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Vancouver's UBC Hospital Mood Disorder Clinic says about two per cent of Canadians suffer from a seasonal affective disorder (SAD), a form of depression that occurs during the darker, colder months of the year. (David Zalubowski/AP)

In Depth

Mental Health

SAD: Dealing with seasonal affective disorder

Coping tips

Last Updated Feb. 29, 2008

Pedestrians brace against strong winds as they climb a hill in St. John's as a snowstorm hits the Newfoundland capital on Dec. 28, 2007. Research indicates that people are crabbier, more depressed and lazier in the light-deprived winter. (Jonathan Hayward/CP)

Sub-zero temperatures, shorter days, longer nights — Canadian winters aren't the most inviting. Although many people embrace this time of year and take advantage of snow sports and festivities, at least 600,000 Canadians have a particular reason to dread winter, according to figures from Vancouver's UBC Hospital Mood Disorder Clinic.

The clinic says about two per cent of Canadians suffer from a seasonal affective disorder (SAD), a form of depression that occurs during the darker, colder months of the year.

Jennifer Hicks is among them.

Five years ago, Hicks was diagnosed with SAD. As she describes the heavy feeling that descends on her in the snowy weather, there's little inflection in her voice.

"I can add (inflection) in but it's difficult, it's not natural. It's also harder to smile. It takes more effort and doesn't feel genuine," she says. "When the daylight is around, I have energy. When [the sun] goes or it's cloudier, everything becomes more difficult. I don't want to be responsible to make decisions.

"It's like I go into survival mode — I can take care of the necessary things like paying bills, but laundry and cooking I have to let go of. I just can't manage it. I have a 'why bother' attitude," Hicks explains. "It's a very pervasive feeling. It's always there. It's like a dreadful, heavy feeling in the pit of my stomach from October to March."

Degrees of SADness

According to the Mood Disorder Society of Canada, two to four per cent of Canadians suffer from full-blown SAD.

Dr. Raymond Lam, professor of psychiatry and medical director of the Mood Disorder center at the University of British Columbia, says that another 15 per cent of the population has a milder form of SAD, typically called the winter blahs. "Like anything else in psychiatry, there are degrees � SAD is at the extreme end of the spectrum."

The most common symptoms of SAD include extreme fatigue, oversleeping, not being able to get out of bed, overeating, carbohydrate cravings and weight gain. It can also be accompanied by the regular symptoms of depression, such as low mood, loss of interest in activities and trouble concentrating.

"In other sorts of depression, people have a loss of appetite and often lose weight or they have insomnia. People with SAD usually have the opposite symptoms," he explains.

Coping strategies

Hicks' condition lies on the extreme end of the spectrum and it's forced her to make some serious life changes. Once a full-time speech pathologist with a clientele of brain injury sufferers, she has scaled back to just a few clients. Speech pathology isn't the main focus of her life any more.

"That became stressful and a little too strained," she says of her former career.

Hicks now works as a "Nia" instructor. Nia is a body-mind-spirit cardiovascular fitness practice that combines dance and martial arts techniques. She finds this helps her regulate her mood and alleviate the symptoms of SAD.

Hicks has also been diagnosed with bi-polar disorder, which is not uncommon in people with SAD. Because of the dual diagnoses and her desire not to over-medicate, Hicks uses lifestyle management, rather than drugs, to find relief.

"I've been through a lot of therapy so I know what to do. I have to make sure I am keeping active, not retreating or withdrawing and surround myself with positive people," she says.

Hicks adds that not watching the news and getting enough sleep also makes a big difference.

Seasonal affective disorder, like many mental illnesses, can also be treated and managed by various methods, including light therapy, medication and cognitive behaviour therapy. Those with less severe cases can often find some relief through regular exercise and outdoor activity.

According to the Mayo Clinic, light therapy, also called bright light therapy or phototherapy, has been used to treat SAD seasonal affective disorder since the early 1980s. Many mental health professionals now consider light therapy to be standard treatment for seasonal affective disorder. It involves sitting, eyes wide open, in front of a light box — a small, portable device that contains fluorescent bulbs or tubes — for approximately 30 minutes a day.

The light emitted from the device mimics natural light and causes a biochemical change in the brain that lightens mood and helps relieve SAD symptoms. It is not the same light that is found in tanning beds, so there is no risk of getting a burn or UV exposure.

"Sixty to 80 per cent of people with SAD find substantial relieve from using light therapy," Lam said.

According to a study done at the UBC Mood Disorder Clinic, light seems to work as well as medication. Light therapy has slightly fewer side effects than drugs, but Lam adds that many people don't have any side-effects to medication so it isn't normally an issue.

"It's often a matter of preference," Lam said. "The two therapies seems to be equally effective."

Cognitive behaviour therapy, meanwhile, is a type of counselling that focuses on modifying certain thoughts and behaviour patterns to control the symptoms of a condition.

CBT is often used to treat anxiety and depression, but its effects on SAD in particular haven't been studied as thoroughly as those of light therapy, and so it isn't normally a physician's first recommendation for treatment.

While there are several approaches to treating SAD, Lam recommends getting a proper diagnosis and treatment advice from a professional before issuing a self-diagnosis and purchasing a special light or murmuring CBT mantras.

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