I was diagnosed with Seasonal Affective Disorder (SAD) in 2009.
I have met so many people who live with this disorder and felt compelled to share my experiences in the hope that this may be of help to you or people you know who may be affected by it.
The information contained in this article is not intended to constitute or replace medical advice. Please see your healthcare provider for a diagnosis and treatment options in the first instance.
A touch of the Winter Blues or SAD?
Many people who live far from the equator are familiar with and experience some form of the ‘winter blues‘ or simply dislike the cold and blustery weather. As the daylight hours shorten, it’s only natural to feel more introverted, less inclined to socialise and to have less energy. I feel that this is simply nature telling us that we should be slowing down to conserve energy during the autumn and winter.
If it doesn’t affect one’s quality of life, then just go with it – give yourself permission to slow down and go to bed earlier – allow these lifestyle adjustments to help you maintain some energy for the commitments you do have to fulfil.
Seasonal Affective Disorder – a recognised mental health condition – is a recurrent depression that occurs with the onset of autumn and lasts until the daylight hours begin to increase in the spring. Note: it is known for SAD to affect some people just in the spring and summer months but this is far less common. I will be referring to autumn/winter depression in this article.
SAD symptoms vary from person to person but on the more severe end of the scale, they can deeply impact one’s quality of life. These include persistent depression, low energy ranging from lethargy to deep fatigue, lack of motivation, difficulty with cognitive function and concentration, irritability, mood swings, tearfulness, loss of enjoyment and interest in normal day to day activities, sleep problems (needing a lot of sleep or insomnia), withdrawal from social engagements, feelings of despair and hopelessness and changes in eating habits. Some people also experience suicidal feelings and physical ailments as a result of a lowered immune system.
What causes SAD?
Whilst there is no definitive answer as to the cause(s) of SAD, it is understood that the short daylight hours directly affect our brain chemistry and hormonal activity. I believe this to be the case for me.
Our circadian rhythm (body clock) is governed by daylight and darkness. Melatonin is the hormone that is secreted when darkness falls and makes us feel sleepy. People with SAD may produce higher amounts of melatonin in response to the onset of darkness. Another theory is that those with SAD simply need more daylight.
Research shows that the quality of daylight (in places far from the equator) is very different in the darker months. In autumn and winter, there is a lack of the blue spectrum of light that we enjoy in abundance from the summer sky. I will come back to this later when I talk about light therapy.
There are other possible causes and predisposing factors to SAD including a history of depression or other mental illness, being genetically pre-disposed (I have a blood relative with SAD) or having memories of difficult events such as bereavement or trauma during the darker months.
I have never enjoyed autumn and winter. As a child I remember experiencing a sinking feeling in September and it had nothing to do with ‘back to school’. All my happy childhood memories belong to the delight of spring time and the long, carefree days of summer I am a self confessed sun worshipper and love warmth and light. However, it wasn’t until I returned from my five month stint in India (from the end of October until March) on my first teacher training in 2007 that the symptoms worsened drastically and rendered me unable to function.
I visited my GP for three consecutive years – in October – with fatigue and depression. Blood tests came back normal. The first year I took antidepressants for about 7 months. Then I plummeted again the following autumn. When my GP and I identified the pattern and I was diagnosed with SAD, he said: ‘you have three choices – try light therapy, take medication or spend six months each year in the Southern Hemisphere.’
The latter, as inviting as it seemed, was not an option! So I tried light therapy. The first SAD light box I purchased was an ‘old school’ one. It was about 18″ in height, emitted a bright white light and two hours per day of sitting directly in front of it at close range was required for any effectiveness. It helped me feel a little less tired but did not restore my energy at all or boost my mood. The following year I was given the best Christmas present ever – my Philips goLITE BLU.
13 years on….
I still live with SAD. For six months of the year I am not myself. I don’t socialise often and I need about two hours more sleep a night. In the depths of the short days (Nov-Feb) I struggle to be awake for more than 8 hours a day. In December, at 4pm, I could easily go to bed for the night. But I know it’s coming each year, I accept it but it’s still tough.
