Are you SAD this winter?

Alexander Marshall highlights Seasonal Affective Disorder (SAD), outlines why individuals can be affected, and where those in need can find help.

The English band Wizzard once wished it could be Christmas every day. For many, this would be hell, and not just because of the limited collection of songs endlessly repeated in stores. The days are short, the nights are cold, and according to the Mental Health Foundation, 1 in 15 people will find their days filled with a void of winter-related depression rather than merriment.

Depression can occur for many reasons, and the Christmas period can be filled with lots of unhelpful emotional triggers, such as the consistently-advertised ‘perfect family’, or the gift that you have to buy that’s ‘just right’. These unrealistic expectations and added pressures to achieve perfection are applied to many of us though, so why do only 1 in 15 suffer? Well, it probably depends on how biologically susceptible we are to Seasonal Affective Disorder (SAD).

A somewhat insensitive acronym, SAD is a form of depression that occurs due to the changing seasons. The symptoms of SAD are like many other forms of depression: long periods of low mood, lack of interest in previously enjoyable activities, suicidal thoughts, and so on. However, it is unlike most other forms of depression due to its cyclic nature, where a person’s mood will drop between the months of September and April (though it is generally at its most severe between December and February).

SAD is often associated with bipolar disorder, a separate disorder where a person’s mood and energy levels can swing uncontrollably between extreme highs, where they can lose any sense of danger, to extreme lows, where they can instead become suicidal. However, SAD can occur on its own, and is a recognised disorder in its own right. Whilst different, both do occur in cycles and seem to have some underlying genetic components, so it is not shocking that people have questioned if SAD is merely a variant of bipolar disorder.

The primary cause of SAD is thought to be that winter is accompanied by a lack of sunlight. Sunlight is a key regulator of sleep via the release of two chemicals: the hormone melatonin, and its precursor, serotonin. Specifically, melatonin is produced over the course of the night, and its production is stopped when the eye detects sunlight and sends a signal to the brain. This detection of sunlight prevents the conversion of serotonin to melatonin, leading to an increase in serotonin throughout the day.

Excess melatonin or reduced serotonin during daylight hours have both been implicated in SAD, and two of the major treatments currently available try to target this balance. The first treatment involves being exposed to a ‘sun lamp’. These specially designed lamps mimic natural light, reducing melatonin production and therefore allowing the user to compensate for the hours lost during winter.

The other major treatment available is medication. Although a host of anti-depressants are available, those that inhibit the re-uptake of serotonin in the brain, allowing serotonin to remain active for longer, seem to be especially effective at dealing with SAD. Overall, both treatments aim to restore the balance of serotonin and melatonin, which is disrupted during the winter months.

While sun lamps and medication can be helpful, they are unlikely to completely alleviate any issues alone, and an individual is likely to need additional forms of support. Two other types of treatment that are frequently recommended are more general: lifestyle alterations, such as reducing alcohol consumption, and counselling. These can make huge differences in allowing an affected individual to cope during the winter months, and tackle some of the deeper issues that they may be facing.

In summary, if you are feeling depressed or suicidal, please do seek help from a qualified professional, or if you find yourself with a friend who is dealing with depression, remember to give them time, patience and reassurance.

The UK Samaritans operates a 24-hour service available every day of the year (their phone number is 116 123). Instead, if you prefer to write down how you’re feeling, or if you’re worried about being overheard on the phone, you can email Samaritans at jo@samaritans.org.