Category Archives: SAD Basics

Why do we suffer from Seasonal Affective Disorder (SAD)?

Hello there! I hope you’re well and getting into the swing of your light routine? Finally, here is instalment number two of my ‘who, why, what, where, when and how’ of Seasonal Affective Disorder (SAD) and Winter Blues. It’s another long one, but I hope you’ll find it interesting! 😀

In this post I’ll be covering a couple of the accepted theories of why people get SAD and Winter Blues / Winter Depression. This is my own understanding, based on what I’ve read over the years and a little background reading I’ve done for this post. It’s taken me quite a while to write, as I keep changing my mind what to put in! I don’t want to overwhelm you with too much info, but wanted to give you enough too. As always, do let me know what you think?

Do we actually know what causes SAD and Winter Blues?

In short, no. The first thing to say is that nobody seems to really know what causes SAD and Winter Blues! There’s a lot of theories, but it’s likely that there’s a complex interplay of factors that determine whether an individual develops SAD or not.

The most commonly held theory is that a lack of exposure to daylight in the late autumn to early spring months affects the brain’s production of the hormone melatonin and the neurotransmitter serotonin.

The body has an internal body clock, known as the circadian rhythm. It regulates sleep/wake cycles, appetite, digestion, mood and many other functions. This explains why SAD affects us in so many different ways.

What we have to remember is that we are animals and in evolutionary terms our bodies haven’t caught up with the lifestyles we’ve adopted as humans. Before we learned to artificially light our homes, people went to bed when it became dark and woke when the sun rose. They also spent a lot more time outdoors and had more physical jobs.

 

SAD and melatonin

The brain responds to decreased light by increasing production of the hormone melatonin, which signals to the body that it’s time to sleep. In the morning, when light reaches the eyes, melatonin levels begin to decrease and the hormone cortisol is released. This gives us the get-up-and-go that we need to start the day.

Red traditional alarm clock - these can be difficult for SAD sufferersIn the depths of winter, when many of us need to get up while it’s still dark, the body hasn’t received the correct signals to wake up. This is why it can be a real wrench to get up and you may feel shocked out of sleep by a traditional alarm clock – your body simply isn’t ready to be awake! When you think about it, this way of waking is likely to activate your fight or flight response. You wake up stressed before you’ve even started your day! A dawn simulator can help with this, waking you up in a more natural way.

But the problem isn’t only to do with waking. On very dull days, your levels of melatonin can stay high throughout the day, leading to those feelings of lethargy and sleepiness that you might recognise all-too-well. Before I was diagnosed with SAD, I would return from college and want to go straight to bed – I couldn’t keep my eyes open!

SAD and serotonin

The neurotransmitter, serotonin, is also thought to have a key role to play in SAD, as it appears to in other types of depression. Researchers have found that levels of serotonin can vary from day-to-day and across the year, with levels markedly lower in winter. People with lower levels of serotonin appear to be more likely to experience symptoms of all kinds of depression.

Reading about how to increase serotonin in the human brain without drugs (Dr. Simon N. Young, 2007), this theory makes sense to me. If you’re anything like me, in winter you’ll be less likely to go outside at lunchtime, or whenever. Often eating at my desk means I move my bones less, get less natural light and I’m probably eating stodge, too. Carb cravings are a common symptom. I mean – who really fancies a salad in the middle of winter? Certainly not me! Haha – yes, yes, I’m aware that I don’t always follow my own advice! 😀

So, if light, exercise and a healthy diet are major natural ways of increasing serotonin production, then it would seem to follow that not doing/having these things may cause you to feel rubbish. At least, that’s how I understand it! 

Some further reading

As always, if you haven’t already, I’d recommend you have a look at the following excellent articles about SAD. They explain a bit more of the why in more medical terms than I have done:
NHS
Mind

If you’re interested in doing a bit more digging around into theory, here’s a few other theories that caught my eye:

People who suffer from SAD have an ‘unhelpful’ way of controlling serotonin –
Seasonal difference in brain serotonin transporter binding predicts symptom severity in patients with Seasonal Affective Disorder – Mahon et al (2014)

People who suffer from SAD may have retinal sensitivity anomalies –
Evidence of a Biological Effect of Light Therapy on the Retina of Patients with Seasonal Affective Disorder – Marie-Pier Lavoie,Raymond W. Lam,Guylain Bouchard,Alexandre Sasseville,Marie-Claude Charron,Anne-Marie Gagné,Philippe Tremblay,Marie-Josée Filteau,Marc Hébert (2009), Biological Psychiatry, Elsevier

People who suffer from SAD have lower levels of cortisol production in winter –
Seasonal differences in the diurnal pattern of cortisol secretion in healthy participants and those with self-assessed seasonal affective disorder – Thorn, Lisa and Evans, Philip D. and Cannon, Anne and Hucklebridge, Frank and Clow, Angela (2011), Psychoneuroendocrinology

An ongoing debate…

There’s a lot of debate still ongoing, though, as many of the theories don’t give absolute or satisfactory answers. So for example, suppressing melatonin doesn’t ‘cure’ SAD. Anti-depressants don’t work for everybody. Light therapy works for around 85% of people. It really does seem that individual differences can play a big part. So you may be more at risk of developing SAD if you or your family have a history of depression, or if you’ve been under chronic or sudden stress. If you suffer from depression that isn’t seasonal, it can feel worse in the winter.

