ST. LOUIS — Not feeling like yourself lately? We’ve entered a tricky time of the year for many people who may suffer from seasonal affective disorder or SAD.
According to the National Institute of Mental Health (NIMH), the lead federal agency for research on mental disorders, SAD may affect millions of American adults.
Those who are more prone to SAD are people experiencing major depressive disorder or bipolar disorder, especially bipolar II, which the Mayo Clinic said can include at least one major depressive episode and at least one hypomanic episode, without a case of mania.
Additionally, those experiencing SAD tend to have other mental disorders, such as attention deficit and hyperactivity disorder (ADHD), an eating disorder, an anxiety disorder, or panic disorder, according to NIMH. The disorder can be hereditary through those who have relatives with schizophrenia or depression.
Dr. Jessi Gold, a Washington University psychiatrist at BJC Healthcare, said she does not know whether the field of psychiatry possesses a good ethnicity or racial breakdown regarding SAD likelihoods. However, they have studies on the where you live being a factor because of the exposure to light.
"Obviously, there are some countries that have different ethnicities than others and that could also be impacted by the latitude so I think that could be a factor," she said.
She also said she does not think that SAD is well-defined in children either.
Gold said, however, women are more prone to SAD and depression.
The reason why, she said, is a very broad question.
"I don’t think we know really. Some people might say that men underreport than women in studies. So we're just not capturing a good amount of the men who are actually struggling," she said. "[Men] come into [mental health] care less often...so that’s a reason too...it skews some of the data."
She said she thinks women have hormonal reasons why their mood is more affected by SAD. A lot of their hormones fluctuant which are related to mood components.
The institute said symptoms can start in the late fall or early winter and go away during the spring and summer, which is known as winter-pattern SAD or winter depression. Some people may experience depressive episodes during the spring and summer months, which is called summer-pattern SAD or summer depression and is less common.
What are the signs and symptoms of SAD, according to NIMH:
Feeling depressed most of the day nearly every day.
Losing interest in activities you once enjoyed.
Experiencing changes in appetite or weight.
Having problems with sleep.
Feeling sluggish or agitated.
Having low energy.
Feeling hopeless or worthless.
Having difficulty concentrating.
Having frequent thoughts of death of suicide.
During the winter-pattern type, additional symptoms may include:
Gold said some people who have underlying depression notice that their symptoms are more present in the winter. So being aware that winter might be a hard time of the year, people can prepare and prevent it.
"Being able to say January and February are some of the worst months. Saying 'This month might be bad, I should preemptively focus on my schedule, try to make social plans, try to get out of my house,'" she said.
During the summer-pattern type, you may experience:
Restlessness and agitation
Episodes of violent behavior
NIMH also outlines possible causes of SAD. They admit that scientists do not fully understand what causes the disorder.
There may be a reduced amount of the brain chemical, serotonin, which helps regulate mood; minimal sunlight which controls the levels of molecules that can contribute to your mood; extreme melatonin production which then increases sleepiness.
With SAD, these biological or mental health functions become imbalanced and disrupted because of the change of season.
Gold said depression itself interferes with your day-to-day life.
"It interferes with what you want to do, affects your work or relationships, all other aspects of your life, your sleep, your mood and your appetite, it’s occurred multiple years in a row even, then you might want to go talk to a doctor about medication or other options," Gold said.
Gold also said she thinks SAD goes unnoticed in some people and under-noticed in others. She also said she thinks the problem is cultural.
"Winter is the time where people feel worse," she said. "I’m going to stay inside, I’m not going to be as social, I’m just not going to like winter. So, I think we very easily can say I don’t feel good because it's winter, not I can’t actually function well because its winter. That’s different."
Gold said she thinks it’s very easy to minimize, but she thinks that what you have to recognize is that in a culture that also minimizes mental health in general, some of these reactions are normal reactions. But some of them are not.
"We don’t have to pathologize everybody who feels sad in the winter," she said. "But if you’re feeling sad in the winter and you’re eating differently, having trouble concentrating, having trouble in your workplace, having trouble at home, those are times when you say, 'I’m not just normal sad, I’m like capital letters sad.'"
But at the same time there are really people who are struggling, and we shouldn’t just normalize it, she said. It’s kind of a double-edged sword.
How do you adjust your serotonin and melatonin levels during the winter-pattern or summer-pattern type of SAD, triggered by season or even erratic weather change?
Ways to boost your serotonin and melatonin:
Create light in your indoor environment and manage your dark-light cycles
WebMD, an online publisher of news and information pertaining to human health and well-being, suggests using a 300-watt bulb with three feet for 20 minutes three times a day.
5 On Your Side recommends “light-washing” your living space to clean your indoor environment with natural sunshine or light if the weather permits, preferably in the morning.
Gold said there are also those light boxes that you can buy on Amazon.
"They’re just like more intense light that is fluorescent, and you look at them in the morning and it convinces your brain that it's morning now," she said. "People can do that for 30 minutes in the morning in the winter and there are minimal risks."
WebMD suggests forcing yourself to start 15 - 20 minutes of dancing to the radio or fast walking, which can reduce a sweet tooth and improve mood.
Keeping commodities in your pantry such as popcorn, oatmeal, nuts, egg whites for omelets, peanut butter, pre-washed vegetables, fruit, whole grain crackers and bread, deli turkey, or cottage cheese are recommended, according to WebMD.
Gold said people who are already on anti-depressants can decide whether these months are times you want to increase your dose and go back down later.
If you’re a person who is not already on anti-depressants and you have to do things such as be around people and get serotonin in other ways to make you feel good, then considering therapy and an accountable friend can help.
"Therapy can help for this stuff too because really what therapy is going to do is help with skills around it," she said. "So, if you want to sleep all day, which is what people with depression do anyway, then how do we get you activated behaviorally to do the things that you need and want to do."
"Also, having a friend that can help with accountability. 'I know that my mood stinks in the winter so if I start to avoid you, not make plans with you, then find me and make me do something with you.'"
5 On Your suggests doing more research on this disorder to explore other possible indications that you or someone you know may have SAD.
To find out how SAD is diagnosed, click here.
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