As the days of fall get darker, so can our moods.
Join Psychiatrist Dr. Ken Robbins, to learn about Seasonal Affective Disorder, how to identify it, how to manage the symptoms if you experience it, and how to best avoid it in the future.
Do You Suffer From Seasonal Affective Disorder?
Featured Speaker:
Ken Robbins, MD
Dr. Kenneth Robbins is board certified in both psychiatry and internal medicine and is a Clinical Professor of Psychiatry at the University of Wisconsin School of Medicine and Public Health. Dr. Robbins is the medical director of Stoughton Hospital's Geriatric Psychiatry Department. Transcription:
Melanie Cole (Host): As the days of Fall get darker, so can our moods. Seasonal Affective Disorder is a type of depression that comes and goes with the seasons, typically starting in the late Fall and early Winter and going away during the Spring and Summer. Here to speak with us today, about Seasonal Affective Disorder, is Dr. Ken Robbins. He’s a Psychiatrist with Stoughton Hospital. Welcome to the show, Dr. Robbins. Tell us a little bit more about what Seasonal Affective Disorder is and who might be at risk for this.
Dr. Ken Robbins (Guest): Yeah, great question. Seasonal Affective Disorder is a change in mood that is triggered by a change in the seasons, and in particular, in the Northern latitudes, it tends to be depression that takes place – as you said in the intro – as the light starts to disappear. As Fall starts to hit and the daylight is increasingly short, people start to experience a change in their circadian rhythms and a change in their melatonin secretion, and they start to experience depression. This is fairly common. It occurs in somewhere between 15 and 20% of people in Northern latitudes.
Melanie: Is it the same as depression? Are these two things the same thing or is this under the umbrella of – a type of clinical depression?
Dr. Robbins: It is a type of clinical depression. This particular type of depression is somewhat unique in that people who experience Seasonal Affective Disorder usually have an increase in sleep. With classic depression, people can either have an increase or a decrease in sleep. With Seasonal Affective Disorder, it’s usually an increase in sleep; it’s an increase in appetite. There’s often carbohydrate craving. There’s often weight gain. People’s energy is diminished. It’s hard for them to function as well as they had -- they’re not as efficient; they’re not as able to concentrate. You can think of it in some ways as like what a bear would do in Winter. It’s this interest in hibernating.
Melanie: Wow, what a great way to put it. So, symptoms of it – if we have that interest in hibernating or if you’re feeling pretty blue, how do you know that this is not just something that’s very, very temporary? How would you know that it is Seasonal Affective Disorder and when to seek help?
Dr. Robbins: Lots of people in Northern latitudes have some of these symptoms, but when it is really impairing your capacity to function, when you really are not able to get things done that you would normally get done, when you’re having trouble experiencing joy, when you’re not enjoying the things that normally you would enjoy, when you’re feeling increasingly depressed associated with these various symptoms, it’s time to get help because there is help. This is a very treatable illness.
Melanie: What are some things – before we talk about what you would do as a Psychiatrist or getting counseling to help this – what are some things that we can do at home? We’ve heard in the media about light therapy or vitamin D – you even mentioned melatonin. What are some home lifestyle treatments that we can try?
Dr. Robbins: Well, first of all, for any depression, exercise is helpful. Having a standard routine where you go to bed at a particular hour and get up at a particular hour and where during the day you do exercise – aerobic exercise. Those are some things that are very easy to do. In addition, for Seasonal Affective Disorder itself, which is in part triggered by the decrease in light, light therapy can be very helpful. You have to be careful that it’s an appropriate amount of light and that you’re exposed to it for an appropriate amount of time. What most experts would say is that the light intensity should be about 10,000 Lux. Just to compare that, on a bright, sunny day, there’s about 50 to 100,000 Lux outdoors. On a cloudy day, there’s 1 to 5,000 Lux. In an indoor, office environment it’s 500 Lux. This is 10,000 Lux, so it’s something more than what you would experience outside on a cloudy day, and you need to be exposed to it for at least 30 minutes. It seems to work best if you do it first thing in the morning, so the light has to be shining at your eyes, but you don’t want to stare right at it. Ideally, if the light is in your peripheral vision for at least 30 minutes, it can have a very significant impact.
