Although SAD is not a “standalone” diagnosis in the current Diagnostic & Statistical Manual (DSM-IV-TR), published by the American Psychiatric Association, it has received much attention by the medical community over the past several years.

The most common symptoms of winter-onset SAD are:

• Loss of energy
• Weight gain and an increase in craving carbohydrates
• Anhedonia (inability to experience pleasurable activities)
• Anxiety
• Depressed mood
• Difficulty concentrating
• Social withdrawal
• Hopelessness/helplessness
• Decreased sex drive

The most common symptoms of spring/summer-onset SAD are:

• Anxiety
• Poor appetite
• Increased sex drive
• Insomnia (difficulty sleeping)
• Irritability
• Weight loss

Some believe SAD can be caused by a dysregulation in the biological clock (circadian rhythm); melatonin levels (a hormone that assists in the regulation of mood and sleep patterns); duration of sunlight; and serotonin levels (a neurotransmitter in the brain that affects mood).

Treatment options include:

• Phototherapy (light therapy). Light therapy is an easy way to decrease the symptoms of SAD. Most people can purchase a light therapy box and put it in their homes or office. The light from the light therapy box mimics outdoor, full-spectrum lighting. Some insurance companies will pay for a light therapy box if you have a prescription from your physician.
• Medication. You can speak with your physician, psychiatrist or nurse practitioner about psychotropic medications that may help decrease the symptoms of SAD.
• Psychotherapy. A mental health therapist can assist you in changing your negative thought processes and behaviors that contribute to your overall mood. Therapists understand how difficult it is to manage the stress of life, especially when you are feeling depressed. Therapists treat each person in a holistic manner and guide you along the way to wholeness.

Many researchers have found that a combination of psychotherapy, medication management and light therapy are beneficial to the treatment of SAD. Please speak to your physician or mental health professional if you believe you are experiencing SAD or any other mental health condition.

Other ways to combat SAD include:

• Exercise. Getting any amount of exercise is better than no exercise at all! If you work in a high-rise building then take the steps and if you have steps in your home then use them for 10-15 minutes each day. Join a gym; the cost of memberships this time of year tends to be pretty fair.
• Get adequate sleep. Sleep is vital to regulating your mood and behaviors. Try to get 6 to 8 hours of sleep per night.
• Relaxation. We are bombarded in our world with cell phone calls, text messages, Facebook posts, Twitter, and emails. We go to work each day and are overwhelmed, then come home and the kids need our attention. This week spend 10 minutes alone in your car or a quiet space in your home. Turn off the radio, television and cell phone so you can BE.Become a watcher of your thoughts but do not analyze or react to them at all. Watch the thoughts drift by like clouds in the sky. If you begin to think about the grocery list, then focus on your breath. Some people benefit from counting breaths to keep the mind focused on the number being mentally said instead of their thoughts. If this works for you it is helpful to count to 10 and then return to 1. If you are able to get to 10 with no interruption of thoughts then that is great! Most people begin and only get to 5 or so until they run away with a thought. If this happens, return to 1 and begin again.

  Spend the 10 minutes in being instead of doing. Start off with five minutes if 10 is too much. Your breath will return to normal and your body will get the chance to rest, even for a brief period. Do this once per day and then increase the time if you are able. This simple exercise is best done sitting in a comfortable chair or on the floor in a comfortable position; it is not recommended to do this in bed because your body is already trained to sleep in that space.

• Eat well. You do not need to be a dietitian in order to eat well. Listen to your body and eat what it innately craves. Replace unhealthy “fast foods” with alternatives such as sandwiches and salads.
• Get more sunlight. If it happens to be a nice day, then go outside when it is sunny. It may also help to get more sunlight into your home by opening your blinds up or sitting closer to a window with light coming in.
• Find balance. You can be the best you can be when your body, mind and spirit are aligned. Do not be too hard on yourself. Many people make New Year’s resolutions and often fail. It takes almost one month to change any bad habit, but be gentle with yourself and love yourself. Nobody is perfect and you cannot change every “bad” characteristic all at once. Instead of swearing off alcohol, fatty foods, men, women, cigarettes, or whatever your vice may be, look at your life and ask yourself, “Where in my life am I out of balance?” If you believe you work too hard, then you need to rest a little more. If you exercise too much, then you need to relax more.The adage “what we resist persists” is true. If we focus on the negative, that is what we will receive. For example, the “battle to lose weight” idea focuses on weight loss being a war of some sorts; however, if we shift our perspective to “eating healthy for me” then there is no negative related to thoughts around our food intake. If we believe eating is always going to be a battle, then chances are it will be a battle that we cannot win. So, our thinking patterns do affect our outcomes.

It might be helpful to enjoy a sunrise, spend time in your spiritual place (church, temple, mosque, spiritual home), laugh more, and enjoy the life you were meant to live. Everything is always changing and balance is a healthy way to endure the changes we face. We were not created to be overstimulated and out of balance. Focus on your strengths and positive ways to introduce balance back into your life. Remember that you are whole, complete and perfect — half the battle is in believing it.

