Northwestern Medicine expert offers tips to battle seasonal affective disorder

Northwestern Memorial HospitalFeb 10 2013

Winter is in full force. With short days and less exposure to sunlight, everyone feels less energetic and more people are vulnerable to depression. Seasonal Affective Disorder (SAD), or winter depression, is a mood disorder related to seasonal variations of light. Symptoms start in late fall and oftentimes last until April or early spring. It affects between 10 to 20 percent of Americans, primarily younger adults and women. Although the exact cause of SAD is unknown, experts believe changes in melatonin and serotonin levels, or a disruption in the body's internal clock may be to blame. Northwestern Medicine®  expert John Stracks, MD, says there are ways to beat the blues caused by SAD and suggests those who experience symptoms visit their doctor before symptoms become severe. 

"Even though the days are getting longer now, it is not too late in the winter to experience SAD symptoms and get treatment," said Stracks, a family medicine physician with Northwestern Integrative Medicine.

People who suffer from SAD experience the following symptoms to the extent that they are not able to function normally:   

• Feeling depressed, fatigued and lethargic
• Difficulty waking up in the morning and a tendency to sleep more, although the increased sleep time does not allow them to feel rested
• An afternoon slump in mood and energy
• Increased appetite, especially for foods full of carbohydrates, leading to weight gain
• Loss of interest or enjoyment in activities once enjoyed or with others
• Trouble concentrating

Women with SAD often report premenstrual worsening of these symptoms. 

The primary treatment for SAD is morning bright light therapy, which has several decades of research to support its efficacy.  Light therapy works by providing the brain a large stimulus of light, which causes biochemical changes in the brain that reverses the mood disturbance. The "dose" of light, the distance of the face from the light box unit, and the timing of light are all important factors in treatment. Treatment sessions last 30 minutes and are adjusted based upon response.  Other treatments for SAD include psychotherapy and activating antidepressant medications.  Stracks suggests that people who believe they suffer from SAD be evaluated by a mental health professional to rule out other causes of the symptoms, such as low thyroid hormone levels and anemia and to discuss treatment options. 

For the majority of people who have mild symptoms that do not interfere with functioning, there are small things that can be done to keep mood balanced during this time of year:

• Sleep well – Make sure to wake up and go to bed at the time same every day, including weekends. Doing so will keep the body's internal clock in sync.
• Let the light in – Get as much exposure to sunlight as possible by opening the blinds at home and making sure that work space has natural or bright light.
• Control cravings – Eat a balanced diet while limiting the amount of carbohydrates consumed. Carbohydrates can provide a short-term energy boost but leave a person feeling worse later in the day.
• Embrace an exercise routine – Exercise is not only good for physical health, but also helps relieve the stress and anxiety that can increase the symptoms of SAD.  A daily half-hour walk outside is an excellent plan to improve light exposure and get muscles working.  Yoga and Pilates type classes are a good way to relax and exercise at the same time.
• Learn to manage stress – Take time to relax each day and try to manage stress so it doesn't lead to depression and overeating. Make it a point to stay connected to people who are important to you, as they will help you remain calm and happy.

"The symptoms of SAD should not be ignored and can be treated," said Stracks. "With the proper treatment and regimen, people with SAD can find relief from their symptoms."