Outside it’s cold, gray and gloomy.
Could the way you are feeling have something to do with the weather?
Oftentimes referred to as the “winter blues,” living with Seasonal Affective Disorder (SAD) can put a damper on your mood, but there are several things that you can do to keep your mood steady throughout the year.
Dr. Steed talks to you about the causes of SAD and effective ways to treat the disorder.
Shedding Light on Seasonal Depression; Effective Ways to Treat Seasonal Affective Disorder (SAD)
Featured Speaker:
Alan Steed, PhD - Psychology
Dr. Alan Steed is clinical director of Allina Health Mental Health and psychologist at Allina Health Eagan Clinic. Dr. Steed has professional interests in behavioral medicine, anxiety and mood disorders, hypnosis, group therapy, stress management, chronic illness and behavioral therapy applications. Transcription:
Shedding Light on Seasonal Depression; Effective Ways to Treat Seasonal Affective Disorder (SAD)
Melanie Cole (Host): Outside it’s cold and gray and gloomy. Could the way you’re feeling have something to do with the weather? Oftentimes referred to as the winter blues, living with seasonal affective disorder or SAD can put a damper on your mood, but there are several things that you can do to keep your mood steady throughout the year. My guest today is Dr. Alan Steed. He is the clinical director of Allina Health Mental Health and psychologist at Allina Health Eagan Clinic. Welcome to the show, Dr. Steed. What is seasonal affective disorder or SAD?
Dr. Alan Steed (Guest): SAD is a type of depression. Actually, SAD is a qualifier. SAD is a major depression that may be very much related to seasons, and people that experience symptoms of depression during the fall and winter months are said to be affected with SAD.
Melanie: How is it actually caused?
Dr. Steed: I wish we had a really good answer for that, but there are probably many contributing factors. SAD is considered to be light-related, so as the days grow shorter in the fall and certainly in the winter months. We’re exposed to less sunlight, less vitamin D. That’s another possibility that if affects our vitamin D levels, which affects energy. There’s a thought that it is also related to serotonin levels in the brain. Serotonin is a neurotransmitter that creates a sense of well-being for us. And if this is impacted, then obviously we’re going to experience symptoms of depression or just lethargy.
Melanie: How common is this? Do a lot of people experience this, or are some immune from it?
Dr. Steed: There are some that are immune. I wish we had more specific numbers, to be very honest. But it’s estimated that anywhere from 10 to 20 percent of the population experiences some degree of it. However, I think a much smaller percentage of people, maybe 1 percent—and I think that’s an estimate—are very much debilitated by it. Certainly, I’ve dealt with some of those people in my clinical practice who just have difficulty getting up and going to work, lose their jobs, become extremely depressed, and struggle with it for the period of time that the days are shorter.
Melanie: Now, are there certain risk factors that increase chances of developing SAD? If your family has clinical depression in your genetic history, are any of those things contributors?
Dr. Steed: Yes, it’s a contributing factor. Those people with SAD are more likely to have a biological relative that has major depression in their background. If you have a close blood relative that also experiences SAD, it’s more likely, although not determined, that you may also experience SAD.
Melanie: Then what are the symptoms people might experience that would let them know this is what’s going on and maybe I need to take control of it and do something about it?
Dr. Steed: The symptoms are very similar to those of just general depression. If you have a period of a couple of weeks at least where you’re just feeling tired and little energy and feeling hopeless, irritable, you may notice a change in your weight and appetite. You may notice a change in your sleep pattern. You’re having difficulty falling asleep or staying asleep, or possibly sleeping too much. Anything that impacts sleep is related to depression. Some people tend to become more irritable. Now, these are more symptoms that are characteristic of the winter SAD. There is a version of summer SAD, which occurs during summer months for some people and at a smaller percentage. But in that instance, you may have some of the symptoms of depression but probably more symptoms related to agitation and anxiety.
Melanie: Dr. Steed, let’s talk about treatments. First line of defense. If you suspect that this is what you’re suffering from, you’re feeling that hopelessness and you’re feeling sad and tired, maybe gaining weight, lethargy, any of these things, do you start off by trying to do something for yourself, such as exercise, or do you see a doctor pretty quickly?
