The Sad Season

Winter is the cruelest time of year for those with seasonal depression. Some have found that light therapy can help.

The first fall and winter I lived on the East Coast, I seldom left my bed. It was 2006, and my husband, Ron, and I had recently relocated 3,000 miles from California. The move proved more difficult than I had anticipated. I spent hours fused to my sheets, like a bug tangled in a web, staring at the ceiling. On gray days, I would look out the window and scowl at the overcast skies. Some days it could take hours before I mustered enough energy to shower and trudge down the hallway to my home office.

A February escape to Mexico helped. As I soaked up the sun’s rays, the ocean breeze lifted the weight from my chest and my sadness subsided. When I returned home, cherry blossoms were swirling. Color had come back to the world. I felt rejuvenated and dismissed my winter blues as a case of homesickness.

But when the symptoms returned the following November, I began to wonder if I suffered from something other than missing California. When the pattern repeated yet again a year later, it occurred to me that I probably had seasonal affective disorder (SAD).
First identified in the early 1980s by researchers at the National Institute of Mental Health (NIMH), SAD affects as many as 35 million Americans, according to Mental Health America, a nonprofit organization that promotes mental wellness.  Most suffer from mild cases of the “winter blues,” but for 6 percent of the U.S. population, the symptoms are more severe. Similar to those associated with chronic depression, they include hypersomnia, social withdrawal, no interest in everyday activities, weight gain, changes in appetite and melancholy.

The distinguishing factor is that the symptoms are cyclical. For most people with SAD, depressive episodes recur in fall and winter and resolve completely during the summer months. In its most pronounced form, SAD can lead to hospitalization or suicidal thoughts, says Dr. Kristina Deligiannidis, medical director of the Depression Specialty Clinic at the University of Massachusetts Medical School in Worcester, Mass.

Carrie,* a 22-year-old Arlington resident, says that her episodic depression resulting from SAD has put a strain on her career. She’s lucky to have an understanding boss, who allows her to maintain a flexible work schedule in order to meet deadlines. “I need to be creative,” she explains. “On a rainy day, my production level might be down 90 percent, so I’ll work on [a sunny] Saturday.”

Many SAD sufferers decline to seek treatment, assuming it’s something they just have to live with. They fear exposing themselves to the social perception that SAD is a made-up illness.

Greg,* a 52-year-old Falls Church resident, feels depressed each winter but questions whether his recurring melancholy qualifies as a clinical disorder. “We see trees drop leaves in October, but we don’t get all panicky,” he says. “Trees aren’t supposed to flower 12 months out of the year.” He isn’t sure humans are supposed to either. Still, his goal every winter is to “hold it together” and maintain a regular exercise routine to fend off malaise.

SAD is most common in adults between the ages of 20 and 40, and affects four times as many women as men. That propensity may be due to cyclical hormones, says Dr. Norman Rosenthal, a clinical professor of psychiatry at Georgetown University Medical Center who pioneered some of the earliest research on the disorder. It’s also more common in northern latitudes. Population surveys published in Psychiatry Research show that nearly 10 percent of people in New Hampshire have reported symptoms of SAD, compared to just over 6 percent in Virginia and less than 1.5 percent in Florida. A 2009 Centers for Disease Control and Prevention survey found that people who live in sunnier climates tend to be happier than those who don’t.

Lynn,* a 43-year-old mom in Falls Church, can attest to this geographic theory. Although she’d had a lifelong pattern of low moods and lethargy during cold spells, her SAD became debilitating when her family moved temporarily to London, where she spent the winters sitting indoors eating chocolate and sipping red wine. With three kids and two dogs, she had a schedule full of obligations, but she found herself ignoring appointments and after-school activities so she could lie in bed.

Eventually, Lynn found help in a treatment that’s proved effective for some 80 percent of SAD sufferers: a light therapy box that mimics sunlight. Her family has since moved back to Virginia, where she continues to rely on the “happy glowing light” that sits next to her computer as a daily mood booster. She has also installed recessed lighting throughout her house and keeps a standing tennis date once a week.

Synthetic light has also helped Carrie maintain a more even keel.  “I use my sun lamp a ton,” she says, explaining that she practices one hour of light therapy every morning starting in September and increases the time as the days get shorter.