Experts explain the myths and facts of seasonal affective disorder and what to do about it

“This season is my nemesis,” a friend grouses to me recently. “I’m just hanging on until spring.” The good news, I guess, is that at least now the days are getting longer again. But for those of us who don’t live in a warm and sunny part of the world, winter can be a real mood killer. The American Psychiatric Association estimates that about 5 percent of American adults suffer from seasonal affective disorder (SAD), a condition marked by “mood swings and depression-like symptoms” and often (but not exclusively ) associated with the winter months.

The notion that a certain time of year can exacerbate mental health issues seems to make sense. I mean, look outside. It’s dark, is that right? But the concept of seasonal depression is quite modern. The term is attributed to author and psychiatrist Norman Rosenthal and his colleagues at the National Institute of Mental Health, who recognized the condition in 1984. It entered the DSM just a few years later. It’s still one of the more mysterious mental health conditions.

“Little is known about the exact origin of SAD.”

“Not much is known about the exact origins of SAD,” says Sarah Rollins, a licensed clinical social worker and practitioner with Embodied Wellness in Michigan. “Researchers have pointed to several possible causes including your biological clock, vitamin D deficiency and melatonin.”

As with any mental health disorder, a SAD diagnosis requires a professional, but Rollins says “Common symptoms of winter depression include excessive sleep, changes in appetite such as cravings high in carbohydrates, weight gain, low energy or fatigue and negative thoughts.”

Like other real and misunderstood disorders like OCD and ADHD, SAD can be a casual shorthand for a self-diagnosed range of emotions and responses. It’s certainly not a neat cause and effect that colder weather equals misery. A 29-year survey of suicide rates in the US found peak occurrences in April, May and June. Not exactly a month known for being cold. And as a feature in Johns Hopkins Medicine noted in 2019, “Those numbers may be two to three times higher than in December, when suicide rates are at their lowest.” Similarly, a UK 2018 review of psychiatric referrals found that “There are fewer referrals to psychiatric liaison services in the winter months compared to other seasons.”

Conversely, while a recent WalletHub study listed Hawaii among the happiest states in the US, it also placed decidedly non-tropical Utah, Maryland, Minnesota and New Jersey at the top. And when the World Happiness Report annually lists its happiest countries, the top spots inevitably go to countries with some of the world’s longest, darkest winters — Finland, Denmark, Switzerland, Iceland, the Netherlands, Norway and Sweden. Maybe winter itself isn’t always the problem here.

“When we think of Norway and Iceland, they also have some socialized medicine, they have social determinants of health that make life more ‘difficult’ in our country,” said family physician Dr. LaTasha Perkins. “If you know you can go to the doctor any time you need to, if you know your basic needs are going to be met, that helps your baseline sense of well-being go a little bit higher.”

If you are in a culture that prioritizes stability and strong social connections, the dark days may not be so sad.

Perkins says we need to “Think about the socialization and sociology of those places you’re talking about.” If you look at the happier regions of the US and the world, it seems clear that if you’re in a culture that prioritizes stability and strong social connections, the dark days might not be so sad. They may not be as dark.

“You don’t have to lay out on a Hawaiian beach to reap the benefits of sunlight,” says Perkins. “Sunlight helps with vitamin D. Also, there are serotonin receptors in your brain that are dampened by how much time you spend in the sun.” He said that “Even though it’s winter, there’s sun and there’s snow that reflects that sunlight,” he said. “It’s definitely worth getting up and opening those shades and getting some winter sunlight into your house. Having 20 minutes of indirect sunlight is great for your mood.”

While seasonal affective disorder is a complex diagnosis, it still affects millions of us. Millions more experience periods where the cold and lack of sunlight negatively affect our mood and our ability to do the things that give us pleasure. But there are positive actions to help get through the tough weeks. Emily Pagone, the founder and clinical director of Authentic Growth Wellness Group in Illinois, says that since this time of year tends to be “pretty sedentary” for many of us, she recommends “Push through and lean into the cold to get those dopamine levels up. Being in nature, working with mindfulness and other mental wellness techniques, are very important to do. Take risks, even when it’s cold, to continue that.”

Pagone says winter is a good time of year to check in with your physician and mental health provider to see if there are any changes that might make a difference. “See what their recommendations are in terms of labs, supplements to include, making sure the greens are coming in, the whole constellation of things that can change because of the winter.”

And on days when the weather’s rage keeps you out of the house, says Dr. LaTasha Perkins, “During the winter, I often tell my patients to dance. Turn on the music and move your body. Sweat it out, even if it’s some old school jams. that really gets your body moving, because the music releases endorphins in your body if it is connected to a happy memory.” Perkins also recommends, “Call someone you haven’t talked to in a while. You can spend hours scrolling through TikTok, or in an hour you can call someone you haven’t called in a while. The interaction to people is a way to get through quote unquote dark times.”

Sarah Rollins, meanwhile, suggests spinning a fun lamp. “These lamps are specially designed to mimic natural light,” he said. “They are relatively cheap and available in major retail stores. It is recommended to sit in front of the lamp 30 minutes a day. It is easy to brush your teeth, get ready for work or watch TV in front of a cheerful lamp. “

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When the trees are bare and the sky is thick and dark and seeing your loved ones means, ugh, putting on a coat, it can be very tempting to just stay inside until spring. But if you’re feeling blue this season, it’s worth taking stock of what’s going on. Are you less active? Are you depressed? These are the things that can help. And whether it’s to ease seasonal depression or just have a more pleasant time until the next equinox, Pagone says it’s worth putting on that coat anyway.

“If a person feels emotions, that is legitimate, especially if it turns when those clocks change and it gets dark around 4:15. But, he added, “If we boil it the one thing to remember that ties it all together is behavioral activation, moving your body before your mind takes center stage and stops you from doing the thing you’ve been thinking about for a long time, which might just be going for a walk in the cold. Use the strength you can, no matter what body type you have, or what your body can or can’t do. Move toward something you want to work on,” he says, “and see what happens.”

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