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The change in season also brings with it gradual, creeping depression – a condition known as seasonal affective disorder, or SAD. It doesn’t usually come on overnight. First, getting out of bed may become a struggle. Then fatigue sets in. Comfort food beckons – sweet and stodge – and with that comes weight gain and a further lack of motivation.
Over time, the low mood can get worse – guilt, anxiety and a desire to be alone may creep in. As one sufferer I know put it: ‘I feel like all my systems have been turned off in the winter… I’m leaden, and heavy. The fatigue is agony. I have to drag myself from one place to the next.’
At worst, patients may feel suicidal. So, needless to say, it’s a serious condition. But while there is no cure for SAD, there are things you can do – starting today – to help. With a little determination, and by following my simple step-by-step guide, you can stop it from blighting your life.
It was back in the mid-1980s when I first suggested there was a specific type of depression that was triggered by the lack of light in winter. I was working at the National Institute of Mental Health in Bethesda, Maryland, in the US at the time. My thesis was met with a deal of scepticism in the medical community. Although some people supported this new diagnosis, others were dismissive – contemptuous, even. Some colleagues even thought SAD was a joke.
Professionally, it was a little galling. More importantly, for a very long time, sufferers found it hard to get taken seriously. Thankfully, more than three decades on, things are different. SAD has won mainstream acceptance and treatment is available on the NHS. One in five Britons are believed to suffer to some extent.
According to a recent YouGov poll, symptoms are acute for eight per cent of people. Women are 40 per cent more likely to be affected than men. We don’t know for sure why some people are affected, but we think it’s due to combination of genetics, our biology – such as hormones and age – light and stress.
One major discovery was the hormone melatonin, which is integral in regulating our sleeping and waking cycles. Melatonin is secreted by the pineal gland, which is tucked beneath the mid-line of the brain.
Its activity is regulated by special light receptors in the eyes. Darkness signals the gland to begin secreting melatonin into the bloodstream, making us feel drowsy. Light, as the sun rises, is detected by the eyes, and halts production.
But the chemical messenger does so much more than put us to sleep. In animals, it governs reproductive cycles. It even governs antler growth in reindeer.
I wondered: did light have other effects in humans? Around this time, I encountered another scientist who suffered mood changes in the darker winter months – but much more severely than I did. So we decided to carry out an experiment: to see if light therapy could make a difference to his mental health.
It’s not just the ‘worried well’
Light therapy – basically, sitting near a source of very bright light, known as a light box – is the cornerstone of SAD treatment. But back in the 1980s, no such thing existed. So we rigged together the first prototype, made from a fluorescent ceiling light. These emit what is known as white light – which is similar to the light emitted by the sun.
Is it the winter blues …or full-blown SAD?
The following are core symptoms of SAD. They develop as the seasons change from summer to autumn and winter:
- REDUCED energy
- INCREASED eating, including carb cravings
- DISTURBED sleep
- LOWER sex drive
- THINKING problems, such as difficulty concentrating
- MOOD problems, particularly depression.
If you have some of these symptoms during autumn and winter, and find them problematic, you may well have SAD or subsyndromal SAD.
It is common to suffer from SAD alongside other mental health problems, including non-seasonal depression, premenstrual syndrome and eating disorders.
Whether or not this is the case, you might benefit from the treatments described on these pages, and in my book Winter Blues.
However, it’s always wise to consult your GP if you feel unwell, so they can rule out other causes such as thyroid gland problems and chronic viral illnesses.
My colleagues Thomas Wehr, Alfred Lewy and I gave our volunteer – the scientist suffering from seasonal mood changes – three hours in front of the box before dawn, and three after dusk.
This simulated the length of a day in summer, in terms of hours of light. Within three days, he began to feel better – dramatically so.
Over the following years, we gathered evidence and treated more patients suffering from what became known as SAD.
Many sceptics initially argued that we were dealing with ‘the worried well’ – people who felt a little down during winter, but had nothing wrong with them. But gradually, the diagnosis of SAD became accepted worldwide.
There is also what we call subsyndromal SAD, sometimes known as winter blues: when you feel less productive in winter, but not so much that you’d need medical help.Symptoms can vary in severity from one year to the next, and exist along a spectrum. One year a patient might have full-blown SAD and then a less debilitating manifestation the next year.
We know now these conditions are common – particularly in places such as England and Scotland. SAD is seen less in sunnier climes, affecting, for instance, just 1.5 per cent of people in Florida.
And more needs to be done to raise awareness and alleviate suffering caused by short, dark days.
In a recent study of more than 1,000 people with SAD, participants suffered, on average, 13 winter depressions before receiving any treatment. Alongside light therapy, we have a wealth of other strategies to tackle the problem – from lifestyle changes, to medication.
The key is to start taking steps as the seasons change. That means, if you think you’re a SAD sufferer, you need to take action today.
And here is what I advise…
Most people with SAD benefit from light therapy. Indeed, studies suggest it is as effective as antidepressants are for non-seasonal depression. That’s why I don’t think it’s necessary, in most cases, to jump straight to medication.
Many SAD patients will need to start light therapy during October: once the clocks go back, the longer evenings can be a burden.
Ideally, you should have a diagnosis before starting treatment, so your progress can be monitored by your doctor. But if your symptoms are mild, it may be worth giving light therapy a go for up to two weeks, to see if it helps.