- Dr. Lee Brotherston
Feeling SAD? Spend more time outside.
With the cold, and often dreary weather upon us, it seemed a good time to talk about seasonal affective disorder (SAD), what it is, and what you can do about it.
SAD, often called the winter blues, or seasonal depression, is a type of depression that occurs with the changing of the seasons. Typically, it occurs as fall progresses into winter, and remits when spring comes. However, it can cause depression in the spring and summer, too.
According to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), SAD isn’t a standalone condition, but rather a subtype of depression that coincides with the changing of the seasons. Symptoms can include: low-energy or tiredness, irritability, oversleeping, difficulty getting along with other people, changes in appetite (either increased, or decreased appetite), weight gain, and a heavy feeling in the arms and legs.
So what causes SAD? Well, we don’t really know for sure. Researchers are still working away at it, but what we think is going on is related to our circadian rhythm (our biological clock). That is, our bodies are responding to changes in the amount of daylight. In the past, as diurnal creatures, we were awake and alert when the sun was up, and we slept away the dark nights. Electricity has changed all that, and we’re no longer productive solely when the sun is shining. However, our ancient biological clocks haven’t adapted to the modern world. Our circadian rhythms still want us to sleep more as the days shorten, but our schedules don’t differ that much from winter to summer anymore – thus, we feel tired more of the time in the winter. That’s one theory. Other theories involve changes in chemical messengers like serotonin, and melatonin, which can influence our sleep, mood and appetite.
What can you do about it? Typical treatment involves the use of phototherapy, psychotherapy, or medications. Light therapy, or phototherapy, is often the first treatment used because it is non-invasive and has been shown to be effective in relieving SAD symptoms. Often, a light box will be used. These are a bright light, which you sit near for 20-30 minutes a day. There are a wide variety of light boxes available, and you should seek professional guidance before deciding on a particular make or model to ensure it will meet your needs.
Alternatively, you could make the most of the winter months and spend some more time outside. Many people tend to hibernate when the snow and cold come, wishing away the winter months. Instead, try finding an outdoor activity that you enjoy doing. Not only will it make winter more tolerable, you’ll quickly learn to love it... or at least like it a bit more. Skiing, snowboarding, snowshoeing, fat biking, ice fishing, and skating outside are all ways to increase your exposure to sunlight. Durham Forest is a favourite place of mine, and I promise you, it is never more beautiful than after a fresh snowfall on a cold, sunny day. Plus, there are no mosquitoes.
Getting active outdoors not only helps with light exposure, but you reap the benefits of exercise as well. Exercise has long been shown to be beneficial in reducing anxiety, stress, and depression.
If you think you may be suffering from SAD, consult your medical doctor for appropriate testing and referral. In the meantime, get outside and show winter some love, and it will love you back.
Dr. Lee Brotherston
Oak Ridges Health Group
BMJ Best Practice. (2017). Bestpractice.bmj.com. Retrieved 3 January 2017, from http://bestpractice.bmj.com/best-practice/monograph/985/diagnosis/criteria.html
Seasonal Affective Disorder (SAD) - Canadian Mental Health Association, Ontario Division. (2017). Canadian Mental Health Association, Ontario Division. Retrieved 3 January 2017, from http://ontario.cmha.ca/mental_health/seasonal-affective-disorder-sad/#.WGwEsLGZORs
Seasonal affective disorder (SAD) Lifestyle and home remedies - Mayo Clinic. (2017). Mayo Clinic. Retrieved 3 January 2017, from http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/basics/lifestyle-home-remedies/con-20021047
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