Having said that, there does seem to be strong evidence to support the theories surrounding melatonin and serotonin having a key role to play. Correspondingly, there’s also strong evidence to support light therapy. If you want to do some more reading still, have a look at Lumie’s page of research abstracts. SADA members also receive monthly e-bulletins and longer newsletters three times per year which contain scientific news on SAD and Winter Blues.

I hope that this will have been a helpful post for you. Do you think there’s anything I need to add? What other theories have you read?

Take care,

– Neens –

Image credit
Alarm clock: http://www.freeimages.com/photo/alarm-clock-1621256

What is Seasonal Affective Disorder (SAD) and Winter Blues?

Well, I promised you in ‘SAD basics – where to start…‘ some longer, more detailed posts on the what, who, where, why, when and how of SAD and Winter Blues… and here’s the first of these posts. I hope you’ll find it helpful – do let me know, I’d love to hear your thoughts! 

Some analogies to help you understand SAD

I already told you my Tigger and Eeyore analogy, but I have a couple more for you that I use when trying to explain to friends and colleagues what SAD is. Before I go into them, I’d like you to know that these are just my ways of thinking about SAD and my experience. I’d also encourage you to look at the SAD Association (SADA) page, or NHS page for a more medical explanation, if you haven’t already – I’m not trying to replace or replicate their information.

I find it helpful to think of SAD and Winter Blues as a scale, or continuum, and everyone has their place on it. On one side, you have people who experience no change to how they feel in winter compared with how they feel in summer. Then further along are those who feel a bit down and notice a change in their moods when winter comes round (Winter Blues). On the furthest point of the scale are people who suffer from SAD and will be significantly affected by the lack of daylight in the autumn and winter months. Don’t laugh at my amateur attempt with Paint, but this is what I mean!:

SAD scale with non-sufferer on one side, further along is Winter Blues and at the far end is SAD

SAD is a type of depression, but it is different to other types of depression in that it has a definite seasonal pattern. Symptoms will appear in the autumn months and usually last until spring. But sometimes, if our lovely British climate gives us a long spell of rainy weather in summer, people can experience SAD symptoms in the summer months. Left un-managed, SAD can become debilitating to the same extent as any other type of depression.

How does SAD and Winter Blues make you feel?

My favourite way to describe this is that ‘I would quite like to hibernate, thank you very much!’ Like this little guy:

baby hedgehog

Like a hedgehog, before I learned to successfully manage my SAD symptoms, I really, really wanted to hibernate for the winter. I would’ve been quite happy to just sleep and for the world to leave me alone!

Like many people who suffer with SAD, I started noticing that I felt awful in winter around 17/18 years old. Typically onset of symptoms appears between 18-30 years old and is about twice as common in females as males. I was diagnosed with SAD at 20 after visiting my doctor in 2003.

I had all the classic symptoms: finding it hard to get up, get moving, concentrate. I would feel weepy and down and/or irritable for no reason. And I just wanted to sleep and eat – stodgy carbohydrates in particular! I remember my first year university flatmate laughing when she saw my food basket – filled with several different breads and potatoes and a token bit of chicken! 😀

Looking back at those few winters I spent feeling like that, I can barely believe I felt so bad. I’m not really sure how I functioned to be honest, but I know I wasn’t a pleasant person to be around on some days! I’m very glad that I had a clued up doctor; I appreciate not everyone has been so lucky to be diagnosed quickly and have lived for many years not knowing why they felt so bad.

I’m being really honest and open because I want you to know that you’re not alone in feeling this way. Or if you’re hoping to provide support to a family member or friend, then I want to stress that this is a serious condition and it’s not ‘all in the mind’. I want to help people understand the realities of suffering from SAD and Winter Blues and know that although there is no ‘cure’, you can manage the symptoms. Also, a little support and understanding goes a long way! 🙂

What helps with SAD and Winter Blues symptoms?

According to SADA 85% of people can successfully manage their symptoms using light therapy, which is how I manage mine mostly. If light therapy doesn’t work for you, or isn’t enough on its own to manage your symptoms, then your doctor might recommend using anti-depressants and/or having some Cognitive Behavioural Therapy (CBT) sessions. I’ve tried both!

CBT was very useful for encouraging me to be more compassionate towards myself when I’m struggling. I’m very perfectionist and hold myself at times to standards that I would never expect of someone else – but I’ll beat myself up about not getting things done or not being good company. I know many people with SAD do this! I’m slowly learning to give myself a break. I can also recommend Paul Gilbert’s compassion work.

Last year, my doctor also convinced me to take a low dose of antidepressant all year round. I say convinced because believe me, I really didn’t want to go on them! I had to do a lot of soul-searching to understand why I was so resistant and I think I will do a separate post on this, so won’t go into detail here. Suffice for now to say that the medication helps and I’ve finally accepted and am grateful for this help because what it comes down to is this: you don’t get given any medals for struggling on.

