in yourself with a seasonal pattern and starting in fall and winter, you may be suffering from SAD:
- Feeling depressed a lot with no apparent reason
- No interest for activities you generally enjoy
- Feeling low on energy most of the time
- Being tired most of the time
- Oversleeping (= hypersomnia)
- Changes in appetite and cravings, very often for food high in carbs (and sugar)
- Gaining weight
- Being ill-tempered
- Having issues concentrating, for example at work
- Feeling worthless, hopeless or guilty
- Avoiding social contact
- Having thoughts of death or suicide
- Substance abuse such as alcohol or other drugs (more a response rather than a symptom)
Research suggests that physiological symptoms such as fatigue, hypersomnia and increased appetite can occur much earlier than cognitive (thinking) and affective (feeling) symptoms.
I have been observing this in myself. My SAD generally starts with feeling tired and exhausted and a shift in appetite. If I don’t start precautions, psychological symptoms will kick in soon after.
Main symptoms I have observed in myself:
- I am constantly tired. As soon as the sun is down my body tells me it is time to go to bed. Unfortunately, the sun goes down at 4pm during winter.
- I am having tremendous issues focusing on work as soon as it got dark. In fact, writing this blog post is a big effort. It is only 6pm.
- Getting up in the morning I’m feeling like it must be 3am when the alarm goes off, but it is actually 7am. In summer, I am a morning person.
- I am more hungry than usually and am craving for less healthy food. And for coffee. Lots of coffee.
- Very often, I am feeling sad with no apparent reason. Anxiety and self-doubts are creeping in, too.
- Don’t even ask about my libido. Food and sleep over sex.
- Years ago, when I was not aware of my disorder and was not actively taking precautions, I would frequently question if life was really worth living. This is the most extreme of all symptoms. Luckily, for me it has not come up any more after I got out of an unhappy relationship and started working out.
What can cause winter depression?
The specific causes are still unknown to researchers. Research, however, suggests a number of different potential causes for winter depression from which I have picked five (not a hierarchical order):
Phase shift/ disrupted circadian rhythm
Basically this hypothesis suggests that your body’s sleep-wake cycle has been disrupted because of the changes in the environmental light-dark cycle. More specifically, the onset of sleep, body temperature going down and melatonin and cortisol levels going up is delayed. You may find it harder to fall asleep and you do not feel ready to get up at the usual time in the morning.
Brain neurotransmitters, especially serotonin levels
Serotonin is a protein that functions as a neurotransmitter, sending signals between your nerve cells. Serotonin helps regulate mood, appetite, digestion, sleep, memory function and your libido. According to research, people with winter depression have slightly higher levels of serotonin. For example, high-carb meals can enhance serotonin turnover which may explain SAD patients’ cravings.
Genetic preconditions
Studies have indicated that winter depression may partially be an inherited disorder. People suffering from SAD are more likely to find blood relatives with the same or another form of depression. However, it is difficult to pinpoint specific genes because there are various vulnerability factors which in turn are shaped by different genes. Digging around in your family history may give you some clues why you are struggling with depression.
Melatonin levels
Basically what seems to happen with people suffering from winter depression is this: They turn into nocturnal creatures. Not kidding. Research has observed a nocturnal pattern of melatonin release in SAD patients that promotes more food and more sleep, at the same time less physical activity and reproduction. Therefore, SAD may be the ability in humans to track seasons like animals do.
Vitamin D deficiency
Vitamin D is produced by your body when your bare skin is exposed to sunlight. A variety of studies with depressed patients have shown that many of them had low vitamin D levels.
How to help yourself deal with SAD
Different treatments are available to reduce the symptoms of winter depression. Of course, as with every kind of depression, there can be medical treatments, as well. However, I will not list those here. Instead, I will focus on those treatments that do not require seeing a doctor. In addition, I have made good experiences myself with the following four options.
Light therapy
As soon as I can feel my winter depression to start, I set up my UV light and try to use it every day. There are very affordable home lights, the size of a tablet, that can be set up on your desk. The standard, optimal dose is said to be 10.000 lux of full-spectrum or cool white fluorescent lights behind an ultraviolet shield. Research suggests an optimal time from morning to mid-day for around 30 minutes up to 2 hours. I personally am using my light for around 20-30 minutes daily and can feel the difference in my mood and energy. Light therapy is supposed to phase-advance your disrupted circadian rhythm, thereby promoting normalised melatonin, cortisol and serotonin levels. It can take up to 4 weeks though to feel symptom relief when you started too late into winter. It really makes me feel so much better when I’m using my UV light on a daily basis.
Exercise
Research suggests that morning exercise may be beneficial assuming it induces a phase-advance of your sleep-wake cycle, aka it wakes you up. However timing might not be that important. Only late night exercise should be avoided because it may result in further phase delay. Note that exercise in bright light is more effective. Therefore, in winter you should favour a gym workout over outdoor activities. Exercising also helps regulating your mood and food cravings through various hormonal processes. For me, it can be difficult in winter to get up and go to the gym. However, being there gives me a lot of energy from the general atmosphere, sounds and light, and of course my own workout.
Psychotherapy
Individual psychotherapy can help working with your specific emotions and thoughts. No one needs to be afraid of being in therapy. I have been in psychotherapy myself for around 5 years and I am very proud of what I achieved during this time. It is not a weakness, but a strength to seek the help of a professional with the goal to change something. There have also been tests for group therapy for SAD in the form of a tailored version of cognitive-behavioural therapy (CBT). Those groups were using pleasant activity to fight the “hibernating” component of winter depression. Specific exercises were supposed to reduce negative associations with winter. Don’t be shy to research what options you have in your area. In Germany, you can for example consult “Deutsche Depressionshilfe” (www.deutsche-depressionshilfe.de).
Vitamin D
The Vitamin D Council (www.vitamindcouncil.org) recommends a dose of Vitamin D for those suffering from winter depression that starts at 5,000 IU/day (125 mcg) and goes up to 10,000 IU/day (250 mcg). Up to that level vitamin D is considered as being safe to supplement. If you go higher than that, you should consult a doctor who will check your vitamin D level at least twice a year. Vitamin D is available in the form of pills or liquid drops. I am using liquid drops from Bodylab24 (www.bodylab24.de).
There are other ways to make you feel better, too. If you have the opportunity to take vacation in winter, do it! Go and get some sun. I generally would not recommend going to the solarium. However, when you have come to a point where you just can’t stand it any more, it may feel nice. Pretending to be laying at the beach somewhere warm. Eating fruit instead of sweets helps me a lot. I associate fruit with summer. Another important thing is to stay away from people that do not have a good energy. Surround yourself with those who bring you up and not down. And the most important point: Talk about it. If you do not feel well, don’t just suck it in. Tell your friends and family how you are feeling and how they might be able to support you.
Take action now, it’s actually very easy to make a change
As serious as winter depression needs to be taken, as easy it is to get relief when you take some action. Start with exercise, light therapy and vitamin D and see you this makes you feel. Most likely, you will be fine if you are consistent with your routines. In most cases, psychotherapy will not be necessary.
Be aware of your friends and family. Do some of them change over winter? Never hesitate to talk about it with your loved ones. Let them know they are not alone with this, just like you are not alone with it. Start by sharing your newfound knowledge. Maybe start by sharing my post with your network <3
If you liked my post, also check out “5 actionable tips to make yourself a happier person“.
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004726/
https://www.ncbi.nlm.nih.gov/pubmed/10888476
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202491/
https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651
https://www.vitamindcouncil.org/health-conditions/depression/#.W-BrdnpKjOQ
http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/