Synopsis: Some people, especially those in northern latitudes, may get the blues or worse as fall sets in and days get shorter. They suffer from seasonal affective disorder, a chemical change in the brain caused by decreased exposure to sunlight. Experts discuss causes and remedies.
Host: Nancy Benson. Guests: Dr. Nicholas Forand, clinical psychologist, The Ohio State University Wexner Medical Center; Jim LaValle, clinical pharmacist and nutritionist and author, Your Blood Never Lies and Cracking the Metabolic Code
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Seasonal Affective Disorder
Nancy Benson: For some people, especially in places where winter includes gloomy skies and snow, this time of year can be exceptionally difficult. Holiday cheer may be all around them, but their mood and energy get lower and lower. They suffer from the symptoms of Seasonal Affective Disorder, or SAD.
Dr. Nicholas Forand: Actually they’re very similar to the symptoms of depression. So there will be the decrease in mood, so feeling sad, feeling blue, feeling down; certainly a decrease in energy.
Benson: Dr. Nicholas Forand is a clinical psychologist at the Ohio State University Wexner Medical Center.
Forand: Some of them more specific symptoms associated with this seasonal pattern of mood disturbance are difficulty waking up in the morning, tending to oversleep, sleeping more, having a craving for carbohydrates or a general increase in appetite, which may lead to weight gain. There can also be an increased sensitivity to rejection and along with that a withdrawal from friends, family, social activities, decreased sex drive and other things like that. Other more common symptoms, or symptoms that are more in common with other kinds of depression would be difficult concentrating, completing tasks, and other things of that nature, sort of the more typical symptoms you might see in depressed individuals.
Lavalle: There are some symptoms, too, that you may not think are related to Seasonal Affective Disorder, like your limbs could feel heavy. That’s interesting, right? That you literally, as a part of this, that you could have that your legs are moving through quicksand.
Benson: That’s Jim Lavalle, a clinical pharmacist and nutritionist and author of the book, Your Blood Never Lies, and Cracking the Metabolic Code. He says Seasonal Affective Disorder is a function of getting less sun as the days get shorter.
Lavalle: What happens is during winter months when we’re not getting as much sun exposure literally your brain makes more of a certain chemical compound. What ends up happening is you don’t have as much available serotonin, so when your serotonin’s low, you’re going to get more grumpy, you’re going to notice yourself be more agitated, you also end up making more melatonin in this situation, so you end up being kind of tired when you wake up in the morning and feel fatigued and lethargic through the day. It all has to do with the fact that when you’re not getting enough sunlight it alters the neurochemicals in your brain, serotonin being the principle one, and that causes a change in your mood.
Benson: And as you’d expect, Seasonal Affective Disorder is much worse in areas of the world where there’s less sun.
Forand: The prevalence rates are, it depends on what you consider to be the actual condition, but for Seasonal Affective Disorder itself, it ranges from between around one percent to around nine percent in the U.S., and that depends actually how far away from the equator you are. In Florida, it’s about 1.4% of people who develop Seasonal Affective Disorder. In Alaska it’s 8.9%, and the higher latitudes have higher rates. So in northern Europe and other places around the world where there’s less light around this time of year.
Lavalle: I moved from Cincinnati to California, and one of the striking things I noticed was that in general people were happier in California. It would be easy to say, oh well, it’s California, but hey, more traffic, more expensive to live. You wouldn’t think, necessarily, that that’s the case, but I’m telling you, I could see a huge difference in people in the winter between here and back in the Midwest where it gets very dark, the sun doesn’t come out a lot during the winter months.
Benson: Forand says Seasonal Affective Disorder may have an evolutionary purpose. Our caveman ancestors had less food available in the winter, so it made sense to be less active. But now a down trend in a person’s mood stands in stark contrast with the holiday cheer we’re supposed to be feeling, even if it’s not all due to SAD.
Forand: In my practice I find that there is more or less an even split between people who are pleased that the holidays are coming around and those people that are quite upset and stressed out about the holidays coming around. A lot of people visit their families and not everyone has a happy family life. Not everyone enjoys seeing their families. There’s also the stress of putting on holiday get togethers, having people over to your house, you may not, if you’re the kind of person who’s already depressed or anxious or stressed out for various reasons, this is another burden added on you. So, it’s not uncommon for some folks to find this to be quite a difficult time of year.
Benson: However, people who get the blues every fall like clockwork can do something about it. First, Lavalle says, get out into the sun whenever it’s there. Open the drapes in your house. Block carbs in your diet with kidney bean extract, consider a winter vacation to a sunny destination, and cuddle a little more with the one you love.
Lavalle: It sounds weird, but hugging stimulates your immune system as well as reduces feelings of anxiety and depression and creates positive moods by creating different neurochemicals in your brain. You get the feel-good neurochemicals when you hug and when you cuddle.
Benson: If that doesn’t work, Forand says scientists have confirmed the effectiveness of several treatments for Seasonal Affective Disorder.
Forand: The most studied treatment for Seasonal Affective Disorder is bright light therapy. There’s some evidence that people that are vulnerable to get their sleep-wake cycles or circadian rhythms a bit off set during times when it’s darker during the morning and the evenings. Some of that can be corrected by providing bright light in the morning and in the evening. You can get a light box that will provide this light for you. Use it for 30-60 minutes, sometimes once a day, sometimes twice a day. It’s proven to be quite effective.
Benson: And if that doesn’t work either, seeing a therapist often does the trick.
Forand: There’s a study that just came out that suggests that a specific type of psychotherapy called Cognitive Behavioral Therapy is actually as effective as the light box over the shorter term and more effective over the longer term at preventing relapse. It teaches you that the connection between how you think, what you do, so your behaviors and cognitions, and how you feel — it uses those ideas to help you make some changes.
Benson: Forand says people with Seasonal Affective Disorder often isolate themselves, and that only makes the condition worse. Cognitive Behavioral Therapy can help people get out of what’s really a self-fulfilling prophecy.
Forand: These people might have thoughts around this time of year that, we can imagine what they might be like. “Oh no, it’s dark again. I always get depressed around this time of year, holidays are coming up, everything’s going to be terrible. I can’t stand my family, this is just going to be the worst; I’m going to hide in my house.” Those aren’t very helpful. They may or may not be accurate. They may be some thoughts that are relatively biased, there may be some thoughts that aren’t quite right. They have a large effect; they are very convincing when you’re thinking those things. They make you want to stay inside and hide. What CBT does is actually teaches you to be a bit more objective about those kinds of thoughts. It actually provides you with some tools to evaluate and see if they actually make sense or if they might be a bit biased.
Benson: Forand says it’s a good idea to be proactive. Get out and do things and that will fight your urge to stay home and hibernate. It’s also likely to make the holidays a little happier for those who never felt very merry before. You can find out more about all our guests on our website radiohealthjournal.net. Our production directors are Sean Waldron and Nick Hofstra. I’m Nancy Benson.