- - Friday, October 23, 2015

As we usher in crisper air, leaves falling from trees, shorter days and decreased sunlight, Mother Nature has begun her preparation for winter. And the while ” ‘Tis the season to be jolly” draws nigh, the reality is that nearly 10 million Americans may experience seasonal affective disorder (SAD) and another 25 million may experience a milder form known as the “winter blues.”

Dr. Nina’s What You Need To Know: About Seasonal Affective Disorder and The “Winter Blues”

What is Seasonal Affective Disorder (SAD)?
Depression that coincides with the fall and winter months and dissipates in the spring and summer. The symptoms are the same as clinical depression. And the “winter blues” refers to a mild version of SAD.

What’s the mechanism behind SAD?
The exact mechanism is not completely understood. It is believed that the decrease in sunlight — perceived through our eyes — affects multiple brain regions. They include:
• Sending our body’s biological or internal clock into a tizzy
• Affecting melatonin levels which can decrease quality and quantity of sleep
• Decreasing brain chemicals that affect our mood, namely serotonin. Serotonin is a neurotransmitter, meaning it relays signals from one area of the brain to another.

How is SAD diagnosed?
Unlike diabetes, hypertension or myriad other illnesses, it is diagnosed by symptoms, as opposed to findings from a physical examination or laboratory/radiographic testing.

Symptoms of SAD can include sadness, irritability, depressed mood, decreased energy levels, difficulty concentrating or sleeping, and increased appetite that leads to weight gain. If you believe that you or a loved one may be suffering from SAD, speak with your health care provider.

Who is at risk for SAD?
• Women and men are both affected
• The average age is 23 years old, but people of all ages can experience it
• Those who live further away from the equator. It is estimated that SAD affects 9.7% of New Hampshire residents compared to 1.4% of Floridians
• People with creative abilities

Can staying active help decrease SAD?
Absolutely! In addition to lowering our risk for obesity, heart disease, and dementia, exercising can increase our endorphins. Endorphins are our body’s “feel good” chemicals. They bind to the same receptors as some pain medicines and are also released when we eat our favorite foods, laugh, and see someone we love. Staying active is a win-win-win situation!

What about socializing?
Maintaining social interactions and bonds is an excellent way to bring cheer into our lives. The cold weather may be a deterrent to getting ready or getting into our cars to see family and friends. But remember that once we are with them, they are likely to warm our hearts. And if we do not feel like going out to a bar, nightclub, or restaurant, consider having a dinner party at home with warm food and drinks, such as delectable soups or hot chocolate.

Does eating healthy help fight off SAD?
In addition to keeping inches off of our waistlines, healthy eating can also help fight off a depressed mood, inability to concentrate, and fatigue. Foods that are rich in vitamins and nutrients are fuel to our brain. Some noteworthy “brain foods” include nuts, seeds, avocados, whole grains, olive oil, salmon, fruit, and veggies.

And if we suffer from the winter blues, we may find ourselves craving for carbohydrates. This can lead to unwanted weight gain as well as worsen a depressed mood because of subsequent drops in blood-sugar levels following a spike. When this happens try reaching for “brain foods.” And also remember that although the blues will fade away in the spring, we will have to put in the work to burn off those extra pounds.

Can getting more light be helpful?
Yes! Don’t let the cold weather scare us away from spending time outdoors, when possible. We may even be able to elevate our mood by sitting indoors near the window and catching a few rays.

Additionally, artificial light therapy is the most widely used treatment for SAD. These devices emit a controlled amount of light with a built-in screen to filter out harmful ultraviolet rays. It is believed that the light rebalances our internal clocks and melatonin and serotonin levels. Experts recommend beginning therapy when symptoms begin and using it daily until springtime. Symptoms typically improve after 1-2 weeks.

Take note of alcohol consumption
As we enter the winter months, alcohol may seem like a great cold-weather drink, physiologically (gives us a sensation of warmth), socially (cooped up indoors), and emotionally. However, alcohol is a depressant, and can worsen the winter blues or SAD. It is wise to avoid alcohol when experiencing these symptoms. If you are drinking more than usual, speak with a loved one or your healthcare provider.

When to see a doctor?
We all can have days when we feel down – but if you feel down over an extended time or feel hopeless and cannot get motivated to do what you normally enjoy – make an appointment to visit your doctor. In addition, if your sleeping and eating patterns change and you feel blue – or turn to substances for comfort – it is time for a check-up with your physician.

If it goes away on its own when spring arrives, should we avoid prescription medications?

In some situations, you and your healthcare provider may determine that medications are appropriate to treat SAD symptoms. Of note, it can take 4-6 weeks to see the effects of many anti-depressant medications.

As we start preparing for the festive holiday season, we should take note that the shorter daylight hours can impact our mood. For some, “The most wonderful time of the year” may feel like it is the most difficult. By knowing what the winter blues and seasonal affective disorder are, we can better recognize the symptoms, make active efforts to prevent them (or minimize them), and speak to a healthcare professional to get additional assistance when needed. And, too, if you notice a loved one experiencing these symptoms, talk to them about it.

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