Melanie: Are these special lights?
Dr. Robbins: Well, they’re special lights in that they have to have the 10,000 Lux. If you go to a lighting store and ask or there are a number of companies -- if you were to Google “Seasonal Affective Disorder lights,” there are a number of companies that advertise them. They have come down a great deal in price. They used to be $300 to $500, and now they’re more like $60 to $80.
Melanie: And what about things like melatonin and vitamin D? Are those things that we can – or supplements that we can try that can help with the mood a little bit?
Dr. Robbins: Melatonin and vitamin D, there’s no evidence that those actually help. Now, interestingly, what happens with melatonin in this disorder is that the melatonin actually is around for a longer period of time. If you’re measuring somebody’s melatonin, somebody who’s particularly sensitive to getting Seasonal Affective Disorder, when there’s less light, there’s more melatonin in their system, and it lasts longer. That’s the same thing that you find with bears who hibernate. If you measure people who don’t get this disorder, there is not that kind of change in melatonin with the seasons. There’s clearly something chemical going on. I don’t think melatonin is likely the cause. It is probably just part of what happens when this disorder hits. Taking melatonin and taking vitamin D, unfortunately, don’t seem to solve the problem.
Melanie: And what about Cognitive Behavioral Therapy? Is that what you do? How can you help somebody?
Dr. Robbins: So yes, seeing a therapist who has skills with Cognitive Behavioral Therapy whether your depression was triggered by a change in light or it’s just a more typical depression that can happen at any time – often in response to stress – Cognitive Behavioral Therapy can be very helpful. There are other therapies that can be very helpful. And in addition, particularly if the depression becomes severe, antidepressants should be considered. They are as effective with Seasonal Affective Disorder as they are with more routine depressions. Particularly, if somebody gets a severe depression -- just like in any other depression, as it gets more severe, people can get hopeless and can experience suicidal thoughts. Of course, at that point, it’s really important to see a mental health professional, get assessed properly, and likely someone who’s got severe symptoms is going to be started on an antidepressant potentially in addition to talking therapy and light therapy.
Melanie: Now, if somebody is put on an antidepressant -- and some people don’t want to go on those -- but would it be a temporary thing if it is Seasonal Affective Disorder they’re suffering from and not clinical depression?
Dr. Robbins: Yes, that’s a really good point. If it’s a depression that is triggered by a changing light – and those depressions usually get better in the Spring as there’s more and more light – there are many people who simply go on antidepressants seasonally because they know the depression is going to take place as the light gets less and less. They start an antidepressant in the Fall, and as Spring approaches, they’ll wean themselves off the antidepressant so yes, that may be very appropriate.
Melanie: Give us your best advice and summary, Dr. Robbins, for possibly preventing Seasonal Affective Disorder and what you want the listeners to know about what they should be on the lookout for -- red flags -- and maybe ways that they can prevent it altogether.
Dr. Robbins: In terms of doing your best to prevent Seasonal Affective Disorder, exposing yourself to as much light as you can during the Winter. That means when it is light outside, taking walks, going outside and being in the cold, and just dressing appropriately so that it is not so uncomfortable. That can make a big difference, exposing yourself to what light is available. Exercise is helpful. Keeping a regular bedtime – making sure you go to bed at the same time, and you get up around the same time plus or minus an hour -- avoiding alcohol, and doing some kind of -- if you can do regular, aerobic exercise for about 20 to 30 minutes, at least three to four times per week, that too, makes a big difference.
Recently, there has been some evidence that meditation – if that’s something that sparks your interest – that meditation too, can be very helpful in preventing depression. If you do, however, start to experience symptoms – and in Seasonal Affective Disorder, the most common symptoms are depressed mood, an increase in sleep, an increase in appetite -- cravings for carbohydrates, in particular, and often, people can gain a significant amount of weight -- if you’re starting to notice those symptoms and the depression is consistent, I think getting in for help can be very important because this is an illness that can become increasingly severe over time before it hopefully disappears in the Spring.
Melanie: So it is very treatable if you get the help and recognize those symptoms?
Dr. Robbins: Exactly. The combination of the things we talked about for prevention and then the light therapy, Cognitive Behavioral Therapy, and antidepressants are all very effective in treating this illness.
