Most of us have moaned about winter being a slog. Many will have felt down in the dumps too, the grizzly weather and long, dark nights taking their toll, counting down the days until spring, when everything will be cheerier, brighter, more fun.
But when does a touch of winter blues become full-blown seasonal affective disorder (SAD)?
A recent survey by Innolux lights from Purelifestylewonders (www.purelifestylewonders.com), which quizzed 1,000 25-65-year-olds, found 70% knew either very little or nothing about SAD.
It’s also become one of those terms that’s easily bandied around, but not so keenly understood - like obsessive compulsive disorder (OCD), a potentially major and debilitating mental health condition, far more than just being a bit anal about housework and needing things neat and tidy.
It’s believed around 6% of UK adults suffer from SAD, according to a report published in the British Medical Journal (BMJ). It’s three times more common in women, the Royal College of Psychiatrists notes, and the average age of onset’s around 27.
The simplest way to understand SAD is to think of it as depression - which is what it is, except it’s a form of depression triggered by the seasonal switch - so the symptoms will look the same. This includes low mood.
“You might be feeling like you don’t really want to meet anybody, you’re spending more time at home and isolating yourself. You’re sleeping more, or you’re sleeping less, becoming fidgety and irritable,” says psychologist and CBT psychotherapist, Chireal Shallow. “It’s a general sense of not being your usual self. You might not take great care of your appearance, you lose your temper a bit more, there’s also loss of appetite [though some people may find they over-eat].
“SAD is depression, but it just happens at a time when it’s affected by the cycles of nature.”
While associations between the seasons and moods have been talked and written about for eons, SAD was only officially recognised as a disorder in the Eighties.
It’s thought the lack of sunlight during winter affects the production of serotonin, the neurotransmitter linked to mood, appetite and sleep regulation (aka ‘the happy hormone’). Shallow notes “some people are more sensitive” to these changes.
NORMAL TO FEEL LOW
She points out that it’s normal to have off days and not feel at our happiest all of the time; it doesn’t automatically mean there’s something wrong.
“It’s important to normalise low mood. We all have periods of the day when our mood fluctuates, and that’s normal,” says Shallow. “In my view, most people will experience some kind of slump [during winter] because they’re more sedentary. We’ll be getting up in the dark, coming home in the dark; we will have a dip in our motivation and energy levels.
“But where it becomes significant - I might ask my patients, is it every day, is it several days? When you’ve got someone who’s experiencing it every day, that’s an indicator you’ve got something going on,” she adds. “And are you plagued with negative thoughts, like you’d be better off dead or hurting yourself in some way?”
Another indicator is where a drop in mood and motivation starts to “significantly impact on your ability to do your day-to-day activities”.
“When somebody is unable, because of how bad they feel, to get out of bed, leave the house, to talk to anybody, that’s a real concern,” states Shallow.
Most relevant for SAD, is that the depression follows a clear seasonal pattern.
“It’s not depression that’s related to external events, life events like losing your job, it actually just happens because of the season,” says Shallow, explaining that healthcare professionals - such as your GP - will ask whether somebody’s noticed a cyclical pattern in their symptoms coming and going with winter, year after year. “You might even notice that one year, you didn’t have it, but that’s because you took a holiday!”
That the depression returns annually is relevant, because, of course, it’s also perfectly possible to experience a depressive episode that just happens to coincide with winter. With SAD, winter is the cause - which is backed up by the fact many people with the condition find ‘light therapy’ (using a ‘light box’ or lamp that emits light designed to mimic natural sunlight) helpful for managing symptoms.
Although NICE (The National Institute for Health and Care Excellence) says evidence of their effectiveness is still unclear, some studies have reported positive results, and light therapy is often recommended.
SEE THE LIGHT
There’s lots that can be done to help manage SAD and reduce symptoms. Shallow notes the condition can vary in severity too, which might influence the treatment options recommended. “The NICE guidelines suggest treatment for severe depression is medication and behavioural therapy, CBT,” she says, adding that some might benefit from “behavioural prompts and tools”. This might mean self-help books, therapy, or making tweaks to our behaviours and choices that could make a big difference.
For example, “thinking about the food that we eat; we tend to eat more carbohydrate ‘comfort food’ in winter, and that can make us more sluggish and slows us down”, Shallow points out. Sticking to regular sleep patterns, getting plenty of exercise, and avoiding stress at work are also things that can help us manage low moods.
:: If you’re worried about depression, or feeling low is impacting your life, it’s always a good idea to speak to somebody, whether it’s your GP, a friend or a trained stranger on a mental health helpline such as Samaritans: 116 123
:: For more information about Innolux lights, visit www.purelifestylewonders.com