Family and friends might be unsure if recovery is possible. They question how they can help. Mental illness creates a feeling of helplessness for everyone involved. My and my family’s experience with chronic mental illness has allowed me to understand how important it is to have a support group. It can define the journey taken to recover from mental illness.

My diagnosis is rare. I was diagnosed with bipolar II disorder when I was 12. While my siblings were attending school and playing soccer on weekends, I was confined to a children’s psychiatric hospital. I remember wondering what was wrong with me. I remember my parents, wide-eyed, watching as my moods shifted by the hour, even the minute. We were all terrified. Mental illness is frightening at its core.

Unsure what to do, my parents brought me to doctors, psychiatrists, therapists and even nutritionists. The various doctors told them I had Attention Deficit Disorder; the psychiatrists told my parents they were parenting me badly. They were certain that explained my erratic behavior.

The therapist asked me to draw pictures that they thought would explain my moods. I refused to use any crayon that was not black, threw the toys that were carefully placed around the brightly lit room, and tore up the paper. I was unable to control myself. She dismissed me as being ‘overemotional’ and ‘narcissistic’ at the ripe age of 11. The nutritionist told me I was allergic to dairy products. My family, in a show of support, stopped eating anything containing dairy.

Fourteen years ago, professionals simply could not believe a child could have a serious mental illness−despite our family tree being defined by mental illness and suicide.

The years before my diagnosis were painful and affected our family dynamic immensely. My two siblings watched their older sister fall apart; they viewed their parents trying to catch me as I fell into blackness. My illness was quickly making my family ill.

It is impossible to capture my experience with mental illness in a few words, but I can tell you that without the support of my family, friends and a support team, I would not be writing these words. Twenty-six years old now, I feel I have some experience under my belt (so to speak) and would like to share different ways in which people can support a loved one struggling with mental illness.

Often, a newly diagnosed person is confused and angry. They may believe they do not need help. They might push away family and friends. As a person living with a chronic mental illness, I can tell you that isolation often results from fear. Mental illness carries stigma and it is frightening.

For example: I fall into a severe and crippling depression each winter. Each time it occurs I am, somehow, surprised. I quickly forget that my life is usually full of color and that waking up each morning often makes me smile. When I become ill I am certain I will never be well again.

If a family member or friend is unstable, the most important thing you can do is remind them that they will become well again. Without my family and friends to help me through each winter, to assure me that my life will become mine again, once spring arrives, I would certainly struggle more.

It is important to have a plan of action. Effective communication will be crucial if the person with mental illness shows signs of a relapse. A plan of action for such an event creates a feeling of security both for the person struggling and for those who love them.

An example: My family and I sat down with my psychiatrist−once it was clear my episodes were seasonal−and made a plan, in writing, that stated the steps that would be taken if I became ill. It was a difficult thing to do at the time. Seeing my diagnosis on paper made it real. But that paper provides a feeling of security for all of us.

The plan can include medication alterations, community outreach, and simple things like charting your mood and recognizing patterns. I believe this can be one of the most useful tools when working to help someone recover from a mental illness. It certainly is not a document that is placed on my fridge—it’s hidden away somewhere—but it has been instrumental in my recovery.

The health of those who support the mentally ill person often gets ignored. When I first became ill, my entire family suffered. My parents, while working full-time and taking care of my two siblings, spent years focused on my illness and recovery. In the process, they became unwell themselves. My mother slipped into a depression and my father worked to keep our family functioning. It was not easy.

Often, when a person must spend so much time focusing on someone they love, they forget to take care of themselves. It is impossible to help someone else if you become sick yourself. Ask yourself: “Do I need to step back?” Sometimes you do. My family has learned both to support me and support each other. It is in this way that we have been able to embrace recovery together.

SAD affects around 14 million Americans, according to author and SAD specialist Norman E. Rosenthal, M.D., in his book Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder. (About 14 percent of American adults struggle with the winter blues.)

People with SAD experience a variety of physical, emotional and cognitive symptoms that impairs their daily functioning. They’re usually unable to perform at school or work and have difficulty interacting with others. Tasks that once seemed simple, such as household chores or paying the bills, suddenly become overwhelming.

The ability to think clearly also becomes impaired. In fact, according to SAD expert Dr. John Docherty, the disorder causes many problems for people at work. Dr. Rosenthal cites Docherty in his book. He lists these at-work problems by how often they occur: “decreased concentration, productivity, interest, and creativity; inability to complete tasks; increased interpersonal difficulties in the workplace; increased absences from work; and simply stopping work.”

