The Dose24:45How can I take care of my mental health through the dark months?
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As winter sets in and daylight fades earlier, you may be starting to notice some familiar patterns.
Perhaps you’re having a hard time getting out of bed in the morning, even if you slept a solid eight hours. Maybe your appetite has increased, or you don’t feel like leaving the house.
It could be that you just feel sad.
“People have heard the term SAD, or seasonal affective disorder — and affective is just a psychiatric term for mood,” said Dr. Raymond Lam, a professor of psychiatry at UBC who has spent decades researching seasonal depression.
“These are people who have clinical depressions but only during the wintertime,” Lam told Dr. Brian Goldman, host of CBC’s The Dose.
“By spring and summer they are actually feeling better — and in the summertime they’re feeling well.”
What is SAD?
SAD is another name for seasonal depression or winter depression. It’s listed in the Diagnostic and Statistical Manual of Mental Disorders as a subcategory of clinical depression.
Roughly 15 per cent of Canadians will have at least one mild episode of SAD in their lifetime, while two to three per cent will have more severe episodes, according to the Canadian Psychological Association. In order to be diagnosed, symptoms need to significantly undermine daily functioning, experts say.
But even if that’s not the case, you may still not feel your best at this time of year, said Lam.
“We also think about seasonality as a dimension, or a spectrum,” he said.
Some people may experience the “winter blues,” he said.
“They have a lot of the same symptoms of winter depression — but not to the point where it’s really interfering significantly with their functioning.”
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What causes winter depression?
While it’s difficult to establish the exact biological cause of most mood disorders, research has shown the connection between winter depression and the reduced amount of daylight caused by shorter days, Lam said.
“SAD may be like a form of jet lag, where there’s a disconnect between the internal clock and the external environment,” said Lam. “Light is the strongest synchronizer of that biological clock.”
Other research connects seasonal depression and serotonin, one of the neurotransmitters in our brains that helps regulate our moods.
Serotonin “clearly has a seasonal pattern of metabolism,” said Lam.
Because of changes in daylight, we have higher levels of serotonin in summer and fall and the lowest levels in winter and early spring, he said.
What are the symptoms?
Common symptoms for winter depression include low mood, reduced energy, fatigue, increased appetite, craving carbohydrates, weight gain, withdrawing from activities and problems with concentration and memory.
More serious cases could include thoughts of hopelessness and suicide.
“When you’re in that state of mind, the journey from the bed to the couch is a long journey,” said Marian Goldstone, an educator and mental health worker in Manitoba.
Goldstone speaks from experience, both professionally as a consultant for the non-profit Mood Disorders Association of Manitoba, and personally through her lived experience with depression.
“One of the things that I want to do in the winter more than anything else is socially isolate. And I have to keep pushing myself to keep connected with people,” she said.
Shine a light on it
There are many options for treating winter depression or preventing symptoms from worsening.
One of the most common treatments is light therapy, which researchers have been studying for 40 years.
During light therapy, people sit in front of a light device or lamp for about 30 minutes each morning.
“It isn’t a one-off treatment. You have to continue using it on a daily basis,” said Lam.
About 60 to 70 per cent of people using light therapy get relief from their depression symptoms, with most noticing within a week or two, he said.
Lam said it’s important to choose a light device that is bright enough to be effective.
“The key ingredient is really the intensity of light,” said Lam.
That intensity is determined with a light measurement called lux, defined as the amount of illumination when one lumen is evenly distributed over a square metre. Experts recommend using a light device that has a 10,000-lux intensity.
Put in context, direct sunlight can be from 50,000 to 100,000 lux, while typical lighting in a home’s living room would be less than 100 lux, Lam said.
For the 30-minute light therapy sessions, the device needs to provide the 10,000 lux of intensity to someone who is sitting a reasonable distance away from it — not just a few inches, he added.
“You can be reading or eating breakfast or looking at your screens during that time,” said Lam.
What else can ease symptoms?
Seeing a therapist can help, with experts pointing to cognitive behavioural therapy (CBT) as being particularly effective in reducing symptoms of winter depression.
“People say, ‘Oh, I always get depressed in the winter. I’m never gonna be able to do anything,'” said Lam. But CBT, he said, can help change a person’s negative thought patterns about winter.
“It’s this extremely powerful tool to gain control of emotions through understanding the way we think,” added Natasha Sharma, a therapist and owner of NKS Therapy in Toronto.
Getting regular exercise, particularly outdoors, can make a difference all though the winter.
“We have to continue to get outside even when it’s cold,” said Sharma. “That fresh air, that exposure to daylight plays a big role.”
Some people may benefit from taking antidepressant medication, said experts.
How to prepare
People who know they are prone to seasonal depression symptoms can take steps to be better prepared, said Sharma.
She recommends creating a mid-summer calendar reminder to start monitoring your mood and self-care efforts. Steps could include journaling, eating healthier and sleeping well.
Goldstone advises having a support team in place before the worst of the symptoms hit.
“What do I have to watch for? Who do I need around me to help get me through this?” Goldstone said.
“It’s pretty hard to do that kind of work when you’re down in the tank in the middle of January.”
Other factors
Be mindful of other things happening in our environment at this time of year that may be affecting our mood, said Sharma.
That could be holiday stress or even current events that we find disturbing.
“It’s hard to tease out how much of this is seasonal affective disorder and how much of this is our environment that kind of goes a little crazy towards the end of the year,” Sharma said.
“The environment plays a huge role in our mental health … we are living in a very difficult time.”
If you or someone you know is struggling, here’s where to get help: