Wintertime blues: How to manage seasonal depression

When Jem Aswad was in college, he spent a semester abroad in London. The New York state native loved his classes, had lots of friends and lived in a fun and lively neighborhood. “But by the end of February, I was glum and depressed and absolutely could not understand why,” he says.

A trip to Madrid in March shed light on his strange funk. “I was practically intoxicated by all the sunshine,” he recalls. “I was actually giddy and having trouble sleeping while I was there. I realized my problem was the dismal English weather.” Winter days in London are short and gloomy, and his semester abroad coincided with the worst winter England had seen in 40 years.

Seasonal affective disorder (SAD) is a form of mild to moderate depression that descends in the fall or winter months and fades in spring. In addition to sadness and irritability, symptoms can include oversleeping, increased appetite, craving carbohydrates or sugar, social withdrawal and low energy. Some people feel the slump at the same time every year, but certain factors can bring it on for the first time. Moving to a new region or a home that receives less light, an especially harsh winter, working the night shift, and physical or emotional stress all predispose you to seasonal mood changes.

Is seasonal depression real?

The term “seasonal affective disorder” was coined in the 1980s by Norman Rosenthal, MD, a psychiatrist and research scientist who studied mood and biological rhythm disorders at the National Institutes of Mental Health. In his best-selling book Winter Blues, he revealed his own struggle with SAD and pointed to light deprivation as a major cause. By the 1990s, the concept of seasonal depression was generally accepted by most Americans.

In 2015, researchers announced they’d discovered a new explanation for seasonal ups and downs: Genes promoting inflammation are more active in winter. This could be why many chronic conditions ― including Type 1 diabetes, multiple sclerosis, rheumatoid arthritis and depression ― flare in the colder, darker months.

Then in 2016, a report analyzing data from 34,000 Americans suggested that SAD either doesn’t exist or is very rare. Was seasonal depression merely a widespread cultural myth? For every statistic that supports the winter blues, some experts argued, you can find another that indicates the opposite. Suicide rates are higher in spring and summer. And in some communities near the Arctic Circle that get little or no sun in winter, depression rates are steady year-round and sometimes lower than in regions much farther south.

In spite of the naysayers, most mental health professionals believe seasonal depression is real, according to Gabriela Cora, MD, a psychiatrist, wellness coach and medical director with Aetna Behavioral Health. “I’ve seen it in my clinical practice. And if you’re tracking your habits, it’s kind of obvious,” she says.

Treatments for SAD

Doctors and therapists often recommend a combination of therapies. “Depression is not one of those diseases where you can pinpoint one gene that’s responsible. So you can’t treat everyone with the same cookie-cutter approach,” Dr. Cora explains, adding that lifestyle factors play a major role. “During the summer, we go outside more, eat more fruits and vegetables. When it’s getting colder and darker, our habits change. Sleep patterns change. People may gain a little weight. It’s the chicken or the egg: Is it the sun, or your activities?”

For mild to moderate blues

“Focus on the four pillars of health: nutrition, exercise, sleep and relaxation,” Dr. Cora advises. “Plan more outdoor activities, and eat more plant-based foods.” Some SAD sufferers manage their symptoms with vitamin D supplements in the fall and winter months. Vitamin D deficiency has been linked to depression; your primary care physician can check your D level with a blood test.

A winter vacation can also do wonders for your state of mind, and some people suffering from SAD truly consider it a health requirement. Experts agree that spending a few days somewhere warm and sunny can quickly melt the most stubborn winter blues, due to serotonin flooding the brain.

If a trip south isn’t possible, make time for winter sports close to home. Hiking or skiing allows you to soak up more sunlight, boosts vitamin D and gets your heart rate up. But moderate exercise of any kind can have a significant impact on depression. At the very least, avoid placing added pressure on yourself: Postpone big projects until spring, and make the holiday season a time to recharge.

For moderate to severe depression

If you feel hopeless or unable to function, self-care is not enough. See your primary care physician or a counselor as soon as you can. You’ll be screened for common conditions that can mimic or worsen seasonal depression, from thyroid problems to anemia (a vitamin B deficiency). Therapy and medication have both been shown to alleviate major depression.

Light therapy can also raise your spirits, sometimes dramatically. Experts recommend using tabletop light boxes of at least 10,000 lux. (Not any bright light will do, so don’t try self-treating with regular bulbs.) If you’re an Aetna member, your plan may cover the use of light therapy for seasonal depression that recurs two or more years.

Mind over weather: Making the most of winter

A Scandinavian proverb advises, “There’s no such thing as bad weather, only inappropriate clothing.” In other words, proper preparation and a can-do attitude have a huge impact on our experience of winter.

Scott P. first noticed his seasonal mood pattern in his late teens, when the New Jersey native started college in Syracuse, New York, where the winters are bleak. “In October, I’d start to crave different foods, sleep more, put on weight and get the sads,” he says. He credits lifestyle adjustments with turning things around. “Over time, the extremes have moved toward the center. Daily exercise and keeping social as well as midwinter vacations south all help my mental outlook.”

So this winter, keep in mind what you love about the season ― a steaming cup of cocoa, sledding with the kids, the aroma of pine wreaths. A warm heart is a powerful antidote to the cold.