According to Rosenthal, the physical symptoms can be especially prominent and debilitating. They include sleeping problems, fatigue, a revved-up appetite, loss of interest in enjoyable activities and diminished sex drive. And while mood changes are salient, individuals may feel the physical signs first. In the book, a middle-aged woman describes her physical symptoms:

I don’t really feel depressed. I just feel like all my systems have been turned off for the winter. I feel leaden and heavy and just want to lie about all the time. It’s only when I am expected to do something out of the ordinary, and I realize that I cannot do it, that I feel my mood being pulled down.

SAD Treatment

Light therapy, cognitive-behavioral therapy and antidepressants are effective in treating SAD. In 2006 the Food and Drug Administration approved the antidepressant Wellbutrin XL for preventing episodes of SAD.

Extensive research has shown that light boxes work well in boosting mood and energy. Light boxes emit artificial light that mimics the sun’s rays. They emit anywhere from 2,500 lux to 10,000 lux. (Lux is a measure of intensity.) Light therapy requires a daily commitment. It’s best to use light boxes in the early morning for 30 minutes or more during the winter months. (The 2,500-lux light boxes might even require two hours.) However, you can read or talk on the phone as you’re receiving light therapy. According to Rosenthal, you can do anything during your sessions, as long as your eyes are open, you’re facing the light box and there’s a proper distance between you and the box.

Early research has shown that CBT for seasonal affective disorder may be even more effective than light therapy (and doesn’t require the extensive time commitment as light boxes do). In this 2009 study, Rohan and colleagues compared SAD-tailored CBT to light therapy (along with a combination of both treatments and a wait-list condition). They found that CBT, light therapy and both CBT and light therapy were all effective in treating SAD.

However, at the one-year followup, participants treated with CBT were doing much better than individuals in the light therapy condition. In secondary analyses, Rohan also controlled for ongoing treatment, and the CBT participants still fared better.

Rohan is currently conducting a five-year randomized trial with 160 participants to further test CBT’s effectiveness.

CBT for Seasonal Affective Disorder

So what is SAD-tailored CBT? Specifically, it helps clients identify and incorporate enjoyable activities into their lives and to identify, challenge and change negative thoughts, according to Rohan. It’s classic CBT with a focus on coping more effectively with the wintertime.

For instance, people with SAD tend to view winter very negatively. They commonly say that they hate the cold and can’t do anything during the winter months. Rohan helps clients gain a more realistic perspective. She begins by challenging the strong word “hate.” Remember that you can hate poverty or prejudice, but you probably dislike the winter or simply prefer the warmer months. This slight shift in perspective is a big help. She also asks clients to come up with the evidence that they can’t do anything during the winter and to think of the times they have done fun things. Together, they also devise a plan that includes enjoyable activities.

As Rohan noted, this sounds a lot easier than it really is. Depression zaps your energy and desire to do anything, so engaging in activities may be incredibly difficult. That’s why Rohan starts small. Clients commit to doing 10 minutes of a specific activity. They also discuss potential barriers to engaging in the activity and problem solve to overcome them.

Seeking Treatment for SAD

If you think you might have SAD, it’s vital to see a therapist for a proper evaluation. “It can be dangerous to try to engage in self-diagnosis and self-treatment,” Rohan said.

In his book, Rosenthal outlines the signs to seek medical help:

• Your functioning is significantly impaired. You have difficulty completing tasks that were easier before; you’re falling behind with bills and chores; you make mistakes more often or take longer to finish projects; you tend to withdraw from loved ones.
• You feel considerably depressed. You feel sad more often than not; you feel guilty or hopeless about the future; you have negative thoughts about yourself that you don’t have at other times of the year.
• Your physical functions are greatly disrupted. During the wintertime, you sleep more or have a hard time getting up in the morning; you’d rather stay in bed all day; your eating habits have changed.

If you’re struggling with a mild case of the winter blues, the principles of CBT can be helpful, according to Rohan. Identify fun activities that you can do in the cold months, and avoid spending a lot of time in bed and isolating yourself. Also, be mindful of your negative attitudes and thoughts about winter, and try to challenge them.

And remember that SAD is highly treatable, and there’s always hope!

After the many festivals of light in mid-winter (Ramadan, Hanukkah, Winter Solstice, Bodhi Day, Christmas, Kwanzaa) comes the time of the dark — a quiet time for gathering ourselves for the daylight to come. Not so long ago, winter was a time for lying low, for repairing tools, doing hand work, spinning cloth, and spinning tales. Because the central fire provided the only warmth in colder climates, families gathered around it to entertain children, to catch up on tasks that had been put off or neglected, and to plan for the next season.

In such close quarters, people had to learn get along, to work together and, at times, to respect each other’s periodic need for solitude and silence even when huddled together. When spring came, people were rested and ready for the next spurt of activity. As soon as the sap started to run, people and creatures also felt the call to reemerge from their caves (whether literal or figurative) and to get busy.

In a time of central heating, on demand TV, individual computers, and mass produced goods, we mostly ignore the natural rhythm to things. Instead of convening around the fire, we go off to our own rooms. Instead of sharing our time and telling stories to children, we send them off to play and go our own busy ways. Instead of taking a break from our usual work to do needed reflection and to plan, we push on. We have lost an important forum for learning patience for ourselves and tolerance for others. We seem to have forgotten that January and February are for quiet even though something in our spirits still longs for a time of hibernation.

Unfortunately, the tendency in American culture is to make a natural down time into a problem. We give it the clinical name of “depression” or the not-so-clinical name of “the blues.” We tell ourselves to snap out of it. We tell others who are pulled more into themselves that they should buck up, get with the program, produce. We may look to medicine to override our inclination to curl up with a book or just curl up. Where did we get the idea that once the holidays are over we’re supposed to flip a switch and get back to business as usual? Where did we get the idea that any deviation from full participation and enjoyment of every single minute, regardless of the season, means that something is wrong?

What Is and Isn’t Depression?

There’s a difference between a genuine diagnosis of depression and the natural wintertime pull to rest and regroup. A diagnosis of a clinical depression requires that five or more of the following symptoms have been present during the same two-week period and present a change from one’s usual level of functioning. Please note the “and.” Both must be going on. At least one of your symptoms must be a depressed mood or loss of ability to take pleasure in things you usually like. Further, the symptoms must cause significant distress or impairment in social, occupational, or other important areas of functioning.

Symptoms of depression (according to the Diagnostic and Statistical Manual – IV-R) include:

1. Depressed mood most of the day nearly every day.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
3. Significant change in appetite nearly every day or a change of more than 5 percent of your body weight within a month.
4. Sleeping too much or too little nearly every day.
5. Being observably restless or agitated, or being observably slowed down.
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
8. Diminished ability to think or concentrate or indecisiveness nearly every day.
9. Recurrent thought of death, suicidal ideation, or an attempt, or a plan to commit suicide.

If you truly meet five or more of these criteria, including either No. 1 or No. 2, you should get yourself to a mental health provider for a professional evaluation. Real depression is miserable. It makes it difficult to function at work or in school, to be good to others, and to care about yourself. Fortunately, with a combination of talk therapy and some medication, it can be managed and you can feel better. Really. Most people do respond to treatment. (See the Psych Central’s depression resources for a more complete discussion of clinical depression.)

“If we had no winter, the spring would not be so pleasant.”
—Anne Bradstreet, 1655

It’s a rainy mid-January Wednesday in Boston. The sky is a blank sheet of gray. The air is chilled. In the Northeast, on days like today, most of us wait anxiously for spring. Others wish we’d get more snow so it at least felt like winter.

It’s not pretty out there on the streets. You can’t ski when it’s like this. You can’t frolic through the snow. The roads and sidewalks are slick and full of puddles. The heat indoors is dry. Spring feels a long, long way off.

This is the time of year we start getting cranky. We complain a lot about the temperature and snarl at the Weather Channel. We don’t get enough exercise. We eat too much. As one colleague reported, “I’m irritable, tired of wearing the same coat everyday and sick of being indoors. I want to be lying on a slab of granite in the Greek Islands.” Another co-worker added, “It’s this time of year when I get nervous about how I’ll look when spring finally gets here.” Me, I try to convince myself that the days are getting warmer. I’m generally unsuccessful and sometimes end up with a chill from wearing a coat that’s not warm enough.

It’s this time of year that tends to turn us toward one of three personal management styles:

1. Getting desperate;
2. Faking it; or
3. Persevering and dealing with it.

Avoid Desperation

For those of us who don’t suffer from SAD (Seasonal Affective Disorder) but simply grow weary of winter, it’s important to acknowledge that, eventually, spring will return as it always does. You can use the dog days of winter to prepare for warmer weather, and even provide yourself with a little entertainment and perhaps a couple of dollars in pocket cash. A few suggestions to (at least temporarily) avert desperation:

• Do your spring-cleaning in winter. I have several friends who clear out their closets, give their unused clothes and “tchotchkes” away or bring them to consignment shops, and purchase a few select items.

• Add some color to your life. The same way that flowers perk up the world, they can perk up your home. Hyacinth and amaryllis bulbs are inexpensive and easy to grow. Many are sold in pots where all you need to do is add water and bingo, a little bit of instant springtime.
• Hot, hot, hot. Listen to the music of warmer climates. Dance around your home (alone or with others) to some salsa, reggae or merengue music. Work up a sweat. If you use alcohol (in moderation), drink a daiquiri.

Alter Your Reality

“Faking it” can take many forms. Here in Boston, thousands of students start roaming the streets in shorts as soon as the temperature climbs above 50 degrees. This is not recommended. However, you might try one of the following:

• Go green. Find a hothouse. Most large greenhouses have a section that’s kept warm and humid all year round where you can close your eyes and feel like you’re in the Caribbean, or at least South Carolina. You can also visit a florist and stick your nose in the roses and take a good whiff of springtime to come.

• Turn up the heat. Try to find a public (and clean) steam bath near you or some other such locale. Last week, I went with three friends to “ladies’ night” at the oldest Russian-style steam bath in the U.S. Lots of women — all ages, shapes, and sizes — sat and sweated together while an ice storm pelted the streets outside. We happily wore green mud masks, smiling, sweating, and momentarily forgetting the reality of our climate.
• Go outside. Even though there may still be a chill in the air, it’s worth your while to get outside. Not only do we need vitamin D (provided by sunlight), but fresh air is curative all by itself. Bundle up and get on out there!
• Vacate. While this isn’t always possible, a short trip south of the border is a fantastic antidote to winter blahs. Many websites offer exceptional reduced-price vacations that can be booked either in advance or at the last minute.

Go With the Flow

And then, of course, there’s the “grin and bear it” option. When all else fails, know that spring will come. The crocuses will open toward the sun, windows will open, and the days will lengthen. As George Herbert said in the 17th century, “Sweet spring, full of sweet days and roses.” Those sweet days will be back; I know this in my heart, even as I look down at the street, covered with filthy melting snow, and the sky a leaden gray. But I have hope; in fact, I can see a patch of blue far off toward the east.

For the last 20 years or so, daylight savings time started on the first Sunday in April and ended on the last Sunday in October. Starting this year, however, daylight savings time for most of the U.S. will begin on the second Sunday in March and end on the first Sunday in November. So we’ll get darker mornings and lighter evenings sooner than usual.

The change is all part of President Bush’s Energy Policy Act, mandated in 2005 as an attempt to combat growing energy problems. According to the California Energy Commission, household energy consumption is linked to how many hours there are between sunset and bedtime. When we go to bed we turn off lights and appliances that account for about 25 percent of home energy consumption. It is hoped the change will save 100,000 barrels of oil a day during the extension period, but some doubt remains over this figure.

The Effect on Our Mood

How will a longer stretch of dark mornings and light evenings affect us?

For one thing, we are all likely to become more active in the evenings.

Feeling that the best part of the day’s not over when we leave work can’t help but make us feel more optimistic, and outdoor exercise suddenly will be a nicer prospect! Social activities also are likely to increase when we’re able to savor more daylight. An hour of light after work means more opportunity for ball games, trips to amusement parks and shopping.

Other benefits may include a drop in crime, as people are not out so much in the dark, and an estimated drop in road traffic injuries, as people are leaving work and school in daylight. However, traffic accidents may rise initially: Following the spring shift to daylight savings time, when one hour of sleep is lost, studies have found a measurable increase in the number of fatal accidents. Lost productivity is another short-term drawback, as sleep-disrupted workers adjust to the schedule change.

There are many reasons why people feel down at holiday time. Here are the key causes for the holiday blues:

• Pressure to feel merry: Do you feel joyous when holiday decorations go up and store windows fill with gifts? If you don’t, take comfort in knowing that you are not alone. The disparity between how you actually feel and what you think you are supposed to feel can cause you guilt and confusion. This phenomenon can start you off on the wrong foot, even before the festivities begin.

• Remembrances of holidays past: Consciously or unconsciously, you have a mental record of previous holidays. Your mood may be contaminated by the specter of sad holidays past. If your current life circumstances are unhappy, however, you may long for the happy holidays you once enjoyed.
• Reminders of loved ones lost: Holidays are a time for reflection. All too often your thoughts turn to beloved family members and friends who have passed away. The subsequent sense of loss you feel can spoil even the happiest of celebrations.
• Loneliness: Holidays can be dreadfully lonely if you don’t have a significant other. Additionally, separation from family members (emotional or geographic) can be particularly painful at this time of year.
• Financial hardship: One of the joys of the holiday season is to give to others. If your financial resources are severely limited at this time of year you are likely to feel insufficient, and as though you are “on the outside looking in.”
• In search of sunlight: Many people are adversely impacted by the relative loss of sunlight they experience during the winter months. This phenomenon even has a name: seasonal affective disorder or SAD. Your holiday blues will only be exacerbated by limited sunshine.

Do any of these reasons for feeling bummed sound familiar? Don’t despair. Here are some ways for you to effectively beat those holiday blues:

• It’s OK to feel what you feel: If you don’t feel as happy as you think you should, don’t fight it. Forcing feelings that aren’t there will only make matters worse, and there really aren’t any “shoulds” about it.

