Depression

Seasonal Affective Disorder Beware the Winter Blahs!

Virginia J. Duffy PhD, Psychiatric Nurse Practitioner

That time of the year will soon be on us again. “It” may be called by any number of names, Seasonal Affective Disorder (SAD), Cabin Fever, and Post Holiday Blues. These are types of depression or the blues that occur during winter months.

SAD is the most serious. It is more then the blues but is actually a depressive disorder, although perhaps less severe. Symptoms of SAD (and any depression), include: feeling overwhelmed, frequent crying, and irritability (being easily annoyed). Sleep disturbance may be experienced as either sleeping too much, or having trouble sleeping. Appetite disturbances can also go either way that is, loosing your appetite and weight loss or increased appetite and weight gain.

Post Holiday Blues is a phenomenon of being let down after all the excitement and activities of the season. For those of us who live in the north, the view from Jan 2 tends to be one of three long months of cold and gray. Cabin Fever usually refers to boredom and restlessness that occurs after a time of decreased activities and hum drum days and evenings in a limited space.

What can you do to avoid these situations ? For SAD the most successful treatments are Light Therapy and or antidepressant medications. Light therapy allows the brain to receive the light it needs to decrease the nighttime hormone of melatonin and increase serotonin and other neurotransmitters in the brain. This relieves depression, in the same way that antidepressants do.

Light therapy can be had for free by going outside before 12 noon for 30 minutes every day, without sun glasses. This works even on cloudy days. To use artificial light you can buy a light box for about three hundred dollars, or you can make one. To make one you need to follow certain principles. You can use standard bulbs or fluorescent lights, full spectrum light is no longer considered necessary. The bulbs must produce about 10,000 lux of light. Lux is a measurement of the amount of light that gets to the surface of your eye. To make such a lamp with incandescent bulbs would take many bulbs and produce a lot of heat. One simple way to make a lamp is to mount eight 4 four foot florescent tubes in a shop light. This will supply 10,000 lux at about 3 feet. The lights should be covered with a diffuser and use the kind that doesn’t buzz! For other ideas and specific plans go to either of the following web sites.

• www.ling.upenn./edu/~kurisuto/sad_lights.html
• www.allaboutsad.com/How_to_Build_a_Light_Box.html

Remember, the light should be in front of you. Do not look directly at this or any bright light (including the sun) instead read or complete some other activity in the reflected light. Keep your eyes open. Thirty minutes in the am should help, but it needs to be done daily and before 12 noon. Relax under the light with your morning beverage and a newspaper.

In terms of antidepressants the SSRIs (selective serotonin uptake inhibitors) are the most common. These include medications such as Prozac, Zoloft, Paxil, Celexa and Lexapro.

Some recent research with Fish Oil indicates that 3-4000 mg a day may work as well as prescription antidepressants. Fish oil is also good for many other areas of your health.

Another alternative that has been used successfully, especially in Europe, is SAM-e (S-adenosylmethionine). SAM-e is not an herb or a hormone. It's a molecule that is present in all living cells. It aids in a process that helps regulate the action of various hormones and neurotransmitters, including serotonin, melatonin, dopamine and adrenaline. It seems to work well but is expensive. It can be found in any health food store.

Post holiday blues and cabin fever usually can be easily managed with changes in routine. For post holiday blues and to avoid cabin fever I suggest you have a gathering of your best friends around the holidays. Ask everyone to bring their date book and schedule a monthly outing. Have volunteers sign up for planning a surprise outing within guidelines you decide (get creative).

Going outside is great if you can participate in an activity to keep you warm such as: walking, snow shoeing, skiing etc. Consider taking an outdoor class in winter recreation. If you just can’t bring yourself to get outside, find a place inside with lots of light. It can be a spare room or basement, I like my garage. Set up a table to do projects, crafts, refinish furniture, sewing, paint, draw, anything you like to do. Make sure this a place you can leave things lying around so you can go back to it any time you have a few minutes without having to set up. Try cleaning up and working on all those garage sale items you bought or plan to sell next summer! Take a class and learn something new!

With a little planning and effort you can avoid the blues and even enjoy yourself.

This site is entirely funded by Dr. Duffy Please send any email correspondence to: