Seasonal Affective Disorder is More Than the Winter Blues

By: Rachel Cartwright
Posted In: News

*Names have been changed for privacy reasons.

Every January as winter deepened, Kyle Harris* fell into a slump. He felt tired, worn down, and alone most of the time. In the morning he would struggle to get out of bed and brew his morning coffee, and would often return to bed in the afternoon. Most people find winter dreary, but this was something more serious than simply the winter blues.

This was something that happened every year. Starting in winter, Harris would begin to feel depressed, but by March the symptoms would be gone. Because the symptoms were not constant, Harris chose to live with them. But twelve years ago when his marriage began to suffer, his wife Dana* urged him to see a doctor.

“It was affecting our lives in a major way. He couldn’t function and he was sleeping all the time,” she says. “Someone actually suggested he was an alcoholic, but I knew he didn’t drink.”

Their insurance provider recommended that Harris receive a full check up. When he was psychologically evaluated, his therapist diagnosed Harris with SAD, Seasonal Affective Disorder, a subcategory of major depression.

SAD is an often over-looked depression that is caused by lack of access to sunlight in the winter months. Lack of sunlight causes a chemical imbalance in some people causing reactions similar to those of major depression: lethargy, change in appetite, difficulty sleeping, and feelings of worthlessness. Six out of every 100 people over the age of 20 are estimated to suffer from SAD, according to the American Academy of Family Physicians.

For those like Harris who seek help, there are a variety of treatments. A combination of light therapy, prescription drugs, and counseling is used by psychiatrists to combat the symptoms of SAD and allow their patients to live normally.

Sr. Dorothy Maloney, head of Salve Regina University’s counseling department, says it is easy for most people to ignore the symptoms of SAD.

“A lot of people don’t believe in it. It’s not in many books, and a lot of people don’t believe you should get treatment for depression,” Maloney says. “They have that whole ‘pull yourself up by the bootstraps and snap out of it mentality.'”

One reason people avoid diagnosis is that they don’t realize the symptoms they have are a pattern of depression. Since people aren’t unhappy year round, they create excuses for their depression, ignoring that it happens each winter year after year.

But ignoring the problem can become serious, according to Colette Lafond, Program Coordinator of Adult Outpatient services for Newport’s Mental Health Facility.

“In the beginning it’s just the blahs and people will make excuses. They’ll say, ‘Oh, it’s just so cold out all the time,’ or ‘I’m just a little stressed.’ But if gone untreated, it can become a major depressive episode,” Lafond says. “It can evolve to the point of becoming suicidal if left untreated long enough.”

SAD is a subcategory of major depression. Psychiatrists use it as a separator that can be applied to chronic depression and bipolar disorder to give a more specific diagnosis. People with SAD suffer from a type of depression that only shows itself in winter months.

“I think the first things people will notice are the physical. They’re sleeping more in the daytime but will still feel tired,” Lafond says. “Ironically, the more people with SAD sleep in the daytime the more fatigue they’ll feel.”

People with SAD may have uncontrollable cravings for starchy comfort foods such as bread, potatoes, and cakes. Eventually people begin having emotional reactions including decreased motivation, feelings of worthlessness, and irrational disappointment with their job, children, and marriage.

“People with SAD feel like, ‘Why should the bother,'” Lafond says. “They’ll say ‘I’m just a burden,’ and they won’t bring it to their family members because they don’t want to be a further burden.”

The symptoms of SAD are often difficult for family members to accept. Dana Harris couldn’t figure out why her husband was acting so out of character.

“I was puzzled. I knew him to be a good man, but I couldn’t figure out why he wasn’t doing what he was supposed to be, like everyday chores,” she says. “He was cranky and grumpy all the time.”

Living in Wisconsin put Kyle at a higher risk for suffering from SAD because it is in the northern latitude. People who live in northern latitudes such as Nordic countries or areas in the northern part of the United States are especially vulnerable because the winters are longer and the sun is usually blocked by clouds.

Studies have not linked ethnicity to SAD, but both age and gender are strong factors.

“Younger persons in their 20’s and 30’s are at a higher risk and women comprise between 60 and 90 percent,” Lafond says. “But we don’t know why.”

Although symptoms usually show early in life, it takes a different climate to aggravate the pre-disposition. The move in 1974 from Missouri to Milwaukee triggered Harris’ symptoms.

“Things that I remember are that Missouri winters aren’t like Wisconsin winters. When I was a little kid, winter wasn’t so bad so I went out more,” he says. “The days were nicer, and interesting enough to get you up and out of the house into the cold. The sun was so bright it was blinding, and the sky was so blue. That’s not typical of Wisconsin.”

While people with SAD can’t change the weather, they can change how they react to it. There are three popular methods therapists recommend to patients: therapy, light treatment, and prescription medication.

Light therapy involves exposing the patient to high powered light sources in different levels for approximately half an hour each day. A light box administers a dosage containing 10,000 lux, the international measurement of illumination. This dose of light is equivalent to the amount that would be available outside on a summer day.

One advantage is that people can purchase light boxes and keep them in their homes. Lafond prefers a combination of light therapy and prescription drugs. Because the symptoms are only present in winter, it is easier to put patients on medication for a few months. Light Therapy delivers results quickly.

“A response can occur between one and four weeks, after only thirty minutes a day,” Lafond says. “Now, there are even dawn simulators that can administer the light in the morning and slowly wake people up.”

Sr. Maloney agrees that light treatment is preferable to therapy or medication in cases of SAD, although she would normally recommend talk therapy in other forms of depression.

“I’m a little biased. I was taught to think that therapy could cure anything,” Maloney says. “But light therapy is more natural. And what would be the use of talking about the depression? By the time you’d be out of therapy, winter would be done anyway.”

In cases where light treatment is not fully effective, psychiatrists prescribe medications that are affective against mood disorders. Prozac and Zoloft effectively treat SAD.

Harris uses a combination of light treatment and medication to combat his SAD. After 18 years of suffering, he was relieved to find out that his depression wasn’t simply the winter blues, and could be fixed.

“Everybody is happier half way through March, and I think there’s something to that,” Harris says. “But you have to make a distinction. I can’t imagine what it would be like without knowing how to deal with this.”