Dear Doctor: My boyfriend and I live in northern Ohio, and I think we have that thing where you get depressed from not enough light. He’s kind of skeptical, but I really do think it’s happening. Can you describe the symptoms? Is there anything we can do?
Dear Reader: You’re referring to a condition known as seasonal affective disorder, or SAD. Sometimes referred to as the winter blues, it’s a mental health condition that has been linked to the shorter days and longer nights of the fall and winter seasons. Although the exact causes aren’t yet known, researchers have explored several hypotheses. These include the idea that reduced levels of sunlight have an adverse effect on circadian rhythms, on levels of the brain chemical serotonin or on the hormone melatonin.
There’s also a link between distance from the equator and incidences of SAD. People living in the northern reaches of the United States, as you do, are at greater risk of developing SAD than those in the southern part of the country.
It’s estimated that up to 20 million people in the U.S. experience some degree of seasonally related depression each year. Symptoms often begin with autumn’s annual double whammy of shortening days and the end of Daylight Saving Time. They intensify throughout the darker months of winter, then ease up again in the spring. Symptoms include persistent low mood, lethargy, lack of energy, sleep disruption, irritability, loss of interest in daily activities, feelings of hopelessness, difficulty concentrating, anxiety or weight gain. Episodes of SAD can begin with symptoms that are mild, but which gradually intensify. In some cases, symptoms can become severe enough to interfere with daily life.
If you suspect you may be experiencing seasonal affective disorder, you should see your health care provider. Several other medical issues, such as thyroid conditions, anemia or clinical depression, can present with symptoms similar to SAD. Diagnosis involves a physical exam, including a detailed discussion about symptoms relating to mental health. In order to rule out thyroid issues, a blood test may be performed.
For people diagnosed with SAD, treatment can include light therapy, psychotherapy or medication. Light therapy is just like it sounds — deliberate exposure to bright light. The individual sits in front of a specially designed light box for 30 to 45 minutes each day. These devices are made to filter out damaging UV rays. However, since they are up to 20 times brighter than natural light, they may not be right for everyone. People with certain eye conditions, or who take medications that increase sensitivity to light, must be under medical supervision to use light therapy. Psychotherapy, or “talk therapy,” offers a time and place to share feelings and to learn coping techniques. Medications that affect serotonin metabolism can also be helpful.
Meanwhile, be kind to yourself. Try to spend some time outdoors each day, get regular exercise and eat a healthful diet. Keep screen time to a minimum. And if symptoms persist when the sunlight returns, be sure to tell your doctor.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to firstname.lastname@example.org, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.