• Seek sun and endorphins: If you find yourself feeling blue, be sure to get at least 20 minutes of sunlight each day. This isn’t always easy to do when winter weather hits, but do your best. And don’t forget to exercise. Both sunlight and exercise help to fight any chemical causes for your holiday funk.
• Help someone else: It’s hard to feel down while you are busy helping someone else. Volunteer at a soup kitchen, wrap gifts for unfortunate kids, or spend time with an elderly relative or friend. Instead of feeling glum you’ll find yourself experiencing what the holidays are really about: Giving to others.
• Create your own traditions: Contrary to popular opinion, there are no rules for how you spend your holidays. So if old traditions bring up unhappy memories, start new ones. If you don’t have family, share the holidays with good friends. Don’t wait for them to include you; make them welcome in your home instead. If cooking a Christmas dinner feels like a drag, do brunch. If going to a synagogue or a church service dampens your spirits, have your own worship service outdoors, at home or wherever you wish.
• Stay busy and avoid unstructured time: If you know the holidays are difficult for you, why not plan ahead and minimize your difficult feelings. Try to fill your calendar with fun events. Too much time spent alone may bring you to an old, familiar place: down.

Now here’s the most important thing you can do to beat those blues: No matter what is happening in your life, think of the blessings you do have. Taking stock of all of the positives in your life — right here and now — can go a long way toward ending your “bah humbug” mood.

With a little bit of planning and forethought, the holidays can be wonderful — and not because they are supposed to be.

Multicolored lights twinkle across houses and front yards. Parents and squirming children form long lines to sit on a Santa look-alike’s lap. Red and green decorations adorn every store window. A constant sound of jingle bells and holiday tunes streams through the air.

The holiday season is just around the corner, and if you would rather deck the next guy you see in a red suit than deck the halls, you may be suffering from the holiday blues.

The Blues vs. Depression

The holiday blues, as the name implies, tend to be temporary and seasonal. They can affect both men and women, young and old, according to the Centers for Disease Control and Prevention.

Holiday blues are more of a situational sadness, though physical symptoms may resemble those of clinical depression, says Michelle Pruett, MSW, of the National Mental Health Association in Alexandria, Va. These symptoms may include a general sense of sadness, changes in eating and sleeping patterns, withdrawal from activities you usually enjoy, and, in extreme cases, thoughts of suicide.

You also may feel hopeless, angry or overwhelmed, says Carol Goldberg, Ph.D., a clinical psychologist in Syosset, N.Y., and president of Getting Ahead Programs, which specializes in workshops for stress management and wellness.

Depression, on the other hand, lasts longer and may require treatment, Pruett says.

“If you see changes in your personality or if your sadness is affecting you physically for more than two weeks, then you might have a diagnosable depression,” Pruett said. At this point, you should seek the help of a mental health professional, she adds.

“It’s also quite possible that you feel bummed out just this holiday season. It really varies from person to person,” said Jane L. Cobb, LMSW-ACP, a therapist in Austin, Texas.

Thirty days hath September,
April, June and November,
All the rest have thirty-one
Except for February—
Which has 258!

We extend our apologies to the writer of this clever children’s rhyme for tampering with the last line. But for those of us who live up North, February is the teaser month. Once the busy-ness and the shopping and the visiting and the activity and the lights (especially the lights) of December are over, the dark seems really to set in. Somehow, psychologically, we think that half the winter is over with the celebration of the New Year. It’s not. Not even close. It’s been cold since late October and it’s likely to be cold—even snowing—until April. The afterglow of the holidays and even the decorations may last through much of January. But then February comes. Far from being a harbinger of spring, its coming means we’re only halfway there to warmth and light again. Its scarcity of days doesn’t help. It feels like the longest month of the year!

For those with “winter” depression, known as seasonal affective disorder or “SAD,” mid-winter is especially hard. Not only do they experience the symptoms of more general depression like sadness, a loss of energy, and irritability, they also may develop a craving for sugars and starches and experience a marked weight gain. The sadness in SAD typically begins in the fall or winter and ends in the spring. This type of seasonal depression is diagnosed as SAD only if it occurs during two or more winters. Not surprisingly, it is more and more common the farther away a person lives from the equator. Women seem more susceptible and it does tend to run in families.

Causes and Treatment of Winter Depression

Although there are a number of competing theories, it is generally believed that winter depression occurs in some people when they do not have sufficient exposure to sunlight. For this reason, the most common treatment for winter depression is “phototherapy,” or exposing the eyes each day to bright artificial light built into a special type of visor, lamp, or light box. Treatment administered in the morning, to mimic the natural beginning of the day, seems to be more effective than other times. The treatment appears to work for children and adolescents as well as adults.

Through years of recurring severe depressions, I have come to know what that lump means. I know I have to hurry to get rid of it, before it claims any more of my being—before the energy it takes to erase it is gone.

I begin working, a little bit at a time. It grows smaller as I connect with my daughter and other close friends for some ranting and raving time; time when they listen as I vent my feelings and frustrations at being a passenger on this planet. And when I finish and collapse into slumber or go for a walk, it gets even smaller.

I greet the day, still dark outside, with my close friend of four years, my light box. Reading the paper—skipping the bad parts—in this warm glow continues to lift my spirits. Through the day, I take time-outs to relax, breathe deeply and listen to some good music. A time when I let the past and the future drift away and exist in the present. Being really good to myself, I relax in a tub of warm water filled with the scent of sweet birch or lavender or rose.

