Brutal Weather, Depressed Mood, What We Can Do About It

Our cruel winter took a greater toll on us than has been recognized.

Posted May 05, 2015

            Our cruel winter in the Northeast took a greater toll on us than has been recognized. I know it took a toll on me and it took its toll on my patients. I could feel the effects of day after day without sunlight --cold weather, snow, rain and cloudiness --on my mood. I felt slightly depressed; I had less energy than usual, and wanted to sleep more than usual. I live and practice in a northern suburb of New York City. February in New York was the coldest since 1934 but March and April was even harder to deal with. When it started to warm up, and we had some hope that spring might actually arrive,  we had rain, rain, and more rain.

             I received more calls than usual from people wanting to start psychotherapy, and according to the New York Times Sunday edition, so did many other psychotherapists. People who were accustomed to being on antidepressants were increasing their dosage, said the article "Why Must Spring Be So Passive Aggressive?" (Meltzer 2015). Now that I've been out in a few consecutive days of sunlight, it really does feel that spring is actually here and I feel so much better.

            If you felt more depressed than usual, fatigued, irritable, were sleeping more, had little motivation to do things, and were turning to comfort food, you may well have been feeling the effects of Seasonal Affective Disorder (SAD). The acronym SAD is an apt one. Usually the depression is within the mild to moderate range, but some people succumb to what is called major depression, in which the risk for suicide is greater. Those who suffer from non-seasonal depression or  Bipolar Disorder may find their illness exacerbated during these seasonal changes.

            For much of the 20th century, Sweden had one of the highest suicide rates in Europe. It may seem strange that countries such as Sweden and Denmark that consistently score high on measures of happiness and life satisfaction also have relatively high rates of suicide. It may well have something to do with the long dark winters. 

            It was psychiatrist Norman Rosenthal who first identified Seasonal Affective Disorder. He noticed that after his move from sub-tropical Johannesburg to New York, where the weather changes with the seasons,  he was less energetic during the winter. He researched it and went on to write Winter Blue,: Everything You Need to Know to Beat Seasonal Affective Disorder (2012). He found that around one in ten of those who lived in the northern United States and Europe experienced  seasonal changes in their mood and behavior while virtually no one in sunny Florida did.
            In its most severe form SAD affects five percent of the U.S. population and causes a great deal of difficulty in functioning at work and in relationships. A milder form affects fourteen percent of the population, not severe enough for those who have it to seek medical attention. Nonetheless, this group feels less energetic, less creative and productive during the dark winter days. We need sunlight to feel our best. Many people affected by SAD find that their mood improves when they are in a sunny climate in the winter and so may flock to Florida. We all cannot do that and so the next best option may be treating or preventing winter SAD

            We know that many who have difficulty getting a good night's sleep benefit from the use of melatonin supplements. It was found that bright light can suppress melatonin in human beings, a factor in its success in treating winter SAD.   In 1984, it was discovered that many people with SAD experienced marked improvement through seasonal use of light boxes that emit far more light than is usually available indoors. Light boxes can be purchased at department stores, some drugstores, Amazon.com, COSTCO and other discount warehouse stores for less than $100. For most people who use them, they are quite effective. In light box therapy, one sits in front of a light box, exposed to 2000–10,000 lux for 1/2 to 2 hours daily during the winter. It need not shine directly in your face. I bought a light box, kept it on the kitchen table and turned it on when I sat down to breakfast and the newspaper in the morning. Within a week or so I felt a positive effect. For the optimal effect, you may need to experiment with the time spent with the light box and your distance from it.  A word of caution is needed; those with SAD who also have Bipolar Disorder should be especially cautious and consult their psychiatrist about using a light box because  it  may arouse manic symptoms if used without supervision.

            Other forms of light treatments, pharmacotherapy, and other therapies are currently being tested for SAD. Because the neurotransmitter or brain chemical known as serotonin seems to be dysfunctional  in SAD,  if you try light box therapy and it is not successful, you may well benefit from an anti-depressant medication, especially of the kind known as a Selective Serotonin Reuptake Inhibitor (SSRI), such as Prozac, Zoloft, or Paxil  Although physicians who are not psychiatrists can prescribe these drugs, a psychiatrist is better equipped to evaluate and prescribe for your mood disorder. Unfortunately, these medications sometimes come with adverse side effects.
            An  alternative to treatment is prevention of SAD through the use of bupropion XL (Wellbutrin), 150-300 mg daily before winter starts. This was successful for 44% com[pared to those who received a placebo
            We seem to be out of the woods now but hopefully this information will equip you to deal with our next trial of punishing weather.
 

Meltzer, M. (2015). Why Is Spring Being So Passive Aggressive? The New York Times. April 17.

            http://www.nytimes.com/2015/04/19/fashion/why-is-spring-being-so-passive...

Rosenthal,N. (2012). Winter Blues, Everything You Need to Know to Beat Seasonal Affective Disorder. New York, Guilford Press.