Dr. Steed: Well, I think doing the exercise and doing the things we would normally do to maintain our physical and emotional well-being during these months is important. But I would also say if you have a pattern of these kinds of symptoms over the last year or two that a visit to your physician would be a very important thing to do. When symptoms are mild to moderate, a very common form of therapy is called phototherapy. And in this instance, you would sit in front of a light box, hopefully first thing in the morning. The light box needs to be a minimum strength of 10,000 lux. That’s the measure of the strength of the light. Most people would need to sit in front of that at a close distance for about 30 minutes. Again, as I said, I think doing so first thing in the morning is the best recommendation. After that, you may want to consult with a physician. Anti-depressants are commonly recommended and can be very helpful, but there are other things that you might do which would not require medication, and that would just be surround yourself and get out in as much light as you can. Go for a walk every day. Work in an environment, if it’s at all possible, where you have windows and light, and open the blinds. I think there is a tendency for many people when they’re feeling down is to just shut the world out a bit and close the blinds, then create a dark, safe space. But to deal with SAD, just the opposite behaviors would be very important. Be very much aware of the tendency to overeat and certainly, one of the telling symptoms is craving carbohydrates, and certainly that leads to some weight gain, especially as people diminish their activity. I would also encourage you to continue to develop social support and get out and be with people. Get to the gym. In some of the gyms, actually, they have mind-body therapies. They have yoga. They can do some massage. Anything that helps you get out and stay active can be very helpful. I remember one person that I dealt with many years ago. Her cure for her winter SAD up in Minnesota was to go to Phoenix every winter for a week or two. That brought her mood back up very quickly, but then she came back and had to maintain all the self-care activities that she’d been involved with in the first place. It’s not the ultimate cure unless she can move there.
Melanie: Some light’s a really big deal. Now, what about vitamin D and taking supplements that help sort of replenish your body of those missing vitamins?
Dr. Steed: Well, that’s another physician’s call. As a psychologist, I don’t and shouldn’t be recommending that. However, I know that there are many people whose vitamin D levels dip significantly, and the prescription written by doctors is not for just the over-the-counter dosage of vitamin D, but it’s massive doses. I would recommend that before they consider anything involving vitamin D that they check with their physician.
Melanie: In just the last couple of minutes, Dr. Steed, if you would, please tell us if we can prevent the onset of SAD before it actually happens, and if you have a friend or a loved one who suffers from this, what’s your best advice for ways to help someone else that might be having this?
Dr. Steed: I think prevention is about doing as much as you can. It’s style-based. It’s keeping yourself active all through the summer and not letting it drop off as the days get shorter in the fall, finding ways to maintain social and emotional connections. Just engaging in those pastimes that you normally would despite the perhaps beginning notice and awareness of lack of energy. Just keep doing what has been working previously. Some people just need continuous treatment, and there are some people that I know who have even used the light box well into the spring and beginning just in the late summer. If you have a friend or loved one, just try to be supportive. Encouraging words about winter is just a couple of months from being over and just a month from being over and keeping them active as much as possible. It’s difficult to force them, but at the same time, one can be supportive. You can encourage activities that they used to be involved in that hopefully they will continue to be involved in, such as getting to the gym, getting their exercise, eating healthy, all of those kinds of things.
Melanie: Thank you so much. It’s really great information. You are listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thank you so much for listening.
Shedding Light on Seasonal Depression; Effective Ways to Treat Seasonal Affective Disorder (SAD)
Melanie Cole (Host): Outside it’s cold and gray and gloomy. Could the way you’re feeling have something to do with the weather? Oftentimes referred to as the winter blues, living with seasonal affective disorder or SAD can put a damper on your mood, but there are several things that you can do to keep your mood steady throughout the year. My guest today is Dr. Alan Steed. He is the clinical director of Allina Health Mental Health and psychologist at Allina Health Eagan Clinic. Welcome to the show, Dr. Steed. What is seasonal affective disorder or SAD?
Dr. Alan Steed (Guest): SAD is a type of depression. Actually, SAD is a qualifier. SAD is a major depression that may be very much related to seasons, and people that experience symptoms of depression during the fall and winter months are said to be affected with SAD.
Melanie: How is it actually caused?
Dr. Steed: I wish we had a really good answer for that, but there are probably many contributing factors. SAD is considered to be light-related, so as the days grow shorter in the fall and certainly in the winter months. We’re exposed to less sunlight, less vitamin D. That’s another possibility that if affects our vitamin D levels, which affects energy. There’s a thought that it is also related to serotonin levels in the brain. Serotonin is a neurotransmitter that creates a sense of well-being for us. And if this is impacted, then obviously we’re going to experience symptoms of depression or just lethargy.
Melanie: How common is this? Do a lot of people experience this, or are some immune from it?
Dr. Steed: There are some that are immune. I wish we had more specific numbers, to be very honest. But it’s estimated that anywhere from 10 to 20 percent of the population experiences some degree of it. However, I think a much smaller percentage of people, maybe 1 percent—and I think that’s an estimate—are very much debilitated by it. Certainly, I’ve dealt with some of those people in my clinical practice who just have difficulty getting up and going to work, lose their jobs, become extremely depressed, and struggle with it for the period of time that the days are shorter.
