When fall officially arrives on September 22, the number of hours of daylight and darkness are equal. As we proceed further into fall and early winter, hours of darkness overtake those of light, and a well-rehearsed (because we sing this every year) chorus of “It is so dark in the afternoon!” will be heard. By the end of November, the refrain of, “It’s so depressing!” is added to our song of complaint.
And every year, even before the leaves change color, we noticed changes in energy, appetite, sleep and mood. At first, these changes are hardly noticeable: sleeping a little longer, disinterest in new activities or commitments, feeling tired, craving for starchy comfort foods rather than large salad, and a bit of irritability, annoyance, impatience, and gloominess. That’s seasonal affective disorder, SAD or the winter blues, arriving.
This seasonal disorder with its symptoms of overeating, fatigue, sleepiness, and grumpy mood is provoked by a decline in hours of daylight. Inhabitants of our northern states are more vulnerable than those in the south because the southern states have more daylight in the late fall and winter. For example, on December 21, the first day of winter, Chicago has a little over 9 hours of daylight; Key West, Florida, 10 and a half hours. The symptoms of SAD are not weather related (although there is a variant called summer SAD that seems to be linked to heat and humidity). Indeed, the early symptoms may begin during the early days of fall with its sunny crisp days, and naturally cool nights.
SAD was first described in the mid-l980s, but not much more is known today about how an environmental input like sunlight is able to bring about so many changes in our well-being. The hormone that puts us to sleep, melatonin, has been implicated because daylight naturally reduces its levels in the blood. It was thought that the late sunrises of the fall and winter seasons delays melatonin destruction and leaves us sleepy, but how this would affect the other symptoms such as mood and overeating was (and is) not understood.
One of the first therapies offered to patients was exposure to artificial light that mimics the spectrum of sunlight. Sitting in front of a lightbox or “sunbox” for thirty minutes or so in the early morning upon awakening was shown to relieve the symptoms of SAD. Lightboxes are still used, and some who work in windowless offices often keep them on throughout the morning to brighten their mood. Treatment with antidepressants that increase serotonin activity is now an alternative treatment based on studies showing that serotonin activity seems to be reduced in patients with seasonal affective disorder.
However, many people fortunately never experience the clinical depression of SAD; rather they have milder symptoms which now have taken on the name “winter blues”. Although their weight, sleep, work productivity, and mood are all changed (not for the better), their symptoms may be relieved in part simply by using light therapy.
One of the problems with winter depression is that it creeps up silently, triggering an almost imperceptible change in behaviors that seem to have their own justification, rather than associated with diminishing daylight. Fresh fruit desserts are less appealing than the fruit baked in a cake or pie; fall activities make a good excuse for skipping the gym; new projects or commitments are better off delayed until spring because the holidays will be coming; the irritability, depressed mood, anger symptoms are justified because of work/kids back to school/ family or financial stress; and sleeping longer is necessary because of a persistent tiredness.
Recognizing the early symptoms of winter blues, such as cravings for sweet carbohydrates or increased fatigue, allows strategies to be put in place (like rakes before the leaves drop) to decrease their impact on quality of life. For example, weight is often gained due to the dual effects of craving high-fat sugary foods (like chocolate and cookies) and drastically decreasing exercise because of fatigue. Recognizing this should lead to removing highly caloric carbohydrate snacks like chocolate and ice cream from the kitchen. Once the full blown carb cravings of winter blues hit, it will be difficult to resist eating cookies or ice cream or chocolate, especially when the sun sets by late afternoon. Replacing these highly caloric foods with very low fat breakfast cereal—such as oat or wheat squares or cornflakes—will increase serotonin, turn off carbohydrate cravings, and increase satiety without doing damage to your weight.
Fatigue and disinterest in taking on new activities may shut down any commitment to frequent (if any) exercise. Plenty of excuses will be available as weather, early afternoon darkness, work, holiday, and family commitments erode time for a workout at home, at the gym, or outdoors. It is all too easy to stop going to a yoga or Pilates class or cancel a walk with a friend. One solution is to use an APP, or wearable exercise tracking device that will nag you into taking 10,000 steps a day, or indicate how many calories you are eating and how many you are using for energy. The APP doesn’t care what your excuses are for not moving, but if programmed correctly, will ping and alarm and buzz until you do move.
Better yet, be competitive with someone at work or in the family so that you have to display daily (or at least weekly) whether you met your exercise goals. If you start doing this before the fatigue of the winter blues sets in, it is possible that you will continue with the exercise even if one part of you is begging to lie down on the couch and watch Netflix. There is no cure for SAD or the winter blues other than moving to states where the days are longer. Fortunately, the days start to get longer on the second day of winter, and the symptoms will go into remission by mid-spring.
We can’t keep the leaves from falling, or snow, for that matter. But it should be possible with the right interventions to keep weight from rising, mood from falling, and energy levels intact until that happens.
Seasonal affective disorder: a description of the syndrome and preliminary findings with light therapy Rosenthal N, Sack D, Lewy A et al Archives of General Psychiatry 1984 ;41: 72-80
(β-CIT SPECT imaging shows reduced brain serotonin transporter availability in drug-free depressed patients with seasonal affective disorder Willeit M, Praschak N, Rieder A et al Biological Psychiatry 2000 ; 47: 482-489