I’ve also learned not to overspend my energy when spring arrives. For years after my diagnosis, I felt such a rush of energy and euphoria in March that I found it hard to keep a lid on it! I would over-socialise, burn the candle at both ends and spread myself thinly. I’ve learned through experience that this would leave me more depleted come autumn. Now I make wiser choices in an effort to stay as balanced as possible throughout the year so, in summer, my bed time is still 10pm even though it’s barely dark outside. It doesn’t stop me feeling debilitating tiredness, deep fatigue as though my bones are made of lead and cement is running thought my veins during the darker months, but I do feel healthier inside and these simple acts of self care and moderation in all things goes a long way.
Daylight bulbs and alarm clocks
There are ways in which you can help ‘brighten up your day’ or make for an easier wake up when it’s dark in the mornings.
- Swapping bulbs in your lamps at home for ‘daylight’ or ‘full spectrum’ bulbs creates the effect of daylight which can help to reduce tiredness and improve mood but they are not light therapy.
- Dawn simulator lights are helpful for people who have difficulty in waking up during the darker months as they simulate the sunrise to encourage a natural wake from sleep.
Medical light therapy appliances
- To influence your brain chemistry and provide you with some relief from debilitating SAD symptoms, light therapy comes in the form of a ‘SAD lamp’ which should meet the requirements of the Medical Device Directive. These are medically proven to help shift circadian rhythms back to their normal pattern by delivering the wavelength, colour and intensity of light that we respond to.
I use the Philips goLITE BLU and couldn’t get by without it. It enables me to function better, boosts my mood and gives me a few extra hours of ‘awake’ time in my day plus it relieves the nagging, dull ache that lives behind my eyes in autumn and winter. It’s small, portable and holds a charge. It’s not as intrusive as the old style big ‘boxes’ as this small device should be positioned on the diagonal about 75 centimetres away at appox. waist height with a maximum treatment time of 45 minutes per day. So it’s easy to do other things whilst absorbing the blue light such as working at a computer, reading, watching TV etc. Many others are available on the market now, so if you are looking to make this great investment, do your research and be sure to consult your GP if you have any physical health conditions or other mental health concerns.
Medicines and other help
A lot of people with SAD benefit from taking medication (antidepressants) and for some people it is non-negotiable. Talk to your GP.
Therapy can also be helpful. CBT in particular is great at helping manage thoughts, feelings and behaviours so that one can enjoy a better quality of life. I took a CBT course late summer last year and got a lot out of it.
Yoga as therapy
We all know that yoga, meditation and other mindful practices such as Qi Gong/Tai Chi are wonderful disciplines to support our wellbeing from the inside out. Tempting as it is to stay under the duvet and binge on Netflix when it’s dark outside, now it’s more important than ever to stay healthy and move our bodies.
A sedentary lifestyle is so detrimental to our physical and mental wellbeing. Find something you enjoy and stick with it. I find that I enjoy vinyasa flow to warm me up and ‘shake things up’. It needn’t be rigid or intense, just move your body and build some heat. You can keep it simple by moving through some sun salutations each day and perhaps a few backbending poses which are energising and uplifting.
The great thing with yoga is that we have an array of different styles to pick and choose to suit our needs from day to day. When we’re feeling really depleted and expending energy in sun salutations will make us more exhausted, we may choose Yin or restorative yoga instead. Listen to your body and respond accordingly. Remember though, balance is key. If your autumn/winter yoga practice is mostly Yin in nature (passive, quiet, still) you should move your body in other ways so as to not become stagnant; that could something as simple as going outside for a walk daily.
Personally, committing to a daily meditation and pranayama practice has helped me take on a balanced perspective about living 6 months each year with SAD. With daily meditation or mindfulness practice, one becomes less reactive to external circumstances as well as our own thoughts and emotions. Kapalabhati is a fantastic breathing technique/kriya for depression and keeping our digestive fire strong. Other pranayama techniques that I love during the winter months are surya bhedana (right nostril breathing) and sama vritti (square, or balanced breathing).