Melanie: Now, are there certain risk factors that increase chances of developing SAD? If your family has clinical depression in your genetic history, are any of those things contributors?
Dr. Steed: Yes, it’s a contributing factor. Those people with SAD are more likely to have a biological relative that has major depression in their background. If you have a close blood relative that also experiences SAD, it’s more likely, although not determined, that you may also experience SAD.
Melanie: Then what are the symptoms people might experience that would let them know this is what’s going on and maybe I need to take control of it and do something about it?
Dr. Steed: The symptoms are very similar to those of just general depression. If you have a period of a couple of weeks at least where you’re just feeling tired and little energy and feeling hopeless, irritable, you may notice a change in your weight and appetite. You may notice a change in your sleep pattern. You’re having difficulty falling asleep or staying asleep, or possibly sleeping too much. Anything that impacts sleep is related to depression. Some people tend to become more irritable. Now, these are more symptoms that are characteristic of the winter SAD. There is a version of summer SAD, which occurs during summer months for some people and at a smaller percentage. But in that instance, you may have some of the symptoms of depression but probably more symptoms related to agitation and anxiety.
Melanie: Dr. Steed, let’s talk about treatments. First line of defense. If you suspect that this is what you’re suffering from, you’re feeling that hopelessness and you’re feeling sad and tired, maybe gaining weight, lethargy, any of these things, do you start off by trying to do something for yourself, such as exercise, or do you see a doctor pretty quickly?
Dr. Steed: Well, I think doing the exercise and doing the things we would normally do to maintain our physical and emotional well-being during these months is important. But I would also say if you have a pattern of these kinds of symptoms over the last year or two that a visit to your physician would be a very important thing to do. When symptoms are mild to moderate, a very common form of therapy is called phototherapy. And in this instance, you would sit in front of a light box, hopefully first thing in the morning. The light box needs to be a minimum strength of 10,000 lux. That’s the measure of the strength of the light. Most people would need to sit in front of that at a close distance for about 30 minutes. Again, as I said, I think doing so first thing in the morning is the best recommendation. After that, you may want to consult with a physician. Anti-depressants are commonly recommended and can be very helpful, but there are other things that you might do which would not require medication, and that would just be surround yourself and get out in as much light as you can. Go for a walk every day. Work in an environment, if it’s at all possible, where you have windows and light, and open the blinds. I think there is a tendency for many people when they’re feeling down is to just shut the world out a bit and close the blinds, then create a dark, safe space. But to deal with SAD, just the opposite behaviors would be very important. Be very much aware of the tendency to overeat and certainly, one of the telling symptoms is craving carbohydrates, and certainly that leads to some weight gain, especially as people diminish their activity. I would also encourage you to continue to develop social support and get out and be with people. Get to the gym. In some of the gyms, actually, they have mind-body therapies. They have yoga. They can do some massage. Anything that helps you get out and stay active can be very helpful. I remember one person that I dealt with many years ago. Her cure for her winter SAD up in Minnesota was to go to Phoenix every winter for a week or two. That brought her mood back up very quickly, but then she came back and had to maintain all the self-care activities that she’d been involved with in the first place. It’s not the ultimate cure unless she can move there.
Melanie: Some light’s a really big deal. Now, what about vitamin D and taking supplements that help sort of replenish your body of those missing vitamins?
Dr. Steed: Well, that’s another physician’s call. As a psychologist, I don’t and shouldn’t be recommending that. However, I know that there are many people whose vitamin D levels dip significantly, and the prescription written by doctors is not for just the over-the-counter dosage of vitamin D, but it’s massive doses. I would recommend that before they consider anything involving vitamin D that they check with their physician.
Melanie: In just the last couple of minutes, Dr. Steed, if you would, please tell us if we can prevent the onset of SAD before it actually happens, and if you have a friend or a loved one who suffers from this, what’s your best advice for ways to help someone else that might be having this?
Dr. Steed: I think prevention is about doing as much as you can. It’s style-based. It’s keeping yourself active all through the summer and not letting it drop off as the days get shorter in the fall, finding ways to maintain social and emotional connections. Just engaging in those pastimes that you normally would despite the perhaps beginning notice and awareness of lack of energy. Just keep doing what has been working previously. Some people just need continuous treatment, and there are some people that I know who have even used the light box well into the spring and beginning just in the late summer. If you have a friend or loved one, just try to be supportive. Encouraging words about winter is just a couple of months from being over and just a month from being over and keeping them active as much as possible. It’s difficult to force them, but at the same time, one can be supportive. You can encourage activities that they used to be involved in that hopefully they will continue to be involved in, such as getting to the gym, getting their exercise, eating healthy, all of those kinds of things.
Melanie: Thank you so much. It’s really great information. You are listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thank you so much for listening.