Feb 4, 2014
By: Jackie Oberst, Ph.D. and Matthew Rudorfer, M.D., National Institute of Mental Health
Post-holiday lull and winter got you down? It may be a case of the “winter blues,” or it may be more serious than you think.
Winter blues is a general term, not a formal medical diagnosis. Typically it comes about from some specific event such as a stressful holiday period or reminders of absent loved ones. This type of lowered mood usually clears up on its own without treatment.
Seasonal affective disorder (SAD) or seasonal depression is different. It’s a well-defined pattern of major depression that repeatedly comes on in the fall and winter and seems related to the reduction in number of daylight hours. The depression usually lifts during spring and summer.
About 1 in 20 people — mainly women — in the United States experience SAD. In general, the further removed one is from the equator, the fewer the daylight hours during winter and the greater the likelihood of experiencing SAD symptoms.
Some people say that SAD can look like hibernation. People with SAD tend to be withdrawn, have low energy, oversleep, and put on weight. They might crave carbohydrates such as cakes, candies and cookies. Without treatment, these symptoms generally last until the days start getting longer. Typically, people with SAD have had these symptoms recur for two or more winters.
Since SAD was formally recognized as a diagnosis about 30 years ago, effective treatments have been developed. Most scientists believe that reduced sunlight in winter can interfere with your body’s internal clock, which can lead to SAD.
SAD may be successfully treated with light therapy, using a special “light box” every morning that delivers a “dose” of light many times brighter than typical indoor lighting. However, nearly half of those with SAD do not get better with light therapy alone.
Antidepressant medication (e.g., selective serotonin reuptake inhibitors [SSRIs], bupropion) and cognitive-behavioral psychotherapy (CBT) can reduce SAD symptoms, either alone or in combination with light therapy. All these treatments require management by a medical professional.
Proper exercise and diet can also help reduce symptoms. People in northern areas who are able to travel to sunny places during the winter also report improvement while away.
People with SAD often begin treatment early in the fall to try and prevent an episode of depression from occurring that winter. Most often this involves use of the light box.
The FDA has also approved the use of a long-acting formulation of the antidepressant, bupropion, as a preventive measure for individual with SAD, to be taken daily from fall through early spring. Exciting new research suggests that a course of CBT can even protect against depression the following winter in people with SAD.
If you’re feeling blue this winter, and if the feelings last for several weeks, talk to a health care provider or find a nearby health clinic. Most insurance companies will cover treatment costs for well-documented SAD.
It’s true that SAD goes away on its own in springtime, but that could take 5 months or more. Five months of every year is a long time to be impaired and suffering. SAD is generally quite treatable, and the treatment options keep increasing and improving.
Don’t chalk up your distress to winter blues—get enlightened.