'Tis the Season to Be... Not Jolly

Here's what you can do to beat back the winter blues.

Posted Sep 29, 2020

Maridav/Shutterstock
Source: Maridav/Shutterstock

The “winter blues,” or what’s technically called Seasonal Affective Disorder—aptly abbreviated SAD—is a very real psychiatric condition. 

Much more than a “winter funk,” SAD can rise to a level of severe and sometimes incapacitating intensity. Its name derives from the fact that it often occurs during the late fall and winter months, and resolves during the warmer and longer days of spring and summer. What few people know, however, is that there is a spring and summer variant of SAD, too. And that the symptoms of SAD overlap significantly with the symptoms of clinical or major depression.

Indeed, SAD symptoms include:

  • Feeling sad most of the day nearly every day
  • Losing interest in activities you usually enjoy
  • Disturbances with energy, sleep, appetite, and concentration
  • Feeling fatigued or agitated
  • Feeling guilty or hopeless
  • Loss of self-esteem
  • Thoughts of death or suicide

Also, as is the case with clinical depression, if untreated, SAD often leads to complicating factors such as withdrawing socially, problems with work or school, substance abuse, anxiety or eating disorders, and even suicidal behavior.

To complicate things even further, this fall and winter will occur during the most devastating pandemic the world has seen in over 100 years. In fact, a recent survey indicated that 50 percent of those responding reported already struggling with some significant depression symptoms—twice as many as in 2018 and 2019 (Bates, 2020). So it’s not just the double whammy of the seasonal flu exacerbating COVID-19 we’ll be up against in the coming months, but also the confluence of SAD with an already staggering amount of people suffering from symptoms of clinical depression.

The specific causes of SAD, as is the case with major depression, are not fully understood. But data from the Mayo Clinic suggests that disruptions in circadian rhythms (the “biological clock“) due to a decrease in light stimulation can alter the brain’s levels of melatonin and serotonin which, in turn, disrupts mood and other rhythms (e.g., sleep, energy, appetite, and concentration).

Indeed, depression is being increasingly understood and characterized as an arrhythmia of the brain (e.g., Llinas, R. R., et al. 1999). The brain is an amazingly complex and intricate bioelectrical organ that has various rhythms and cycles. Some are moment-to-moment (e.g., mood, energy, and concentration), while others are hourly (e.g., hunger), daily (e.g., sleep), and monthly (e.g., menstruation). Thus, anything that disturbs the brain’s natural equilibria can lead to a wide range of psychological and physical symptoms.

The good news is that SAD responds wonderfully to a totally non-invasive, non-medical treatment called phototherapy or light therapy. As amazing as it sounds, simply sitting in front of a specific type of light energy for about 20 to 30 minutes a day can literally shine seasonal depression away. But the light needs to be of a specific intensity to be effective. And while the Internet and media are packed full of ads for various kinds of “therapeutic,“ or “full-spectrum“ lights, the vast majority of them will not effectively treat SAD. This is because they usually lack the intensity an effective therapy light must have.

Here are the three essential aspects of effective phototherapy. 

Intensity

To be effective, a light must produce 10,000 lux. A lux is a unit of illuminance or the amount of light energy that illuminates a specific area. The catch here is the amount of lux is a function of distance, meaning a light can claim to emit the requisite 10,000 lux but only at a distance of 6 inches from the surface being illuminated—in this case, the face and eyes—because, obviously, the closer one is to a light source the brighter it will appear. It is generally recommended that for treating SAD, the source of light produces 10,000 lux at 12 to 18 inches from the face.

Very importantly, the light is not to be looked at directly. Rather, its energy should enter the eyes indirectly. As I’ll discuss in further detail below, placing it at the appropriate distance from one’s face (to ensure receiving the necessary 10,000 lux) and then simply going about one’s business is all that’s necessary.

Duration

In addition to intensity, an effective light is best used for 20 to 30 minutes daily. As is the case with medicine, however, light therapy can be gradually introduced in increasing amounts over the course of a week or two. Starting with five or 10 minutes a day and progressing to 20 to 30 minutes is often recommended—especially for people who have never used phototherapy before. And just like with many standard medicines, missing a dose or two will not diminish the therapy’s overall efficacy.

Timing

It is generally recommended that people begin light therapy in the early fall and continue to use it through the spring. It is also usually best when the light is used in the morning soon after awakening. As noted above, it is important to avoid looking at the light directly. So simply putting it on a table or a desk while having breakfast, checking email, reading the paper, putting on cosmetics, or using your phone is perfectly fine to do. In fact, any way you can integrate using the light into your morning routine will help establish the consistency of use that is important for optimum therapeutic benefits.

Some Cautionary Information

As is the case with typical antidepressants, phototherapy can cycle bipolar people into hypomanic or manic episodes. It can also disrupt sleep if used too late in the day or too soon before bed. Other side effects that have been reported include eyestrain, headaches, nausea, and irritability. But most of these are transient and pale in comparison to the benefits light therapy produces.

Some resources that can guide one to safe and effective light therapy devices include the Mayo Clinic, Harvard University, and a qualified healthcare provider.

Remember: Think well, Act well, Feel well, Be well!

Copyright Clifford N. Lazarus, Ph.D., 2020. This post is for informational purposes only. It is not intended to be a substitute for professional assistance or personal mental health treatment by a qualified clinician.

Dear Reader: The advertisements contained in this post do not necessarily reflect my opinions nor are they endorsed by me. —Clifford

References

Bates, T. (2020). The Week. Vol. 20, Issue 995.

Llinas, R. R., et al. (1999). Thalmocortical dysrhythmia: A neurological and neuropsychiatric syndrome characterized by magnetoencehpalography. The National Academy of Sciences.