- Get outside EVERY DAY before noon (ideally within 2 hours of waking) for at least 20 minutes. It’s called ‘light bathing’, a great tip that I learned from the wonderful Jennifer Piercy’s Sleep Course on Insight Timer. She says that one should take light into the eyes, so don’t wear sunglasses (but avoid looking directly at the sun, obviously!) Exposing ourselves to natural morning daylight, even in the depths of winter and if it’s overcast, helps to regulate circadian rhythms and boost mood. Well, that goes for any day of the year but for us SAD people, staying indoors is what we want to do. It’s also an opportunity to take some gentle – or vigorous – exercise outdoors if you wish. Bonus points if you can be in nature – a park or by the sea.
- Surrender to it. I didn’t for years and as with all things in life, if we resist, we suffer. Know that you’ll be less energetic, not wanting to socialise much or at all. Your loved ones will understand if you tell them.
- Eat a nourishing and balanced diet of wholefoods. Again, a no brainer for us all but eating well really is the foundation of good health. If you’re not sure where to start, book an appointment with a nutritionist who may also advise on dietary supplements to fill in any gaps in your diet. Avoid processed foods and limit alcohol as these cause inflammation in the body. Many people living with SAD crave carbohydrates and simple sugars. It’s temping, as consuming refined carbs and sugar will give you an instant hit of energy as blood glucose levels spike but then they will plummet and leave you feeling tired and craving more. Excessive caffeine also plays havoc with our energy levels so avoid the quick fixes and choose sustained forms of energy from wholegrains, healthy fats and proteins with lots of fresh, seasonal produce. Be sure to eat warm, cooked food. Raw and cold foods can take a lot of energy to digest and – according to Traditional Chinese Medicine – may cause dampness, excess cold or heat in the body. Lightly cooked soups and stews with root veg are great for the change of seasons (Earth element in TCM) and are easily digested whilst slow cooked, warm meals in the depths of winter will nourish the Water element. Add in plenty of pulses (especially kidney beans) and some wholegrains.
- Take some winter sun. I know travel abroad is not possible or appealing for many right now, but in the winters that I have escaped to sunnier climes for a week or two, it has helped in two ways: it gives me something to look forward to, it breaks up the winter plus I get a good vitamin D fix.
- Gratitude. When we’re feeling blue, negative thoughts tend to rule and we can find ourselves in a downward spiral. Try keeping a gratitude diary by writing down three things every day that you are grateful for. These can be small things like a nice cup of tea, a moment of rest or the view from your window. It’s important to take a moment to reflect on what you journal and really embody the gratitude, feel it in your body and connect with it. An extension of this is to talk about your blessings more than your problems. Taking time each day to adopt a positive and optimistic outlook can rewire the brain.
- Laughter is the best medicine. Try not to take life too seriously, maintain a sense of humour. Spend time with people who have a positive attitude and make you feel good about yourself. Watch some comedy or play a funny board game. I’m all set for lots of laughter this SAD season as I have two young kittens getting up to all sorts of mischief. Perhaps you may find joy in your children if you have them (or borrow someone else’s!)
- Power nap. Type this into Google and you’ll find there is a huge amount of evidence to support the benefits of a 20 minute nap. Afternoon, between lunch and dinner, is ideal. Set an alarm if you need to. Simply get comfortable, unplug from devices, close your eyes and rest. You may just stave off the afternoon carb and caffeine cravings by giving your mental energy a little boost!
- Remember the impermanence of all things The only thing constant is change. I remind myself that, as much as autumn and winter are a struggle, I am gifted with the beauty of spring when she arrives. If I didn’t experience the darkness and bleakness of winter, I wouldn’t appreciate the return of the light and the renewal of nature in the spring.
The MIND website has a comprehensive list of resources.
sad.co.uk – for light therapy information and products.
“If everything around seems dark, look again, you may be the light” – Rumi
Stay well and remember, you’re not alone.