If your mood seems to be sinking into darkness and gloom along with the freezing cold temperatures, you are not alone. The winter blues are estimated to affect about 1 in 5 Canadians of which 25 per cent have Seasonal Affective Disorder (SAD), a condition in which severe mood disturbances recur over at least two consecutive winters spaced by non-depressed periods in the spring and summer.
The winter doldrums are often accompanied by fatigue and increased need for sleep, carb cravings, weight gain, loss of libido and withdrawal from friends. But individuals with SAD face more severe symptoms, often sleeping an extra two to four hours, experiencing intense food cravings and weight gain and having difficulty functioning due to extreme lethargy and depressed mood.
SAD tends to present in adulthood and affects eight times more women than men. The further north you travel from the equator, the greater the risk of having winter blues or depression. This geographic pattern is thought to arise due to the seasonal shortening of the light-dark cycle known as the photoperiod.
Melatonin, a hormone released from the pineal gland, an ancient part of our brain linking us with our external environment, is the master time-keeper of our internal clock. It is released in response to darkness and turned off by light. Shortening of the winter photo-period causes melatonin secretion to fall out of sync resulting in a phase delay or disconnect between our internal circadian rhythm and the external light-dark cycle. Increased drive on melatonin production may deplete brain stores of the feel-good neurotransmitter, serotonin, a pattern that is seen in patients with SAD during winter depression. Serotonin is an upstream precursor to melatonin and plays a pivotal role in regulating mood, satiety and feeding behaviours. Seasonal disruption of the serotonin-melatonin pathway contributes to wintertime problems with sleep, mood and weight gain.
Beyond phase delays and serotonin deficiency, SAD tends to run in families and is more likely in individuals who are experiencing high stress, have limited social supports, and have a history of early childhood trauma.
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As we gain a deeper understanding of how circadian and seasonal rhythms are at play within our bodies, we will be better equipped to help patients combat wintertime blues and SAD. Here are six steps to get started.
1. Let in the light!
Research has shown that bright light exposure upon awakening in the morning is more effective than evening light in treating winter depression. Morning light causes a circadian phase advance to offset the effects of shortened winter daylight time on melatonin. So let in the morning sunshine for more sleep and a better mood during the winter months.
2. Move more!
Regular aerobic exercise has significant anti-depressant effects. Unlike non-seasonal depression, the timing of exercise may matter more in SAD. While evening exercise can exaggerate the phase delay and worsen symptoms of SAD, a morning exercise routine especially with outdoor activity can provide synergistic benefits. So pick up a new winter sport like snowshoeing, skiing, or ice fishing to add flavour to your winter work out regimen.
3. Cuddle up with someone
While SAD is associated more closely with changes in light than temperatures, staying warm by cuddling close to someone you care about can help ward off winter blues. Keeping socially connected provides a safety net to prevent early symptoms from escalating into bigger problems and boosting intimacy with your partner can help lift a languishing wintertime libido.
4. Get vaccinated
Winter infections are associated with both mood and sleep disturbances. Individuals who have repeated viral infections throughout the winter such as mononucleosis and flu are more likely to develop SAD. Exacerbating the problem, seasonal circadian rhythm disruption can lower immunity rendering us more susceptible to infection. Vaccination prevents spread and reduces illness caused by winter infection and may prevent seasonal blues and SAD.
5. Follow the snowbirds
The tendency of snowbirds to migrate south may be explained by the science of SAD. Floridians are significantly less likely to experience SAD than those living in the North. Even a short escape to climates closer to the equator with longer photoperiods can help. Sun travel provides more than a break from the routine, it can reduce the toll of wintertime on our health.
6. Get help
If morning light and exercise and maybe a sun get-away are not adequately addressing winter blues or sadness, there may be something more sinister at play. Anti-depressant therapy has been shown to be beneficial when symptoms are severe and debilitating and cognitive behavioural therapy (CBT) may hold promise in treating SAD. Speak to your physician and get help if wintertime blues are dragging you down.
Along with the cold and snow, winter can bring changes to our mood, sleep and well-being. Decoding our complex internal clock, may help us to better understand and treat patients with seasonal blues and SAD.
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