Waiting For The Light

For 15 years, Jean had more reason to dread the colder months and shorter days than most of us. “When the winter came,” says the 53-year-old mother of two grown children, “it seemed like I shut down, kind of like I was hibernating.”

She felt more tired than usual and had trouble accomplishing goals. “I just wasn’t motivated,” she says. “I didn’t think about doing anything new and was just stuck in the daily routine. I wasn’t thinking of any of life’s pleasures.”

Dr. Fatima Ali, a psychiatrist and clinical director with Linden Oaks Medical Group at Edward, recently diagnosed Jean with Seasonal Affective Disorder (SAD), a type of depression that typically occurs during the fall and winter months and dissipates in spring and summer. Ali says the depressive periods must occur for at least two consecutive years, last more than two weeks and affect the ability to function. If significant stressors (such as work issues or illness) coincide with the episodes, a diagnosis of SAD is unlikely.

“We all get winter blues,” says Dr. Dawn Kroencke, a licensed clinical psychologist with the DuPage Medical Group, “but, with SAD, it becomes so noted that you’re not doing things you enjoy, you’re not being around people, and you’re expressing the classic symptoms of depression.” These symptoms include a feeling of hopelessness, anxiety, loss of energy, oversleeping, difficulties concentrating, weight gain and changes in appetite, especially cravings for high-carb foods.

The specific cause of SAD isn’t known, but the reduced hours of daylight are a likely culprit. “First, the shorter days disrupt the body’s circadian rhythms,” Ali explains. “Secondly, there’s a hormone called melatonin that’s related to sleep patterns and mood. We need sunlight for the production of melatonin, so, with the shorter days, there’s less production. The third factor is that sunlight affects the serotonin levels in our brain, and reduced sunlight causes a drop-off.”

Some people have proven more vulnerable to SAD than others. As with other types of depression, those with family members who have suffered mood changes or depressive episodes are at greater risk for developing SAD. The ailment also is more common in people living far north or south of the equator, due to decreased sunlight in winter and longer days in summer. And women are more prone to SAD than men. “Sixty to 90 percent of women can be affected by seasonal symptoms,” Ali says. But, she notes that men may have more severe symptoms.

Several options are available to treat SAD, with the use of light therapy boxes gaining particular favor recently. “There’s a lot of research that proves light improves melatonin levels, and there’s some indication it helps serotonin levels,” Kroencke says. Ali recommends spending at least 20-60 minutes in front of a light box: “You don’t have to directly look at it. Just have it at eye-level.”

Jean began using a light box for 45 minutes on cloudy days this winter. She turns it on while she’s reading or getting ready in the morning. “I really feel that it does work,” she says. “I’m feeling up.”

Anti-depressants, cognitive behavioral therapy, exercise, and nutritional and dietary supplements also can bring some relief, as can simple home and lifestyle remedies. To increase sun exposure, for example, open the blinds and cut back tree branches that block windows.

At the very least, sufferers can take some comfort in knowing that the depression is temporary. “February is the worst month for people really feeling down and depressed and a lack of motivation,” Ali says. “Generally, they pick up a bit in the third week of March.”

That’s good news for Jean and all sufferers of SAD who are eagerly waiting for the light of spring.