Winter in Bermuda can seem like paradise to the average traveller with sun most days and an average fall/winter temperature around 68 degrees. Despite this good fortune, people can still feel low in mood and energy in the winter because of the decrease in sunlight. This is commonly referred to as having the winter blues.
When the winter blues are severe, they are called Seasonal Affective Disorder or SAD for short. Many people experience mild winter blues, but SAD is much less common.
SAD rates in the US range from 1.4 per cent of the population in sunnier states such as Florida to 9.7 per cent in more northern states like New Hampshire.
In general, individuals with SAD tend to experience symptoms of depression.
They can feel down, hopeless, anxious and have a lack of energy. They may also experience social withdrawal, oversleeping, lost of interest, difficulty concentrating, increased appetite and weight gain.
However unlike depression, which can occur at any time in the year, individuals with SAD tend to experience these symptoms in the fall/winter months only and have no symptoms in the summer/spring months.
In most cases, this cycle can persist for years if untreated.
Like most mental health conditions, we are not absolutely sure what causes SAD, but it is likely that genetics, age and individual differences in body and brain chemicals such as serotonin (a neurotransmitter) and melatonin (a naturally occurring hormone) are the likely culprits.
Additionally, less hours of sun can result in a change in the body’s natural sleep-wake cycle (circadian rhythm), which may also contribute to the development of SAD.
SAD tends to be more common in women and in countries that are further away from equator, as these countries get less sunlight during the winter months.
Also, those with a family history of depression or SAD may be more likely to develop the condition.
Treatment for SAD is varied and includes light therapy, medications and/or psychotherapy.
Light therapy involves simulating sun light by sitting in front of a specialized bright light daily.
Research has shown that this can change chemicals in the brain linked to low mood within two to four days of treatment and has few side effects.
This is often the first choice of treatment for SAD. Light therapy lamps are now widely and easily available.
In more serious cases, or in cases where light therapy does not work, a medical doctor or psychiatrist might prescribe antidepressant medications.
The most common medications for SAD are a class of drugs called SSRIs, which affect the serotonin levels in the brain.
These medications tend to take two to three weeks to work and can have side effects.
If an individual is experiencing SAD yearly, a doctor might recommend taking medication just before the winter season to prevent the start of SAD.
Some individuals may also find psychotherapy helpful.
Although SAD is thought to occur because of a problem in brain chemistry, research has shown that with time, therapy focused on changing behaviour and negative thoughts that worsen depression may also successfully treat SAD.
If you suffer from SAD or even a milder version of winter blues, there are changes that can be made in your home which may be a protecting factor against the development of SAD.
For example, you can make your environment as sunny and bright as possible by opening curtains or blinds daily, trimming back trees or installing skylights.
Also, getting as much exposure to sunlight as possible, such as sitting outside to eat a meal or sitting near a window in the daytime and regular exercise, have been shown to combat against the development of low mood in the winter months.
If you feel that you are experiencing symptoms of SAD which are not improving, you should contact your medical doctor as soon as possible.
Dr Shawnee Basden, PhD, is a registered clinical psychologist with the Bermuda Hospitals Board.