Seasonal Affective Disorder
So it’s winter here in Ohio, and I absolutely love living in Cincinnati. It’s one of my favorite places. Cool people, cool food, awesome music and art, low cost of living, but I tell you what I could do without: gray overcast days. It’s essentially steel gray overhead from October through March. And I treat a lot of depressed folks. So here’s what I hear a lot of during these upcoming months:
“Gosh doc, I just can’t seem to get out of bed.”
“I’m constantly running late because I’m hitting snooze like 9X.”
“I’m tired all the time…and as soon as it hits 4pm, I’m ready for bed.”
“I think my antidepressants have stopped working.”
“My friends think I’ve been kidnapped…I never show up anymore.”
“I’m still exercising but I want ALL THE CARBS.”
So many of our patients complain of a drop in mood, motivation, energy, and excessive sleep as the days get shorter. As humans, we are wired to be awake and alert during daylight hours, but what happens to us when there’s less daylight?
Seasonal Affective Disorder, now recognized by the DSM V as a form of depression, affects 3% of the general population, 20% of all people diagnosed with major depressive disorder, and 25% of all people diagnosed with bipolar disorder. And the closer to the north pole in latitude you are, the worse it gets.
S.A.D. is characterized by feelings of depression, mainly in the winter months, oversleeping, overeating, possible weight gain, an increased craving for carbohydrates, and a decreased libido. Your body is essentially trying to hibernate as daylight hours decrease and decrease!
Our hormones and neurochemicals are closely tied to sunlight and the sleep/wake cycle, especially melatonin, the “sleepy” hormone which is produced in the pineal gland. When we wake up we naturally get a burst of cortisol, which is usually associated as the “stress” hormone, and a drop in melatonin, the sleepy hormone, as long as we are exposed to daylight in the morning, melatonin will continue to be suppressed for another 10-12 hours and by that time our cortisol level drops as well, making us feel tired. That post-dinner, post-news watching nappy-bye in the recliner? Likely caused by an after-dinner surge in insulin and an increase in your natural melatonin.
Sunlight, in terms of frequency, falls in the blue-light spectrum of colors. You WANT sunlight in the morning but NOT in the evening when you’re getting ready to go to sleep or are winding down for the evening.
Anything electronic: phones, tablets, TVs, all EMIT blue light, which mimics sunlight. Which means your pineal gland believes it’s time to “get up” for the day instead of shutting down and it will further suppress your internal spike of melatonin. This is why blue light blockers have been all the rage since people became addicted to their smart phones a few years ago.
SO WHAT CAN WE DO ABOUT IT?!?!?!?
1. Get some sunlight every day. The best time is between 6-9am when the blue light spectrum is the best, and try to do it for at least 30”. If the weather doesn’t permit, get a lightbox that emits at least 10,000 lux (which is considered medical grade as it simulates sunshine.). Just make sure you have it on with no glasses, contacts, or windows in between you, and best to have it close to arm’s length away. I tell people to keep their light boxes on the vanity in the bathroom so the minute they get out of the shower in the morning they can turn it on while they are getting ready.
2. Keep a regular sleep schedule, at least between 1-2 hours when you wake up and when you fall asleep, even on the weekends. (Yeah, I know, I heard the groans from the back of the room!)
3. Try to avoid naps during the day, unless they are under 20”. It can take away from restful sleep at night.
4. Reserve the bed for sleep and sex only. Don’t do your homework or finish up your charting. Don’t pay the bills or send a ranting email to a coworker. Your brain makes associations between where you are and what you’re doing. It will revert to wakefulness if you’re busy engaging your brain while you’re in bed.
5. Avoid electronics at least 2 hours prior on when you’re intending to go to sleep. Set a timer if you need to. This will help your brain wind down and make a melatonin surge more likely.
6. Avoid over-the-counter melatonin, if you can, for any longer than two weeks or your body will stop producing it internally. If you have rotating shifts, or you’re coming back from a work trip from “across the pond” and have crossed multiple time zones, feel free to take it for a few days to reset your sleep cycle then let your body take over the rest.
7. Avoid any spicy food, caffeine, alcohol, tea, chocolate, mints, or overeating at dinner. All can cause your lower esophageal sphincter to open up and make you more prone to reflux, which is NOT sleep-inducing.
8. Exercise daily, even light walking, for at least 30”. Try not to do anything too strenuous 2 hours before bedtime or you’re going to kick the cortisol up a notch.
If you’ve tried all the above, and you’re still feeling blue, or your sleep is still outta whack, call your doctor for other treatment options. They may recommend getting you onto an antidepressant, checking your hormones, increasing the meds you’re already on, changing meds…there are lots of options. The main point here is recognizing and getting ahead of it BEFORE it affects your work, your relationships, and slows you down. So let’s get out of hibernation, you guys, and kick S.A.D. in the butt!
So, if you found this information helpful, please like, subscribe, and follow us! Tell your friends. We’re @AndersonClinicCincy on Facebook, Instagram, and TikTok. And you can find our Psych Waves podcast on Apple and Spotify. And if you happen to be in the Cincinnati area and are looking for assistance with treatment-resistant depression, anxiety, concussions, or PTSD, give us a call at (513) 321-1753. Start feeling better faster.