As the summer sun bids its farewell, a distinct group of people seem to “fall back” as a mysterious change begins to take hold. Several individuals get caught in the embrace of the transitions of fall and winter, revealing a shift between their mood and energy levels. Ever felt a subtle dip in energy, a touch of melancholy, or an unexpected irritability as the days grow shorter? I’m here to share with you, you’re not alone.
Picture this: As the fall continues and daylight shortens, the days you want to spend with family and friends seem far and few in between. You’re going to bed earlier, not as hungry as before, and your concentration makes your days miserable at work or school. “What is going on? I had a great spring and summer and thought this year would be different.” You’ve just achieved that long-awaited promotion, your marriage is flourishing, and your grades have been stellar. Yet, as autumn unfolds its golden hues, an inexplicable desire to retreat from the world sets in. What’s happening? The answer may be simpler than you think; you could be experiencing SAD.
Not the ordinary “sad,” mind you, but rather a gradual deceleration of your usual mood and joyful spirit, and an uprising of Seasonal Affective Disorder (SAD). It’s not a standalone mental health diagnosis; it’s a specifier for major depressive disorder. A combination of symptoms not limited to low mood, irritability, hopelessness, sleep disturbance, decreased interest or pleasure in most things, significant weight changes, psychomotor changes (how fast or slow you move), fatigue or low energy, reduced concentration, or recurrent thoughts of death, coming together to form a pattern, most prevalent in the fall and winter months. To have a major depressive disorder, you have to exhibit five or more symptoms defined by the Diagnostic Systemic Manual-V for two weeks or more.
It’s a shadowy burden, often unnoticed until it becomes an unwelcome companion during winter’s chill. Individuals facing major depressive disorder with a seasonal pattern find themselves burdened by the weight of the world without a clear understanding. It’s not until they’ve withdrawn and isolated themselves during the cold months that a sense of relief sets in with the lengthening days and shorter nights of spring. This enduring pattern persists for years before some finally seek mental health advice.
As we move toward a more technical world that relies less on leaving our homes and workspaces, we are exposed to sunlight less frequently. Due to the limited exposure to the sun, moods will begin to change. The symptoms must be present for more days than not for a matter of two weeks or greater to establish a proper diagnosis of a major depressive episode. Afterward, you must be depressed for at least two years during the fall and winter months to develop a seasonal pattern of depression.
Fear not, for the solutions are at hand, and they don’t necessarily involve a pharmacy aisle. You don’t have to wait for a prescription to take action. The typical recommendations are not medications unless the symptom severity warrants medications, such as someone who is a threat to themselves, others, or property, or a person who cannot maintain their safety by providing the essentials for survival due to the depressive episode(s).
One recommended precautionary measure or remedy involves sitting and basking in the warm glow of a light therapy lamp for 20-30 minutes each morning, a simple ritual that could lift the weight of winter blues. The therapy lamp provides 10,000 lux of light, placed 16 to 24 inches from your face (warning: no direct staring, please).
For individuals facing more severe cases, a combination of talk therapy, SSRI medications, and consistent exposure to therapy lamp light is recommended. Additionally, prescription-strength vitamin D may be necessary, as low levels of vitamin D are associated with depression, particularly prevalent during days deprived of sunlight. The National Institute of Health reports that 1 in 4 adults lacks adequate vitamin D, a deficiency often linked to the shadows of depression.
Points to remember about seasonal affective disorder (SAD): It is not a psychiatric diagnosis alone. Instead, it is a type of depression specifier that can be used to describe depressive symptoms that present during the fall and winter months for two years or more. Treatment options can include light therapy lamps, exposure to more sunlight (going for walks during breaks), talk therapy, medication management, and replacement of deficient vitamin levels.
If this winter’s tale resonates with you, don’t brave the journey alone. Seek the counsel of a psychiatrist or therapist in your area, and remember the warmth of understanding awaits. Winter may cast its shadows, but you are not alone during the darker days.
Jasmine Kearse is a psychiatrist.
