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Winter blues in Ohio? It may be more than that, local doctors say

Springfield News-Sun - 1/30/2023

Jan. 30—Those living with seasonal affective disorder are feeling the brunt of January's cloudy, overcast days in Ohio.

Doctors define seasonal affective disorder as a type of recurrent depression where individuals living with it will start to experience mood changes for three to five months every year, particularly in the fall and winter when there is less sunlight.

Seasonal affective disorder impacts approximately 5% of adults in the U.S., according to the American Psychiatric Association, which equates to over 12 million Americans by 2020 U.S. Census Bureau statistics. It lasts approximately 40% of the year and is more common among women compared to men.

Local doctors said they are seeing the disorder in area patients.

"Seasonal affective disorder is basically depression with seasonal patterns," said Dr. Christina Waite, medical director for psychiatry at Premier Health'sMiami Valley Hospital. "It can be either a major depressive disorder or a bipolar disorder, but it occurs at the same time every year." Waite said it takes at least a couple of years of symptoms presenting at the same time in order for it to be diagnosed.

Seasonal affective disorder is also more prevalent among people living farther north. For example, individuals living in Alaska or in northern states like in the New England region may be more likely to develop seasonal affective disorder than people living in Florida, according to the National Institute of Mental Health.

"It's a real depression. It's not just the winter blues," Waite said. The winter blues is more when individuals have low energy during the winter months, which Waite said was different from seasonal affective disorder.

What symptoms do people face

Doctors say the depressive symptoms these individuals face can cause significant disfunction in their day-to-day lives.

"The symptoms oftentimes could include the same as major depressive disorder symptoms," Dr. Julie Manuel, clinical program manager at Kettering Health Behavioral Medical Center. said. Those symptoms could include losing interest in activities, loss of appetite, or changes in sleep patterns, such as having difficulty sleeping or sleeping too much after not feeling rested. Manuel said the lack of daylight, or going longer periods without daylight, could contribute to feelings of fatigue.

Other symptoms could include feelings of hopelessness, weight gain, overeating and lack of exercise.

"In the winter months, folks have really have a hard time incorporating an exercise program into their routine," Manuel said.

Social isolation and withdrawing from friendships or community activities can also be another sign of seasonal affective disorder.

"This can really impact day-to-day life because they're not living. It's causing significant dysfunction in their life," Manuel said. For those who have seasonal affective disorder, Manuel said the disorder makes it difficult for those individuals to function during that time period.

Seasonal affective disorder, if untreated, can develop into a serious depression, Waite said. There are also less common types that impact individuals in the spring and summer, which Waite described as even more dangerous and often are occurring alongside another underlying disorder. For those affected in the spring and summer, their symptoms lean more toward insomnia and losing weight, while also being irritable, agitated, and anxious.

"The weather doesn't help"

While the cause of the seasonal affective disorder is unclear, the National Institute of Mental Health said individuals dealing with the disorder may have reduced activity of the brain chemical serotonin, which is a neurotransmitter that helps regulate mood.

"When we have folks come in, often times they will say, 'The weather doesn't help,'" Manuel said. "We've had limited sunshine."

Research suggests that sunlight controls the levels of molecules that help maintain normal serotonin levels, according to the institute, but in people with seasonal affective disorder, this regulation does not function properly, resulting in decreased serotonin levels in the winter.

Waite said that when serotonin drops, individuals also lose vitamin D effectiveness.

"That in turn makes you more depressed," Waite said. "These are real things, and they need to be treated, or they don't typically do well on their own."

Researchers and doctors say that those with season affective disorder also produce too much melatonin, which is a hormone maintaining normal sleep cycles and can cause increased tiredness if the body overproduces it, according to the National Institute of Mental Health.

"The temperatures since Christmas haven't been terrible and so it gives them the ability to get outside, to get that fresh air, which is something that's really important," Manuel said. "But the sunlight is so important, so we do find that oftentimes folks will describe that as one of the significant stressors that is occurring in their life. So we have seen kind of an uptick in that."

Additionally, doctors believe patients may be going untreated because they think they just have the winter blues. Waite said, of the patients her team and she see, they are the tip of the iceberg.

"I think a lot of these patients, even though there's more out there, they kind of go under the radar because they kind of put up with it and pass it off as the winter blues, because so many people have that low energy state, so they minimize it," Waite said.

Healthy ways to cope

Different types of therapy can help improve symptoms of seasonal affective disorder, including bright light therapy and talk therapy. Waite also recommended individuals see a medical doctor to make sure they do not have a different condition that is making them feel sluggish, such thyroid conditions, infections, diabetes, and anemia, which is a low blood count.

Light therapy and talk therapy are about equally effective, doctors say. There are therapy lights that can often be purchased through online retailers like Amazon, and individuals can sit in front of them for about 30 minutes for the treatment. Waite said individuals should check in with their doctors, though, when purchasing a therapy light as some light go up to 10,000 lux. Indoor illumination levels are usually between 100-150 lux.

Doctors also say that antidepressants and vitamin D also help treat seasonal affective disorder.

For non-medication treatments, doctors recommended exercise, as well seeking out indoor and outdoor activities to avoid isolation. Waite also recommended getting out into nature to stimulate your immune system.

"It's very treatable," Waite said, adding that individuals with seasonal affective disorder respond better to treatment than individuals with non-seasonal depression or major depressive disorder. "I urge people to seek help and not just let it slide."

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