Melanie: Thank you so much, Dr. Robbins. It’s really important information for people to hear. You’re listening to Stoughton Hospital Health Talk. For more information, please visit StoughtonHospital.com, that’s StoughtonHospital.com. This is Melanie Cole. Thanks so much, for listening.
Melanie Cole (Host): As the days of Fall get darker, so can our moods. Seasonal Affective Disorder is a type of depression that comes and goes with the seasons, typically starting in the late Fall and early Winter and going away during the Spring and Summer. Here to speak with us today, about Seasonal Affective Disorder, is Dr. Ken Robbins. He’s a Psychiatrist with Stoughton Hospital. Welcome to the show, Dr. Robbins. Tell us a little bit more about what Seasonal Affective Disorder is and who might be at risk for this.
Dr. Ken Robbins (Guest): Yeah, great question. Seasonal Affective Disorder is a change in mood that is triggered by a change in the seasons, and in particular, in the Northern latitudes, it tends to be depression that takes place – as you said in the intro – as the light starts to disappear. As Fall starts to hit and the daylight is increasingly short, people start to experience a change in their circadian rhythms and a change in their melatonin secretion, and they start to experience depression. This is fairly common. It occurs in somewhere between 15 and 20% of people in Northern latitudes.
Melanie: Is it the same as depression? Are these two things the same thing or is this under the umbrella of – a type of clinical depression?
Dr. Robbins: It is a type of clinical depression. This particular type of depression is somewhat unique in that people who experience Seasonal Affective Disorder usually have an increase in sleep. With classic depression, people can either have an increase or a decrease in sleep. With Seasonal Affective Disorder, it’s usually an increase in sleep; it’s an increase in appetite. There’s often carbohydrate craving. There’s often weight gain. People’s energy is diminished. It’s hard for them to function as well as they had -- they’re not as efficient; they’re not as able to concentrate. You can think of it in some ways as like what a bear would do in Winter. It’s this interest in hibernating.
Melanie: Wow, what a great way to put it. So, symptoms of it – if we have that interest in hibernating or if you’re feeling pretty blue, how do you know that this is not just something that’s very, very temporary? How would you know that it is Seasonal Affective Disorder and when to seek help?
Dr. Robbins: Lots of people in Northern latitudes have some of these symptoms, but when it is really impairing your capacity to function, when you really are not able to get things done that you would normally get done, when you’re having trouble experiencing joy, when you’re not enjoying the things that normally you would enjoy, when you’re feeling increasingly depressed associated with these various symptoms, it’s time to get help because there is help. This is a very treatable illness.
Melanie: What are some things – before we talk about what you would do as a Psychiatrist or getting counseling to help this – what are some things that we can do at home? We’ve heard in the media about light therapy or vitamin D – you even mentioned melatonin. What are some home lifestyle treatments that we can try?
Dr. Robbins: Well, first of all, for any depression, exercise is helpful. Having a standard routine where you go to bed at a particular hour and get up at a particular hour and where during the day you do exercise – aerobic exercise. Those are some things that are very easy to do. In addition, for Seasonal Affective Disorder itself, which is in part triggered by the decrease in light, light therapy can be very helpful. You have to be careful that it’s an appropriate amount of light and that you’re exposed to it for an appropriate amount of time. What most experts would say is that the light intensity should be about 10,000 Lux. Just to compare that, on a bright, sunny day, there’s about 50 to 100,000 Lux outdoors. On a cloudy day, there’s 1 to 5,000 Lux. In an indoor, office environment it’s 500 Lux. This is 10,000 Lux, so it’s something more than what you would experience outside on a cloudy day, and you need to be exposed to it for at least 30 minutes. It seems to work best if you do it first thing in the morning, so the light has to be shining at your eyes, but you don’t want to stare right at it. Ideally, if the light is in your peripheral vision for at least 30 minutes, it can have a very significant impact.
Melanie: Are these special lights?
Dr. Robbins: Well, they’re special lights in that they have to have the 10,000 Lux. If you go to a lighting store and ask or there are a number of companies -- if you were to Google “Seasonal Affective Disorder lights,” there are a number of companies that advertise them. They have come down a great deal in price. They used to be $300 to $500, and now they’re more like $60 to $80.
