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Mental health

Winter's SAD times

Last Updated January 22, 2008

Winter got you feeling like you don't want to get out of bed? That's probably nothing to worry about — unless you find your mood slipping around the time the clocks go back in October until they spring ahead in March.

You could be suffering from Seasonal Affective Disorder (SAD), a form of depression that follows a seasonal pattern.

The Canadian Mental Health Association estimates that one to three per cent of Canadians suffer from cases of SAD that are bad enough to affect their ability to cope with life.

Of patients suffering from a major depression, 11 per cent are also likely to develop SAD as the longer daylight hours of spring and summer fade into autumn and winter's longer hours of darkness.

"As the days get shorter, you are more vulnerable," Dr Roger McIntyre, head of the mood disorders unit at the University Health Network in Toronto, told CBC News. "It is not the cold weather."

SAD was recognized as a disorder in the early 1980s, but researchers have been aware of its symptoms for 150 years. One of the problems with diagnosing SAD is that its symptoms are similar to other types of depressions. Those symptoms include:

  • Loss of pleasure in activities.
  • Persistent sad, anxious or "empty" mood.
  • Irritability and desire to avoid social contact.
  • Depression that subsides in the spring and summer months.
  • Changes in appetite, especially increased cravings for sugary or starchy foods.
  • Weight gain.
  • Decreased energy
  • Difficulty concentrating.
  • A tendency to oversleep.

Many people don't realize there's anything wrong. They may dismiss their symptoms as the winter blahs, which might peak in January and February and go away as the daylight hours get longer. But if the symptoms return two years in a row, it may be time to seek medical attention.

Location, genetics, age may be factors

So far, researchers have not been able to identify a cause for SAD.

"The leading theories are that there is something abnormal about the circadian rhythm — our day-to-day rhythm," McIntyre said. "If we can alter that pattern in the clinic, we may be able to return persons back to work and improve symptoms."

Some studies have suggested that people who live in northern latitudes are more susceptible to the condition than those who live further south, where the hours of sunlight don't vary as drastically. For example, less than 0.9 per cent of Asians seem to be affected.

But there may also be a genetic link. An American study published in June 1999 found that 13-17 per cent of people who develop SAD have an immediate family member with the disorder.

Age may also be related. SAD is rare among children and teenagers. The risk increases once you've hit the age of 20. It affects more women than men. But as you hit middle and old age, you are less likely to suffer from the condition.

Your workplace may also increase your risk — especially if you leave for work when it's dark out, go home after the sun sets and don't see much of winter's daylight hours in between. The risk is also greater for people who work shifts.

Treatments

SAD is treatable. The Canadian Mental Health Association notes that even people with severe symptoms — including thoughts of suicide — respond quickly to treatment.

For some people with mild symptoms, taking a vacation in a southern climate — or making a point of getting outside during the daylight — could turn things around. Often SAD symptoms return shortly after the vacation ends.

For those with more severe symptoms, a mixture of light therapy, cognitive therapy and medication usually does the trick.

Light therapy — where a patient sits directly in front of a special light board designed to shine light into the eyes once or twice a day, from 30 minutes to a couple of hours — is estimated to be effective in up to 80 per cent of cases. The light box should emit the equivalent of the output of eight fluorescent bulbs.

Light therapy works to regulate your body's production of melatonin, a hormone that lets your body know when it's time to sleep or when it's time to wake up. It's believed the dark winter months may disrupt melatonin cycles.

Other things you can do to reduce your risk of developing SAD include:

  • Trim tree branches that block some of the light from getting into your home.
  • Keep your curtains opened during the day.
  • Exercise outdoors.
  • If you exercise indoors, do it near a window.
  • Watch your diet.

But if you're thinking about booking a few sessions at a tanning salon, you might want to reconsider. You need visible light to boost your spirits — not the ultraviolet rays put out by tanning beds. The World Health Organization warns that tanning beds pose a risk of skin cancer and no one under the age of 18 should use one.

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