by Dr. Jeremy Bidwell
Today is the first workday of Standard Time for this fall, and we are all noticing an astonishingly early sunset in McHenry County. For some, this part of the year marks the loss of many coping mechanisms that maintain mood and ward off depression. In the winter season, we are less able to do the things that act as “behavioral antidepressants” and the seasonal change for many marks a decrease in regular mood for the next six months. For some, this shift in mood can become quite substantial, requiring treatment.
Seasonal Affective Disorder (SAD) is a condition above and beyond the normal “winter blues”. It is a recognized Psychiatric condition that affects between 6% and 10% of the general population, and can dramatically impact people with a history of Depression or Bipolar Disorder. The symptoms of Seasonal Affective Disorder are the same as those of clinical depression, and can include depressed mood, loss of interest in activities, significant weight changes or changes in sleep patterns, fatigue, excessive guilt, feelings of worthlessness and feelings of hopelessness. For some, suicidal thoughts can form as a result of the disorder.
SAD is likely caused by a combination of several factors. Genetic predisposition likely plays a role, as does the change in behavior and available activities during the winter months. It is also believed that the changes in the amount of natural sunlight hitting our retina influences hormones and chemicals in the body, thus having an impact on mood and sleep patterns. The change in available sunlight is particularly apparent in this part of the country, as the sunset is predicted to be at 4:39pm on the day I am writing this article. Our brains use sunlight to cue the release of chemicals that help keep us on a regular, 24-hour cycle, like a natural alarm clock. This same system is also linked to many of the chemical messengers associated with mood (such as Serotonin).
How is Seasonal Affective Disorder Treated?
There are three generally accepted approaches to treating this seasonal pattern of clinical depression: medications, psychotherapy and light therapy.
Medications: Most antidepressants work by increasing the available amounts of chemical messengers in the brain (called neurotransmitters). There is good data to suggest that antidepressant medication can be a useful tool in the overall treatment of Seasonal Affective Disorder. An evaluation by a trained and licensed mental health professional can help diagnose the condition, and provide clear feedback on if this option is right for you.
Light Therapy: This is very much what it sounds like. There are devices on the market designed to increase the amount of natural light (identical to sunlight) that reaches the retina of your eye during the day. This helps to promote the normal production and release of chemical messengers in the brain that maintain mood and help keep us on a regular cycle of sleep. It may sound fishy, but they have been proven effective, and can be a good addition to the treatment options available for this disorder.
Psychotherapy: Psychotherapy, which is also referred to as Counseling or “Talk Therapy” has been demonstrated to be as effective as antidepressant medications in treating depression. The most effective form of psychotherapy for this disorder is called “Cognitive Behavior Therapy” or “CBT”, and is the predominant style of therapy provided at The LodeStone Center. Cognitive Behavior Therapy for Depression involves assessing the behaviors and thought patterns that contribute to depression. The therapist then works on a weekly basis with the patient to find ways to alter behaviors and thinking habits as a way to improve mood. We have a strong preference for recommending psychotherapy for SAD, as there is substantial research that suggests that the benefits gained from this approach are permanent, because they represent acquired skills that remain with the person for subsequent winters. This is not true of other treatment options.
When to Get Help:
It can be helpful for people with even mild symptoms of Seasonal Affective Disorder to seek out ideas from a counselor with experience and training. There are, however times when it is crucial to seek professional guidance. If your symptoms begin to impact your relationships, work or school, this could mark a shift towards a significant episode of depression. Perhaps the biggest warning sign is an emergence of thoughts about suicide or self-harm. If wither of these begin to become a problem, seek an evaluation by a mental health clinician, or speak with your family doctor.
If we can be of any guidance in diagnosing this condition, or merely helping improve your emotional “keel” through the winter months, don’t hesitate to contact a counselor today. If you have any questions, please follow this link to our contact form, and find out how we can help.