- A decrease in sunlight during fall and winter often sparks depressive thoughts and behavior.
- Seasonal affective disorder (SAD) can be treated by tweaking medication combinations and doses.
- Simple lifestyle habits can prevent and help overcome seasonal affective disorder.
If you feel down, less energetic, and moody in the fall and winter, you are not alone. Seasonal Affective Disorder (SAD) is real! It is a type of depression and its signs and symptoms should be taken seriously.
Each year, many patients complain to me in the autumn or early winter that something’s not quite right. They tell me they feel sluggish, depressed, and irritable—not nearly as energetic as they felt during the summer. They complain that they are overeating, crave carbohydrates, and are either sleeping too much or have insomnia. They say they've lost interest in activities they usually like and are having problems concentrating.
While often people assume having the winter or cold weather "blahs" is "normal," those feeling should never be ignored. Someone who has a mild depressive disorder may find that their intensified depression during the fall and winter months damages their job performance and puts stress on their relationships. Alcohol and substance use can also become a problem for people suffering from SAD.
Inevitably, patients feel relieved when I tell them that their downswing in mood is probably related to the season’s shorter daylight hours and decrease in sunshine. Known as Seasonal Affective Disorder (SAD), the condition is quite common. Below are four lifestyle strategies that can alleviate the depressive symptoms that people with SAD experience. And, if you find that these steps are not enough to help your mood, please talk with your health practitioner about the types of medication modifications I describe below.
4 Lifestyle Strategies
1 Get outside. Studies show that being outside in nature has a positive effect on our mood, cognition, and health. Unfortunately, most people spend less time outside in the cold weather and that is exactly the time we need to soak up sunlight because of the shorter daytime hours. Being active is also an excellent way of combating fatigue and depression. Even a brisk 10-minute morning walk can make a difference.
2. Be mind-body fitness focused. This might be an excellent time to start a yoga practice or take a class in tai chi, qi gong, or meditation. These mind-body practices have an impact on both our physical and emotional selves. They can improve balance, strength, concentration, breathing capacity, and resilience.
Research has shown that mindfulness-based stress reduction can be as effective at reducing anxiety (which generally accompanies depression) as medication. Of course, there are benefits to incorporating mind-body practices throughout the year, not just if and when you are experiencing SAD. Meta-analyses of these interventions have shown that they are effective at regulating mood and modulating anxiety and depression.
3. Plan social engagements. Many people have become more isolated as a result of spending months indoors during the COVID-19 pandemic and working from home or in a hybrid arrangement. The cold weather often exacerbates this tendency to isolate.
It may be tempting to sit at home and watch TV when it’s cold outside but social interaction can help lift our spirits. Whether you engage in community recreational activities or invite friends and relatives to your home, be sure to schedule time to see loved ones.
4. Consider using light therapy. To compensate for a reduction in sunlight, many people use bright light therapy, standing or desk lamps that contain white fluorescent light tubes that block ultraviolet rays. A meta-analysis of studies assessing the effect of light therapy lamps on depression has shown that bright light treatment is effective in mimicking outdoor light and boosting mood. Some health professionals recommend that those with SAD sit in front of a light box for 30 minutes every morning.
5 Medication Modifications to Discuss with your Doctor
Sometimes good lifestyle practices, as I’ve described above, are not enough to spur someone out of their seasonal depression. Many times I find that for the fall and winter months, I need to increase a patient’s dose of the antidepressant drug they might be taking. Or sometimes I will add a small dose of another antidepressant—one that gives an energizing boost, curbs one’s appetite, or reduces anxiety. The ability to tailor medications today to a patient’s symptoms is remarkable. By adopting a “mix and match” approach, it is possible to get the best therapeutic results with a minimum number of side effects. Many, if not all, of these modifications can be reversed once the sunny spring and summer months arrive.
Please consult your health practitioner if you find yourself sinking into a seasonal depression. Here are some of the medication modifications that might be considered and discussed to augment the effect of the psychiatric medication you are taking:
1. Increase the primary antidepressant that has already been prescribed
2. Add another antidepressant from a different category as an augmenting agent.
3. Add a low dose of a drug which quiets negative, ruminative thinking. Abilify is one example of such a medication.
4. Add a low dose of a psychostimulant, like Ritalin or Adderall, to boost daytime energy and help with early morning sluggishness.
5. Add an anti-anxiety medication. This could be a short-acting or long-acting drug, depending on the need.
The experience of falling into a slump during the fall and winter months is very common but there's no need to settle for a depressive and hopeless mindset. Speak to your health practitioner and work together on a plan to ensure that you live your best life all your long.
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