Winter Blues: What is High-Functioning Depression? How to Handle Seasonal Affective Disorder.

It’s not unusual to feel a little isolated and down in the dumps at times during the winter months. Those short, dark days in January and February can bring about moments of the “winter blues.” And many of us have been laid up with viruses like the flu recently too.

But if you are experiencing significant behavioral changes, you may have a more serious condition like depression — or more specifically a type of depression that develops around this time of year known as known as Seasonal Affective Disorder (SAD).

Nearly 21 million Americans suffer from some form of depression. Recently, the tragic death of entertainer Stephen ‘tWitch’ Boss by suicide has shined a spotlight on how difficult depression can be to detect at times and how people often hide feelings of sadness and despair from those around them.

David Downing, PsyD, a phycologist on Summit Health’s Behavioral Health team, explains what you need to know about SAD, its causes, and how to treat it so you can enjoy your winter season. He also sheds some light on high-functioning depression in a related story.

 

What causes SAD?

The amount of sunlight that reaches our eyes and body can affect the chemicals in our brain. These chemicals help regulate processes like our mood and sleep cycle.

When there is less sunlight, people can have either a slow or sudden onset of depressive symptoms. Many people are surprised to learn this can also occur when there is a rapid increase in sunlight as well.

Since being out in the sunlight helps the symptoms of SAD, the pandemic may have exacerbated this condition for many because they had to stay indoors. Dr. Downing says: “people have been staying indoors more because of the pandemic. As a result, it is even more important for people with SAD to get outside of their houses and expose themselves to sunlight along with activities that stimulate their minds and bodies.”

 

Symptoms of SAD

Nearly three million people suffer from SAD. The symptoms of SAD are similar to major depression. Most people think of SAD as occurring from fall to winter. But there is also a type of SAD that happens from spring to summer. Here are the signs to look out for at different times of the year:

  1. Fall to winter
  • Feelings of depression, hopelessness, helplessness, and excessive guilt that do not go away
  • Loss of energy, tiredness, oversleeping, or loss of desire to socialize
  • Overeating, craving carbohydrates, and weight gain
  1. Spring to summer
  • Feelings of depression like those experienced from fall to winter
  • Insomnia, agitation, anxiety, and irritability
  • Loss of appetite and weight loss

SAD is also triggered by where you live. People who live in higher latitudes, where there tends to be less sunlight, are more likely to experience symptoms. For example, only 1.4% of the population in Florida experiences SAD compared to nearly 10% in Alaska.

 

Treatments for SAD

“Seasonal Affective Disorder can be treated in a variety of ways and may require a combination of interventions,” explains Dr. Downing. “The first thing you should do if you feel you are suffering from SAD is to visit your physician or behavioral health specialist for a formal diagnosis and to develop a treatment plan.”

The following therapies have proven effective, either alone or in combination with each other.

  • Light therapy: Increasing the amount of light you are exposed to can help manage your symptoms. During the winter, go out into the sunlight or sit by the window in the morning for 20 to 30 minutes. Another option is to get an affordable, full-spectrum light. Check with your physician or mental health specialist before you begin any light therapy treatment and follow their instructions.
  • Medication: Antidepressants are another option. You can take a continuous, year–round regulated dose, or a seasonal dose that may be higher during the onset of SAD and then taper off as your symptoms lessen. Medication is often combined with cognitive behavioral therapy. Your health care provider will help customize a treatment plan to fit your individual needs.
  • Cognitive behavioral therapy (CBT): In CBT, patients work with a therapist to help them think clearly and realistically about their symptoms and ways to improve them. They will also learn behaviors to help better manage or improve their symptoms. For example, Dr. Korman says to make sure patients are not isolating themselves, oversleeping, or overeating as these can make their SAD worse.

 

Tips for treating SAD

  1. Get plenty of sunlight and take walks or participate in outdoor activities
  2. Eat fewer carbohydrates
  3. Keep up with daily routines
  4. Socialize with friends
  5. Exercise

If these approaches don’t work for you and you continue experiencing symptoms of SAD, see your physician or mental health specialist.