Don’t Be SAD!

Hurricane Sandy has come and gone, leaving huge devastation in its wake. Today, there is another Nor’easter predicted on the east coast. Last weekend, our clocks “fell back” to standard time so it won’t be so dark when we get up in the morning (but now it’s darker earlier at the end of the day). Hurricanes, snowstorms and changing the clocks are seasonal events we can expect each year. Winter is fast approaching and, with it, about a half million people may experience some new sadness or depression. This is a very real phenomenon associated with the seasons called Seasonal Affective Disorder, or SAD. Because it’s seasonal, you can expect that it will happen every year around the same time (sort of like the World Series, but not nearly as much fun.)

According to Mental Health America, an advocacy group for people with mental health issues, and the Mayo Clinic, SAD is caused by a lack of light. Light affects our normal daily body rhythms (circadian rhythms) such as sleep, production of hormones and metabolism – when there is less light, it may affect the way we feel since these rhythms are a little out of sync. The brain produces a chemical called melatonin which is related to sleep. This chemical can also be related to depression. When there is less light in the environment – that is, the darker it is – the more melatonin is produced, which may increase feelings of depression.

A person with SAD may find that he or she feels a lack of energy to do things, feels hopeless, worried about everyday things, and just wants to sleep (almost like animals who hibernate). They also may find that they are eating more, especially starchy carbohydrate foods, and, in general, don’t enjoy doing the things he or she usually enjoys. These are symptoms of the same depression a person might suffer any time of the year. The difference with SAD is that, for most people, it is at its worst during the winter months and tends to get better during spring and summer, when there is more sunlight. However, some people actually have SAD symptoms more in the summer – much of the way an individual reacts to light is what determines when that person will have worse symptoms.

It is more likely if you are a woman that you will be affected by SAD, but men and children of both genders can also have it. The typical age range for the onset of SAD is between 18 and 30 years old. Also, people with SAD are more likely to have a close relative who has some kind of a depressive disorder or alcoholism.

Since lack of light is what seems to cause the problem, exposure to increased amounts of light can help you feel better. Some people can relieve their symptoms by just turning on more lights in their house and/or making sure the blinds or curtains are open to allow more natural light into the room. There is some evidence that walking for an hour per day is as effective as spending some time in phototherapy (light therapy) – these are special lights used for treating SAD. Some of these might even be paid for by your health insurance (if you’re fortunate enough to have some), since it is a treatment, just like a medication or a brace. If not, they can be bought without a prescription.

The fluorescent therapeutic lights for treating people with SAD are usually housed in a metal box with a plastic shield that diffuses the light rays. The light should be near eye-level because it is the light falling on the retina inside the eye that helps to relieve the depression. According to NAMI, the National Alliance for Mental Illness: 1) a light box should be capable of delivering 10,000 lux at eye level; 2) daily sessions of 20 to 60 minutes may be needed. At 10,000 lux – the current standard – 30-minute sessions are most typical. If your light is 5,000 lux, you will need 60 minute sessions; and 3) most people with winter depression benefit by resetting their internal clocks earlier, which is achieved specifically with morning light exposure. But, the optimum time of light exposure can differ greatly with people. The Center for Environmental Therapeutics, a professional nonprofit agency, offers an online questionnaire on its website (www.cet.org) which can be used to calculate a recommended treatment time for you.

You need not imagine yourself sitting and staring blankly at a light box. You can do the things you would normally do, like reading, sewing, playing cards or watching TV while sitting near the light. Most people do not have any side effects from the light therapy, but, if they do, they are usually mild, such as headache, nausea and/or irritability.

There is one very important caution about using phototherapy (light therapy) for SAD – if you have bipolar disorder (sometimes you are over the top active and happy and other times you are so depressed you can’t get out of bed), light therapy can increase the possibility of your switching between mania and depression. If you think you might have bipolar disorder, please don’t use light therapy and see a mental health professional who can help you get it under control with medications and counseling.

Other things you can do to fight off depression are exercising, eating more vegetables and high fiber foods, and laughing. If you still have the same symptoms, in spite of increasing your exposure to light and trying these other suggestions, consider seeing your regular health care provider or a mental health provider. Together you can decide if your symptoms are severe enough to need medications during the times of year when you are most affected.

Remember, if you are feeling SAD, consider lighting up your own life. And be sure to enjoy the various festivals of light to come in these winter months (see photo) – even if you’re not feeling blue! Happy Holidays!!

About Norma Stephens Hannigan

Dr. Norma Stephens Hannigan is a Doctor of Nursing Practice who teaches at the Hunter-Bellevue School of Nursing in New York. Dr. Norma has treated many truck drivers at the various clinics she has worked in over the years. She currently writes for 10-4 from her home in Newburgh, New York.