I save a few minutes to work on that quilt that I have neglected for so long, feasting my eyes on the bright colors and the design, changing as I stitch. None of the cares of the world exist as I work away at the quilt while the lump in my chest grows smaller still.

That book I have been meaning to read. A couple of hours with it and a cup of herb tea curled up in my soft recliner, and the lump continues to decrease in size and intensity.

Short Days and Long Nights

Do you notice that as the daylight shortens through the fall and into the winter, you feel sadder and more fatigued? You may have a hard time getting out of bed in the morning. You lack motivation and have a difficult time experiencing pleasure. Your self-esteem plummets. To make matters worse, you may crave sweets and, as you give in to these cravings, your clothes become tighter and tighter.

In recent years, the phenomenon of Seasonal Affective Disorder (SAD), which is related to lack of light through the eyes, has become widely accepted as a cause of this malaise. The good news is that it is often easily relieved, sometimes quickly, and more often gradually, over a period of weeks by increasing exposure to natural and full spectrum light sources.

What Can You Do to Help Yourself?

1. See your health care provider. If she or he does not have expertise in addressing Seasonal Affective Disorder, ask for a referral to someone that does have this expertise. Naturopathic physicians and other health care providers are often helpful sources of information on SAD.

2. Increase your exposure to natural light. Get outdoors for at least half an hour each day—more if possible—even on cloudy and stormy days. Taking a walk or getting some other kind of exercise while you are outdoors will help you feel better as well. Although window glass is said to block 50 percent of the light, if you must be indoors, spend your time near windows.
3. Replace fluorescent light bulbs in your home and workspace with grow lights or “full spectrum” bulbs that are available in most hardware stores. They are more expensive than regular bulbs, but well worth the expense.
4. Use a specially designed light box. Many people find that they benefit from this. I have used one for years and find it is absolutely essential—well worth the initial expense. Light box options and information on how they are used can be found through an Internet search.
5. Take good care of yourself in every way. Focus on eating healthy food. Instead of eating those sweets that you crave, eat healthy meals that contain lots of fresh vegetables, including root vegetables. Limit your intake of sugar, caffeine and alcohol. Get plenty of exercise. Do things you enjoy. Arrange to spend lots of time with loving family members and friends.

Depressive symptoms begin in the fall or winter and persist until the spring.

People suffering from SAD either are unable to function or function minimally during the season in which their disorder occurs.

SAD shares several symptoms with other forms of depression including lethargy, sadness, hopelessness, anxiety and social withdrawal.

SAD sufferers crave additional sleep, experience daytime drowsiness, and gain a good deal of weight, often feeling irresistible cravings for sweets.

Four to six percent of the general population will experience SAD. Women are four times more likely than men to develop SAD.

SAD is more common among the young (ages 20 to 50) with a general decrease in symptoms with age.

Risk of the disease increases significantly with geographic residence, with increased prevalence at higher latitudes. For example, the incidence of SAD among people living in Florida is one percent, while those living in northern latitudes, such as Alaska or New Hampshire, have a rate of approximately 10 percent.

Treatment for SAD typically involves a combination of daily light therapy and medication. Exercise and stress management also help to lessen the symptoms of SAD.

Read more about seasonal affective disorder, or learn more about depression now…

The holidays are supposed to be joyous occasions marked by meaningful traditions, family connections, spiritual rejuvenation and just plain fun. Instead, for many people, they’re hectic times filled with stress, depression and shiny new possessions that won’t be paid off until March.

“It’s no small feat to try to fit a whole year’s worth of passion and generosity into a couple of days,” says Mariana Caplan, M.A., a counselor from Fairfax, California. Add family conflicts, time constraints and budget concerns, and you’ve got a recipe for temporary insanity.

Jingle-jangled nerves

There are plenty of signs that Scroogitis is epidemic. Consider the emergence of holiday stress management workshops and books. “I don’t know that many people who look forward to the holidays for any reason other than having time off from work,” says Caplan, author of When Holidays Are Hell…! A Guide to Surviving Family Gatherings (Hohm Press). “Holidays are all about rituals, and rituals are meant to create meaning for people. Nowadays, though, holidays often revolve around obligations, expectations, and meaningless going through the motions.” It’s no wonder that people often end up feeling tired and disappointed rather than renewed.

“It’s no small feat to try to fit a whole year’s worth of passion and generosity into a couple of days.”

An October 2000 survey on this issue was conducted for Xylo, a company that sets up private Web-based networks to meet the lifestyle needs of corporate employees. In a national random sample of 625 employed adults, the most often cited sources of holiday stress or anxiety were shopping, lack of time and expense. Despite the stereotype that most of the burden falls on women, the survey found that the sexes reported feeling nearly equal amounts of pressure. For example, 25% of women named gift shopping as their top stressor, compared to 20% of men.

Summer is “a period of fruition, fulfillment, happiness, or beauty.”
Winter is “a period of time characterized by coldness, misery, barrenness, or death.”