Melanie: And what about things like melatonin and vitamin D? Are those things that we can – or supplements that we can try that can help with the mood a little bit?
Dr. Robbins: Melatonin and vitamin D, there’s no evidence that those actually help. Now, interestingly, what happens with melatonin in this disorder is that the melatonin actually is around for a longer period of time. If you’re measuring somebody’s melatonin, somebody who’s particularly sensitive to getting Seasonal Affective Disorder, when there’s less light, there’s more melatonin in their system, and it lasts longer. That’s the same thing that you find with bears who hibernate. If you measure people who don’t get this disorder, there is not that kind of change in melatonin with the seasons. There’s clearly something chemical going on. I don’t think melatonin is likely the cause. It is probably just part of what happens when this disorder hits. Taking melatonin and taking vitamin D, unfortunately, don’t seem to solve the problem.
Melanie: And what about Cognitive Behavioral Therapy? Is that what you do? How can you help somebody?
Dr. Robbins: So yes, seeing a therapist who has skills with Cognitive Behavioral Therapy whether your depression was triggered by a change in light or it’s just a more typical depression that can happen at any time – often in response to stress – Cognitive Behavioral Therapy can be very helpful. There are other therapies that can be very helpful. And in addition, particularly if the depression becomes severe, antidepressants should be considered. They are as effective with Seasonal Affective Disorder as they are with more routine depressions. Particularly, if somebody gets a severe depression -- just like in any other depression, as it gets more severe, people can get hopeless and can experience suicidal thoughts. Of course, at that point, it’s really important to see a mental health professional, get assessed properly, and likely someone who’s got severe symptoms is going to be started on an antidepressant potentially in addition to talking therapy and light therapy.
Melanie: Now, if somebody is put on an antidepressant -- and some people don’t want to go on those -- but would it be a temporary thing if it is Seasonal Affective Disorder they’re suffering from and not clinical depression?
Dr. Robbins: Yes, that’s a really good point. If it’s a depression that is triggered by a changing light – and those depressions usually get better in the Spring as there’s more and more light – there are many people who simply go on antidepressants seasonally because they know the depression is going to take place as the light gets less and less. They start an antidepressant in the Fall, and as Spring approaches, they’ll wean themselves off the antidepressant so yes, that may be very appropriate.
Melanie: Give us your best advice and summary, Dr. Robbins, for possibly preventing Seasonal Affective Disorder and what you want the listeners to know about what they should be on the lookout for -- red flags -- and maybe ways that they can prevent it altogether.
Dr. Robbins: In terms of doing your best to prevent Seasonal Affective Disorder, exposing yourself to as much light as you can during the Winter. That means when it is light outside, taking walks, going outside and being in the cold, and just dressing appropriately so that it is not so uncomfortable. That can make a big difference, exposing yourself to what light is available. Exercise is helpful. Keeping a regular bedtime – making sure you go to bed at the same time, and you get up around the same time plus or minus an hour -- avoiding alcohol, and doing some kind of -- if you can do regular, aerobic exercise for about 20 to 30 minutes, at least three to four times per week, that too, makes a big difference.
Recently, there has been some evidence that meditation – if that’s something that sparks your interest – that meditation too, can be very helpful in preventing depression. If you do, however, start to experience symptoms – and in Seasonal Affective Disorder, the most common symptoms are depressed mood, an increase in sleep, an increase in appetite -- cravings for carbohydrates, in particular, and often, people can gain a significant amount of weight -- if you’re starting to notice those symptoms and the depression is consistent, I think getting in for help can be very important because this is an illness that can become increasingly severe over time before it hopefully disappears in the Spring.
Melanie: So it is very treatable if you get the help and recognize those symptoms?
Dr. Robbins: Exactly. The combination of the things we talked about for prevention and then the light therapy, Cognitive Behavioral Therapy, and antidepressants are all very effective in treating this illness.
Melanie: Thank you so much, Dr. Robbins. It’s really important information for people to hear. You’re listening to Stoughton Hospital Health Talk. For more information, please visit StoughtonHospital.com, that’s StoughtonHospital.com. This is Melanie Cole. Thanks so much, for listening.