Winter is Coming…

Every fall we start to see the trees turn into beautiful colors and we begin waking up to crisp morning. Eventually we all share a similar thought about the seasonal changes and how winter is coming. Every year thousands of Americans struggle with a decrease in their mood as the cold weather sets in. This decrease in mood is also known as Seasonal Affective Disorder. Seasonal Affective Disorder (SAD) is a type of depression that comes and goes with the seasons, typically starting in the fall and early winter and going away during the spring and summer. Many patients will report that when there is a dramatic shift in the weather that they will have more frequent and intense depressive symptoms. In fact, at our clinic our providers receive a significant increase in referrals for mood disorders every Fall.

Some symptoms that you may notice that may be impacting you or someone you loved could be the following:


Feeling depressed most of the day, nearly every day
Feeling hopeless or worthless
Having low energy
Losing interest in activities you once enjoyed
Having problems with sleep, this could be insomnia or hypersomnia
Experiencing changes in your appetite or weight
Feeling irritable
Having difficulty concentrating
Social withdrawal/isolation

Who is at Risk?

Research shows that Seasonal Affective Disorder effects more females than males. In fact, SAD is diagnosed four times more often in women than men. Individuals who live in colder climates have a greater chance for SAD as they have less exposure to the sun and Vitamin D from the suns rays. Patients who have a family history of SAD or a history of other mental illness have a greater chance of experiencing this disorder.

What can I Do?

There are several treatments you can began to help decrease the impact of Seasonal Affective Disorder. You can choose to do one of these suggestions, a combination, or all together. Everyone is different which means we all must find what works for us!
Below are just a few recommendations that I have found to work for many of my patients:

Medication:
Selective Serotonin Reuptake Inhibitors (SSRIs) are used to treat SAD. The FDA has also approved the use of bupropion, another type of antidepressant, for treating SAD. Medications can be an effective tool to combat any mood disorder. However, is it vital to work with a trained medical provider to find the best medication and dose for you. It can be discouraging to try several medication to find the right fit for you and many patients become so discouraged that they quite. However, medication intervention is one of the more effective steps to treating SAD.

Light therapy:
Light therapy has been a recommended approach since the 1980’s. This approach can be especially useful for patients who live in colder climates where there is less sunshine. lights designed for light therapy filter out the ultraviolet rays and require 20-60 minutes of exposure to 10,000 lux of cool-white fluorescent light, an amount that is about 20 times greater than ordinary indoor lighting. It is recommended to place this light either to shine down on the top of your head to reach the optical nerve or to the sides of your eyes to limit direct eye exposure to the light. It is best to use the light early in the morning as using it at night can disrupt sleep.
*A word of caution – light therapy has been shown to cause mania in individuals who have Bipolar Disorder. Please consult your medical provider before use.

Here is a light that I have recommended to my patients

Psychotherapy:
Cognitive Behavioral Therapy (CBT) is type of psychotherapy that is effective for SAD. CBT focuses on challenging and changing unhelpful cognitive distortions and behaviors, improving emotional regulation, and developing personal coping strategies to alleviate depressive symptoms.

Emotional Freedom Techniques (EFT also known as Tapping) is a type of psychotherapy that is effective for many mental health disorders, including SAD. Both tapping and acupuncture heal through stimulating the body’s meridians and energy flow. However, with tapping there is no use for needles as you use your fingers to tap on certain pressure points on the body. By tapping end points on meridians a network of channels that transport energy open and the energy is unblocked and releases the thought, pain, or symptom.

Vitamin D:
Years ago I worked alongside a team of Nurse Practitioners and like clockwork every September they started to advocate to everyone in the office to start taking 5000 IUs of Vitamin D3. We live in a colder climate area where sunshine is limited for 9 months out of the year. Research is limited at the effectiveness of Vitamin D3 for SAD though many patients have claimed that they notice a difference when taking Vitamin D3 along with other approaches such as therapy.

Knowledge and awareness of how the change in seasons impacts a person will help them find ways to address the changes in their mood. If you or someone you love is impacted by SAD remember that it is okay to reach out for help. There are many local counseling agencies and medical professionals that are trained to help.

As Always,
Embrace the Journey

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