Gone are the days of ripe mangoes, sizzling barbeques, and the low evening hum of air-cons across the country working overtime to combat the scorching summer heat. Instead we’re facing cooler days, longer nights, and a serious drop in sunlight.
You may well be reading this and thinking “I’m glad those ridiculous 40 degree heatwaves are over – I love winter weather!” But for many Australians, the onset of winter can bring feelings of despair, sadness and isolation.
Winter depression, also known as Seasonal Affective Disorder (or SAD), affects 1 in 300 Australians – and many more suffer milder symptoms of the winter blues every year. SAD is a form of clinical depression – the symptoms usually appear during autumn and towards the onset of winter, but resolve during the spring months. It is 4 times more likely to affect women than men, and people living in urban areas are also at increased risk of developing SAD.
What causes seasonal affective disorder?
Research suggests that decreased light exposure in winter may trigger seasonal affective disorder by disrupting the body’s circadian rhythms and serotonin levels. When nights are longer in winter, the brain produces more melatonin, a sleep and mood-related hormone that affects circadian (sleep/wake) rhythms. Conversely, less sunlight in winter inhibits the production of serotonin, a neurotransmitter that regulates sleep, appetite and mood.
Symptoms of SAD
SAD can be difficult to diagnose because it shares so many symptoms with other forms of depression. If you’ve been experiencing a combination of the following SAD-related symptoms, it might be time to see your GP:
- Acute fatigue and lethargy
- Sleep disorders (either insomnia or hypersomnia)
- Increased appetite (especially cravings for sugar and carbohydrates)
- Weight gain
- Difficulty focusing and concentrating
- Social withdrawal and introversion
Treatment options for Seasonal Affective Disorder
Over the past thirty years light therapy, anti-depressants and cognitive-behavioural therapy (CBT) have all been used to treat SAD, individually and in combination. Research has shown that the two most effective treatments for SAD are light therapy and CBT.
Bright Light Therapy for SAD
Light therapy involves daily exposure to an artificial lightbox that emits very bright light, on par with the intensity of sunlight. When the light enters the eye via the retinal receptor system, a signal is sent to the pineal gland in the brain to suppress melatonin production, thus regulating the circadian rhythm and sleep/wake cycle.
The recommended session duration is 30 to 60 minutes every morning, and the time of day that yields the most benefit varies depending on each person’s personal chronotype (i.e. whether you’re an early bird or a night owl). You can learn more about your chronotype by taking this survey: http://www.cet-surveys.com/index.php?sid=61524&newtest=Y
If you’re interested in trying light therapy, it’s absolutely crucial that you do so under the guidance of your GP or other mental health professional. Common side-effects from light therapy include headaches, nausea and visual disturbances.
Another alternative to lightboxes are ‘dawn simulators’ – similar to an alarm clock, these lights activate 30 minutes before you wake up, gradually increasing light in your bedroom in a way that mimics sunrise. A recent study demonstrated that dawn simulators were as effective as lightboxes in alleviating the symptoms of SAD. In fact, some participants preferred using the dawn simulators because they had less side-effects than lightboxes, and didn’t require a daily time commitment in the morning.
Cognitive-Behavioural Therapy for SAD
Until recently, bright light therapy was considered the gold standard in treatment for SAD. Yet light therapy only alleviates the symptoms of SAD each season, rather than resolving the condition.
A recent study examined the efficacy of light therapy and cognitive-behavioural therapy for SAD over the course of two winters. The researchers discovered that although both methods effectively treated the symptoms of SAD, cognitive-behavioural therapy (CBT) was by far the most effective form of therapy at the 1 and 2-year follow up.
Instead of suppressing symptoms of SAD and requiring an annual ongoing commitment, CBT tailored to address seasonal affective disorder focuses on developing effective wintertime coping skills.
CBT for SAD identifies, challenges and transforms negative thinking and behavioural patterns that are triggered in the colder seasons. CBT counselling helps people to overcome seasonal mental health challenges by:
- Focusing on incorporating enjoyable activities into their winter routine
- Shifting perspectives about negative winter associations
- Developing distress tolerance skills to combat the winter blues
People who use CBT to recover from SAD experience rapid improvement in symptoms, and fewer relapses as compared to other forms of treatment. As such, CBT is the most effective long-term treatment for SAD.
If you’re struggling with the winter blues, or you’re worried that you’re experiencing the symptoms of SAD, there are a number of helpful things you can do. Talk to your GP about checking your hormone levels, make sure you get outside as much as possible to take advantage of the winter light, and know that counselling support for seasonal affective disorder is an excellent option in the fight against winter depression.
Seasonal affective disorder research resources
Forneris, C. A., Nussbaumer, B., Kaminski‐Hartenthaler, A., Morgan, L. C., Gaynes, B. N., Sonis, J. H., … & Van Noord, M. G. (2015). Psychological therapies for preventing seasonal affective disorder. The Cochrane Library.
Mc Mahon, B., Andersen, S. B., Madsen, M. K., Hjordt, L. V., Hageman, I., Dam, H., … & Hasholt, L. (2016). Seasonal difference in brain serotonin transporter binding predicts symptom severity in patients with seasonal affective disorder. Brain, aww043.
Meesters, Y., & Gordijn, M. C. (2016). Seasonal affective disorder, winter type: current insights and treatment options. Psychology Research and Behaviour Management, 9, 317.
Melrose, S. (2015). Seasonal affective disorder: an overview of assessment and treatment approaches. Depression Research and Treatment, 2015.
Rohan, K. J., Meyerhoff, J., Ho, S. Y., Evans, M., Postolache, T. T., & Vacek, P. M. (2015). Outcomes one and two winters following cognitive-behavioural therapy or light therapy for seasonal affective disorder. American Journal of Psychiatry, 173(3), 244-251.
Srinivasan, V., de Berardis, D., Fornaro, M., López-Muñoz, F., Partonen, T., & Zakaria, R. (2016). Melatonin, Sleep, Circadian Rhythm, and Mood Disorders. In Melatonin, Neuroprotective Agents and Antidepressant Therapy (pp. 117-127). Springer India.
Danilenko, K. V., & Ivanova, I. A. (2015). Dawn simulation vs. bright light in seasonal affective disorder: Treatment effects and subjective preference. Journal of Affective Disorders, 180, 87-89.Ask us how we can help you