When winter blues hit, these strategies can ease the load

By Marissa Harshman, Columbian Health Reporter

Published: November 7, 2016, 6:00am

The shorter, darker days are upon us. And with the change of seasons can come the blues.

“Most of us can relate,” said Dr. Arundhati Undurti, psychiatrist at The Vancouver Clinic in Salmon Creek. “When the weather changes, we’re feeling a little more blah, a little less motivated to go do things than we were in the summer.”

But for some people, the weather change leads to more than just the winter blues. For about 3 percent of the population, this time of year is when symptoms of seasonal affective disorder appear.

Seasonal affective disorder, or SAD, is reoccurring episodes of depression with a seasonal onset and regression, Undurti said. SAD is not a separate mood disorder, but a subset of depression, she said.

“There is very clearly a seasonal pattern to the depression,” Undurti said. “The seasonal pattern has to do with the availability of light.”

Seasonal affective disorder tends to affect women more than men, with the first onset beginning in the 20s, said Dr. Rebecca Hoffman, a family medicine provider at Kaiser Permanente’s Salmon Creek office. But just because a person is diagnosed with SAD, it doesn’t mean it’s a lifelong diagnosis, she said.

“It’s not persistent,” Hoffman said. “It can remit.”

Symptoms of seasonal affective disorder are similar to those of any major depressive episode: persistent sadness, fatigue or loss of energy, less pleasure in doing things that previously were enjoyable, sleeping issues (insomnia or sleeping too much), change in appetite (eating more or losing appetite), trouble focusing and feeling hopeless. If those symptoms persist for two weeks or longer, it’s time to see a physician to evaluate for seasonal affective disorder, Undurti said. Those with suicidal thoughts should seek care immediately, she said.

People often brush those feelings off as “winter blues,” but if they’re persistent, it may be SAD, Undurti said.

“If you’ve been really down, especially for a few weeks, and it’s affecting your ability to enjoy things, talk to your primary care provider,” she said. “There are really effective, safe treatments out there.”

Like regular depression, SAD can be treated with medication and psychotherapy. If someone has a very clear pattern of winter depression, they may not need medication year-round.

“Many patients who take medication in the winter can wean off by spring,” Hoffman said.

The same is true with therapy. The therapy used to treat seasonal affective disorder typically lasts only 12 to 16 weeks, Undurti said.

SAD can also be treated with light.

“I’m a big fan of light boxes,” Undurti said.

Light boxes with 10,000 lux and no ultraviolet rays can be beneficial with daily use. Undurti recommends using a light box every morning for about 30 minutes. Just place the light box about three feet away while eating breakfast or reading the newspaper, she said.

“It really lifts the mood,” Hoffman said.

Dawn-simulating light boxes, which mimic the sun rising on a bright day, are another good option, though they can be more expensive, Undurti said.

For people seeking an easy over-the-counter treatment option, Undurti recommends Omega 3 supplements. There’s some evidence that the Omega 3 fatty acids can help with depression. While the evidence isn’t overwhelming, Undurti said the supplements are a low-risk option to try.

Light boxes and Omega 3 supplements can also be beneficial for those who are experiencing ordinary winter blues, Undurti said. Lifestyle changes can also help with depression and the winter blahs.

Get out of the house, even on cloudy days, for at least 30 minutes each day, Undurti said. Do something fun, even if it feels like a chore at the time, she said.

Exercising regularly and following a healthful diet are also beneficial, Hoffman said.

“Those always help depressive moods,” she said.