Winter Makes Me a Little SAD: What You Need to Know About Seasonal Affective Disorder

Andrew Siegel, MD   12/21/2019  Winter Solstice

Today is the first day of winter in the Northern Hemisphere, the day of the year with the least amount of daylight: sunrise at 7:16 AM and sunset at 4:31 PM.  As bad as this is, it is a whole lot better than Reykjavik, Iceland, where sunrise is at 11:22 AM and sunset at 3:29PM!  Today is an opportune time to review the effect of light on our moods and the topic of seasonal affective disorder. Limited daylight hours in the Northern hemisphere in the winter and the Southern hemisphere in the summer can not only give rise to the “winter blues” with mood swings, fatigue and altered eating patterns, but on a more serious note, can engender a major depression in certain people.

Although winter can be beautiful–earlier this week we experienced a unique glazing of trees that left them silvery, crystallized and tinselled–but I don’t particularly care for dark, dreary, dormant, cold and grayscale, much preferring light, bright, warm, and the blue skies and the vibrant greens of spring and summer.  However, in the words of Anne Bradstreet: “If we had no winter, the spring would not be so pleasant” and in the words of Albert Camus: “In the depth of winter, I finally learned that within me there lay an invincible summer.”

 

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Sunrise this morning, winter solstice 2019, Ridgewood New Jersey

 

It is remarkable how much the presence or absence of light affects one’s mood.  I have noticed that even a passing cloud that transiently dims the ambient light in our living room immediately affects my mood, with a bit of gloom replacing cheer, only to pass as the cloud moves on. 

The pineal gland is that fascinating and mysterious structure situated deep within our brains that responds to light and dark by producing and regulating a variety of hormones–biochemical messengers that can have profound psychological effects. 

Whether seasonally-related or due to long-distance travel, altered quantity of light exposure and disturbance in one’s biological clock can cause range of effects, from a minimal blah feeling to a profound depression. Many people experience minor fatigue, lethargy, and mood swings, while still others experience the winter doldrums or travel “blues,” while a third group react with profound psychological and emotional issues that can be life-disruptive, including irritability, social withdrawal and even suicidal thoughts.  It is the third group that suffer from seasonal affective disorder, a seasonal pattern of major depression with inclusion criterial as delineated in the Diagnostic and Statistical Manual of Mental Disorders. It affects 5% or so of the population and is much more common in females.  The symptoms typically abate during the seasons that have longer days.

The chemical basis for S.A.D. is incompletely understood.  However, fluctuating levels of serotonin, melatonin and other chemical mediators that respond to daily rhythmic light and dark changes likely play a key role. It is probable that genetic factors also contribute to S.A.D. The phase shift hypothesis is that with the shorter days of winter one’s natural circadian rhythm drifts later as sunrise occurs later and later, out of sync with one’s natural sleep-wake cycle, similar to what happens with a prolonged jet lag.

So, what to do?  Light therapy (phototherapy) using desk lamps or light-box devices can be an effective management strategy that works by getting the circadian rhythm back in sync with one’s sleep-wake cycle.  Light therapy is recommended as a first-line option for the treatment of S.A.D.  It generally involves at least 30 minutes of bright light exposure upon awakening. Search “light therapy for SAD” and you will come up with numerous options.

Exercise, by releasing a cocktail of happy chemicals from one’s “internal pharmacy,” has been found to be a helpful antidote for all forms of depression, including S.A.D. The class of anti-depressants known as SSRIs (selective serotonin re-uptake inhibitors) have found utility.  Melatonin supplementation has proven helpful for some people.  Certainly if one has significant S.A.D., psychological or psychiatric consultation and consideration for cognitive behavioral therapy can be effective.  Additional strategies include yoga, meditation and mindfulness practice.

For more info on what to do: How to cope with seasonal affective disorder.

Wishing you the best of health and an invincible summer within the depth of winter,

2014-04-23 20:16:29

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States.  His latest book is Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families. 

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Video trailer for Prostate Cancer 20/20

Preview of Prostate Cancer 20/20

Andrew Siegel MD Amazon author page

Prostate Cancer 20/20 on Apple iBooks

PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families is now on sale at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours). 

Dr. Siegel’s other books:

FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health

Video on THE KEGEL FIX 

 

 

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One Response to “Winter Makes Me a Little SAD: What You Need to Know About Seasonal Affective Disorder”

  1. Mitchell Radow Says:

    Good article Andy, both different and interesting. I find sunlight to be an amazing natural medicine with incredible physical and mental benefits. Can’t find very much here in jolly old London town but when it appears, I take maximum advantage. Cheers,

    Mitchell

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