Seasonal Depression by Matthew Lowe, MS, DO, MBA

As the fall days turn into winter months, the days shorten, the air turns colder, and the sun seems to disappear for months at a time, especially in the Midwest.  For some, this lack of sunshine can make the days seem to last forever.  Some of us are more sensitive to these darker days and can feel our energy drain and our mood dampen.  It’s not uncommon to feel a little less energetic and a little more down during the colder months and develop the so-called “winter blues”.  

However, if you are among the approximately 5% of people who develop clinical depression during the darker and colder winter months, you likely experience many more symptoms and have a much harder time functioning.  Some of the signs to look for to let you know that you may be experiencing seasonal depression include worsening mood during the fall and winter, lower energy levels during this time, difficulty focusing and concentrating while feeling down, changes in sleep (either sleeping more or difficulty sleeping) in the fall and winter, changes in hunger (either eating more or eating less) in the colder months, less interest in doing things that normally would bring you joy during the darker days, feeling worthless or having lots of negative thoughts and feeling guilty about things that you have no control over during these winter months, being less motivated or more agitated during the fall and winter, and/or having thoughts of death or dying during these less sunny days.  If you have a majority of these symptoms, you likely have clinical seasonal depression and should talk to a professional about it.

Unfortunately, we don’t know exactly why seasonal depression happens.  There are a few different theories about it, however.  Some ideas include a change in the way your body regulates serotonin during the winter months.  Serotonin is one of the chemicals in the brain that create feelings of positivity and when that chemical is disrupted, we can feel down or agitated.  Another theory about seasonal depression is that when it is dark outside more than usual our brains continue to produce melatonin during the day.  Melatonin is normally a hormone that makes us sleepy at night, and if we don’t stop making it, we will feel sleepy and tired throughout the day.  And research also shows us that too much melatonin can create feelings of depression.  As you can imagine, being inside more, possibly eating more, being less active, maybe sleeping more, and seeing other people less often during the winter months can also have a negative impact on our moods.

But the good news is that we can do things proactively to help decrease seasonal depression (or just the winter blues), and there are treatments for it.

1. Maintain a good routine and schedule.  Continue to eat a well-balanced diet on a regular schedule.  We tend to eat a little more in the winters and our diet changes to include more carbohydrates in the winter months, which can lead to weight gain.  Being aware of this and watching your diet can help prevent this situation.  Exercise regularly.  Maintain a regular daily exercise schedule.  We tend to exercise more in the warm months when we can get outside, but there are fun and creative ways to exercise inside.  YouTube has a variety of exercise videos for free that can be done with no equipment and are always available.
2. Stay connected.  During the winter months, we have a tendency to stay inside and not socialize as much.  However, staying connected with others helps us feel positive and supported.  Even when it’s not possible to physically visit with others, there are many ways to connect virtually with friends and family.
3. Get outside.  Since sunlight is energy, it is important to get outside and soak up the sun anytime you can.  On sunny days, make an effort to get outside and take a walk.  Plan to do something with a friend outside.  You will be more likely to follow through with plans if someone else is counting on you.
4. Go on vacation.  If you can afford it, and you know you are affected by winter months, you should try to plan a winter vacation to a sunny destination.  Even a week in the sun can help.  Make sure to use sunscreen!
5. Check your vitamin D level.  If you feel down in the winters, ask your healthcare provider to check your vitamin D level.  Vitamin D can help with energy and mood and is known as “the sunshine vitamin” because it is produced on our skin when we are in the sun for a while.  It tends to drop during the winter months because we don’t get enough sunshine.  If your level is low, you may need to take a vitamin D supplement.  Be careful, however, because you can take too much vitamin D, so you don’t want to take it if you don’t really need it.  There are some foods that can increase your vitamin D levels, including oily fish, red meat, liver, egg yolks, and fortified foods like milk and cereals.
6. Use a light box.  One of the most helpful things you can do in the winter months is to use a light box.  A light box is a very bright (10,000 LUX strength) light that you place next to you on your desk or table in the mornings while working or eating or getting ready for the day.  It is recommended that you use it for 15 to 30 minutes each morning to get benefit from it.  The best light boxes are full-spectrum and UV-free.  These lights mimic sunlight, wake up the brain, and stop the overproduction of melatonin that is associated with seasonal depression.  You should feel more energetic and your mood should improve with regular use.  It may take a while to feel better, so don’t give up if you don’t feel better right away.
7. Ask your healthcare provider if Wellbutrin XL could help.  There is one medication that is approved for seasonal depression - Wellbutrin XL.  This medication can help with energy, mood, focus, and motivation.  If you have seasonal depression, ask your healthcare provider if this medication would be right for you.  There are some situations where Wellbutrin XL might make things worse (if you have extreme anxiety or anger, seizures, or an eating disorder), so a healthcare provider should be consulted before starting this medication.
8. Meditate.  Mindfulness is a simple tool that helps you stay in the moment when everything seems to be spinning out of control around you.  It is that special ability to focus on the here and now and not worry about the past or future and to enjoy what’s in front of you.  But mindfulness takes practice.  If you master this technique, you will feel more relaxed, happier, and more focused.  Some apps/websites that can help teach you mindfulness (and there are many more than these two) are Headspace and Calm.  Both are available in the app stores for free.
9. Practice self care.  It is important that you take time for yourself during the winter months.  Do something that you enjoy or something that relaxes you every day.  Make this a part of your regular routine to avoid letting stress get the best of you.
10. Focus on positives, not negatives.  Don’t dwell on the negative and stressful things in the world.  Try not to focus on how bad you feel and how much you miss the sunshine.  Focus on the joy in the world.  Give yourself a reason to celebrate.  Even if the reason is small, focus on that positive thing instead of all the negatives.  This will help improve your mood and give you something to focus on besides the darkness.

​If you know you are affected by the winter blues or seasonal depression, try one or all of these suggestions.  Have a talk with your healthcare provider.  Recognizing the signs of depression early is the key to feeling better faster.  The earlier you implement these strategies and if you practice them consistently, the more likely they are to work.

The team at Providers for Healthy Living is here to help if you need it!  We offer a wide range of therapy and medication management services for depression, anxiety, and many other mental health diagnoses.  If you find that you need more intensive help this winter, reach out to us.  We can help.  Register as a new patient on our website if you are interested in receiving assistance.  If you need immediate help, the National Suicide Prevention Lifeline is always available at 800-273-8255.

Photo:
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