Honestly – I’ve taken this previous paragraph out and put it back in a few times because I am all-too-aware of the stigma of depression and using antidepressant medication. I still struggle with the idea I may be judged harshly. But I run this blog and my events because I want to show up – be real – and encourage you to do the same or we will never get past these stigmas in our society.

Get Help with SAD and Winter Blues!

If you think you have SAD or Winter Blues, I really do recommend you see your GP. Tell them how long you have been feeling as you have and describe all your symptoms as fully as you can. You might find it helpful to keep a simple diary of how you feel each day to show them. You really don’t have to live feeling like you’re a different person for half of your year. It might take you a little while to find the best management strategies for you, but understanding that you have SAD and that you’re not alone I hope will give you some comfort.

I’m going to do a separate, fuller post on treatments, but if you want some info in the meantime, you can take a look through some of the resources I’ve collected for you to read.

I hope this post has given you some useful information about what SAD and Winter Blues are – and some hope that you can feel better – but feel free to use the comments box below to ask any questions you might have.

– Neens –

Image credits:

http://www.freeimages.com/photo/baby-hedgehog-1623457

 

SAD basics – where to start?

Seasonal Affective Disorder (SAD) and its milder form, Winter Blues (also known sometimes as Winter Depression, or medically as Sub-syndromal SAD) affects over a quarter of the UK population*. Does that surprise you? It did me! So even if you don’t suffer from one of these conditions yourself, it’s highly likely that someone close to you does. Read on to help you get up to speed with some SAD basics.

Eeyore looking sad and Tigger bouncingOne of my favourite ways to describe SAD is through these little fellas; Tigger and Eeyore. I tried out this analogy on a friend once and he loved it!

SAD is thought to be caused by a lack of light. During the late autumn and winter months, the shorter days and lack of sunlight can affect chemical levels in your brain, making you feel down, irritable, lethargic and unsociable – a bit like Eeyore. But in the spring and summer months you feel more ‘yourself’, and even in the depths of winter, a sunny day can bring out the Tigger in you! Some people even experience mania-type symptoms once spring comes round, known as Hypomania. That’s probably where everyone’s energy comes from for the big spring-clean! 😉 For a bit of fun, I found this quiz to identify which Winnie the Pooh character you’re most like – I turned out to be Kanga! 🙂 

SAD basics – the facts

SAD is a type of depression. I know some people aren’t comfortable with this description, but medically, they do sit on the same scale. What differentiates SAD from other types of depression is that it has a very definite seasonal pattern. You normally will have experienced symptoms in a particular season that disappear reliably in another season for three consecutive years before you would be diagnosed with SAD.

There are also other, rarer types of SAD that people suffer from, such as Summer SAD. This site mostly addresses Winter SAD and Winter Blues, as the most common form of the condition and the kind that I suffer from. Other tell-tale differences are that unlike ‘classic’ depression, you tend to want to sleep and eat more (usually carbs) when you suffer from SAD, whereas with ‘classic’ depression, people often lose their appetite and find it difficult to sleep. This is a very individual condition though, so it’s always worth checking any symptoms with your doctor, rather than self-diagnosing.

For interest, though, you might be wondering what are the other symptoms of SAD? Well, I mentioned some of the main ones already, but a few of the most common others include:

  • Bread with a heart cut out of the middleDisturbed sleep patterns 
  • Loss of interest in things you normally enjoy and social withdrawal
  • Craving carbohydrates and sweet foods (comfort food!)
  • Loss of libido
  • Anxiety
  • Difficulty concentrating/feeling fuzzy-minded
  • Lowered immune system in winter

Managing SAD

There isn’t a ‘cure’ for SAD or Winter Blues. However, many people can successfully manage their symptoms using light therapy. The SAD Association estimates that this will work for around 85% of sufferers. Your doctor may also recommend treatment with medication and talking therapies. 

You’d normally use light therapy daily from the onset of your symptoms, often from around September until April when the daylight hours lengthen. The treatment involves exposure to a bright SAD light that simulates the level of light you would get on a bright spring day. How long you need to use the light for depends on the severity of your symptoms and the strength of the light. 

I whole-heartedly recommend giving light therapy a go – I have managed my symptoms since being diagnosed using a SAD light and a dawn simulator, which wakes me gently with light in the morning. I recommend dawn simulators to everyone, regardless of whether or not they suffer from SAD – they’re such a lovely way to wake up! 🙂 

I hope this introduction to some SAD basics has been helpful to you. I will write some more in-depth posts, but if you want more information on SAD and Winter Blues before then, please have a look at this NHS page and SADA’s website.

If you’re able to attend events in Newcastle upon Tyne, you can get a taste of what light therapy is all about at Little Light Room events.

What Winnie the Pooh character do you identify with? Is there something in particular that you’d like me to cover in a future post?

Take care!

-Neens x-

*http://www.theweathercompany.com/SAD%20research%20UK

Image credits:
Tigger and Eeyore: http://www.chicagonow.com/cheaper-than-therapy/2013/11/are-you-a-tigger-or-a-eeyore/
Bread: http://www.freeimages.com/photo/love-food-1306422