Well, that sums it up quite nicely, we think.

It is winter yet again. The beautiful colors of the autumn leaves have disappeared and have been replaced by barren tree limbs and icicles sharp and brittle. The harsh winds rattle the window frames and the cold air seems to sing a cruel song that frightens away birds to warmer climates. The daytime gives way to the moon, and darkness sets in way before supper. So, you see, while some perceive winter as a festive time when their worlds are blanketed by the purity of snow, others feel that they are being suffocated by a literally colorless existence.

It is estimated that half a million Americans are negatively affected by the changing seasons and darkening of the summer light. They feel depressed, irritable, and tired. Their activity levels decrease, and they find themselves in bed more often. This depression disorder not only affects their health, but it also affects their everyday life, including their job performance and friendships. This disorder is known as Seasonal Affective Disorder, appropriately acronym-ed, SAD.

What is SAD Exactly?

SAD is a mood disorder that affects an individual the same time each year, usually starting when the weather becomes colder in September or October, and ends in April or May when the weather becomes warmer. People with SAD feel depressed during the shorter days of winter, and more cheerful and energetic during the brightness of spring and summer.

“Hey, Einstein! I knew that already! Tell me something I don’t know!”

Jeez, okay, okay. Irritability is a sign of SAD, so I understand your bitterness, Crankypants. Here are—

10 Things You May Not Have Known About SAD

1. Did you know that between 60% and 90% of people with SAD are women? It’s true. If you are a female between 15 and 55, you are more likely to develop SAD. Great, so not only do women have PMS, Menopause, and child labor to worry about, add SAD to the list, too.

2. Even though the harsh chill in the air might bring you down, SAD is believed to relate more to daylight, not the temperature. Some experts believe that a lack of sunlight increases the body’s production of a body chemical called melatonin. Melatonin is what helps regulate sleep and can cause symptoms of depression.

3. SAD can be treated. If your symptoms are mild, meaning, if they do not interfere in and completely ruin your daily life, light therapy may help you beat SAD. Using light therapy has shown highly effective. Studies prove that between 50% and 80% of light therapy users have complete remissions of symptoms. However, light therapy must be used for a certain amount of time daily and continue throughout the dark, winter months.

4. Some say that light therapy has no side effects, but others disagree. We think it simply depends on the person. Some people experience mild side effects, such as headaches, eyestrain, or nausea. However, these light therapy users say that the side effects are temporary and subside with time or reduced light exposure. Most scientists agree that there are no long-term side effects, but remember to consult your physician before any treatment decisions are made.

5. There are some things to consider if you want to try light therapy in your home, otherwise you will not receive all the benefits that this type of therapy offers.

• When purchasing a light box, do not skimp as far as money is concerned. Buy a larger one so that you will receive enough light to be beneficial.
• The best time for light therapy is in the early morning. (If used late at night, it could cause insomnia.) So, even if it means waking up earlier, set aside some morning time to relax and use your light box.
• Many people are not aware of this, but you must have your eyes open and face the light during therapy. Do not stare at the light. That would be silly. Simply face the light, eyes open.

6. It takes more than just one winter depression to be diagnosed with SAD. Individuals must meet certain criteria:

• The symptoms and remission of the systems must have occurred during the last two consecutive years.
• The seasonal depressive episodes must outnumber the non-seasonal depressive episodes in one’s lifetime.

7. SAD can be treated with certain medications that increase serotonin levels in the brain. Such medications include antidepressants, such as Paxil, Prozac, and Zoloft.

8. There is actually a device that conducts light therapy and allows you to walk around while treated. The device is called a light visor. Just wear the light visor around your head and complete your daily chores and rituals. A light visor still can potentially have the same side effects as the standard forms of light therapy, so only simple activities, such as watching television, walking, or preparing meals is advised. We do not recommend you operate heavy machinery while wearing a light visor. (You would look pretty silly with it on out in public, anyway.)

9. If you have a friend or loved one who suffers from SAD, you can help them tremendously.

• Try to spend more time with the person, even though they may not seem to want any company.
• Help them with their treatment plan.
• Remind them often that summer is only a season away. Tell them that their sad feelings are only temporary, and they will feel better in no time.
• Go outside and do something together. Take a walk, or exercise. Get them to spend some time outside in the natural sunlight. Just remember to bundle up!

10. Although not as common, a second type of seasonal affective disorder known as summer depression can occur in individuals who live in warmer climates. Their depression is related to heat and humidity, rather than light. Winter depression does cause petulance in many cases, but summer depression is known to cause severe violence. So, it could be worse.

There are times in this article, in which I seem a bit blithe. However, please, do not take my somewhat lighthearted approach to SAD the wrong way. SAD is a serious disorder that disrupts the lives of many people, worldwide. It is nothing to laugh at. Sneeze at, perhaps—it is winter, after all. But laugh at? No, not at all.