It’s the time of year in the Northern Hemisphere when daylight length and sun angle relative to the horizon shrink to their lowest levels of the year, and the darkness of night descends in the late afternoon hours. And with that comes the mental doldrums of winter Seasonal Affective Disorder or SAD. Individuals vulnerable to seasonal effects may experience anxiety, sadness, sleep problems, loss of focus, mental fog, weight gain and loss of energy or drive. Suicidal thinking is always a factor to consider when significant depression sets in. Body image can take a hit as there may be a natural impulse to increase carbohydrate consumption, adding excess calories during a more sedentary period of time. All these symptoms can actually reveal themselves in late September and October as the march to winter begins.
A percentage of people with bipolar or manic-depressive symptoms find their mood tumbling in the dead of winter, only to rebound to a hypomanic or manic level in the spring with the return of longer daylight. Perhaps 4-6% of people sensitive to winter SAD suffer from full-blown depression and find winter extremely difficult, especially at latitudes of 40 degrees north or higher. Across all latitudes of North America winter SAD symptoms can be experienced. Seasonal depression is not the same as holiday blues, a milder form of dismay and dysphoria triggered by holiday gatherings and anniversary reactions related to year-end traditional celebrations. The necessity of virtual connection with family members as a COVID-19 safety practice might lessen the impact of stressful family get-togethers.
On the other hand, COVID-19 forces home confinement, disconnect from loved ones and friends and creates daily hassles and grief. People are exhausted and desperate for remedies. Winter SAD adds a greater burden to those suffering from chronic COVID-19 physical and mental effects.
Facing prolonged intervals of time at home amid the Groundhog Day repetition of life, individuals, impacted by fatigue, boredom, and loss of motivation, may nap intermittently during the day, eat or snack at irregular times, mindlessly watch TV or surf the internet late into the evening. These patterns throw body clock rhythms out of kilter. There are reports in the literature of significant and at times intense dream activity around COVID-19 themes related to fear, anxiety and helplessness. Restorative sleep takes a hit.
An empowering choice to manage winter SAD is to increase daytime indoor illumination, especially since cold, icy weather deters quality outside time. Consider one’s windows – are they allowing maximum amounts of light? Are people spending more time in parts of their home or apartment that receive mid-day sunlight? Is the interior décor reflecting light or absorbing it?
Trying to establish a sleep schedule with earlier bedtimes and morning awakening times provides more opportunities for capturing whatever natural light exposure exists during the short winter days. A remedy discussed in the scientific and clinical literature involves artificial full-spectrum light sources (light boxes). These devices, when used with appropriate health care professional oversight, offer additional stimulation and potential increases in neurotransmitters known to enhance mood. Studies show that bright natural or artificial light can suppress morning melatonin levels and allow one to kick start the day. Exposure to morning light can also help people better regulate their sleep-wake cycle overall.
Primary care, naturopathic, holistic or mental health providers may suggest Vitamin D supplementation, increased outdoor daytime physical exercise (weather permitting), counseling and/or medication as well as dietary modifications. Medical providers have resorted to selective serotonin uptake inhibitors (SSRIs) such as Zoloft or Prozac to combat winter SAD. Serotonin levels are depleted in the central nervous system during the winter season and contribute to states of depression and irritability. Cognitive-behavior therapy, a type of psychotherapy that looks at the interrelationship of thought, feeling, and action and challenges maladaptive beliefs, has been utilized effectively with winter SAD sufferers.
Winter SAD generally remits in the springtime, though some individuals may remain depressed. A variant of seasonal depression during the summer exists, fueled by excessive daylight or high ambient temperatures.
As the winter months of 2021 come and go, certainly there will be more light coming through the dark tunnel that we collectively find ourselves in.
National Suicide Hotline: 1-800-273-TALK or 1-800-273-8255.
Dr. Michael V. DeSanctis, PhD, Licensed Psychologist, Diplomate Board of Behavioral Sleep Medicine, December 2020