Mental health professionals call it seasonal affective disorder, or SAD. The afflicted know it as the winter blues, the blahs, that grayness of spirit that matches the clouds outside and worsens as the days get shorter and shorter.
Just thinking about it hastens the downward spiral. The well-off and retired pack up and head south with the birds. The rest of us have to bundle up and carry on.
But for those with seasonal depression, it’s not that easy.
“You just lose a couple of months at the beginning of the winter,” said Marjorie R. (not her real name). “Last winter I did the light box faithfully for an hour every morning. It just wasn’t cutting it.”
This year, she’s decided to take an antidepressant. When the first one didn’t work, she consulted her doctor and is now trying a second.
Like just about every other living thing on the planet, humans use sunlight to maintain circadian rhythms, the internal clock that regulates moods as well as sleeping and waking periods. Sunlight triggers the release of serotonin in the brain, a chemical that results in a feeling of energy, happiness and well-being.
Melatonin, another brain chemical, is released at dark and slows down activity. Melatonin levels go up as winter nights lengthen.
Logically, the farther away from the equator, the greater the number of people with seasonal depression. Overall, between 5 percent and 10 percent of the general population suffers from full-blown SAD, while another 15 to 25 percent of the population experience the milder “winter blues” or mood changes.
Women are four times more likely than men to suffer from the illness. Also, happy news, if you haven’t experienced SAD by age 55, you probably won’t ever have it.
Is SAD more common in Scandinavia than in other countries? According to the tourist website, Go Scandinavia, only a few Nordics are affected by the polar night. Many are immune.
However, statistics from long-term studies contradict that cheerful thought. Oslo, Norway, reports an annual average of 14 percent of the population has winter depression, compared to New York City at 4.7 percent, according to Steven D. Targum and Norman Rosenthal in “Psychiatry,” published in 2008 in Matrix Medical Communications.
So if you’re of northern European stock, you have a greater than average chance to inherit SAD. Should some helpful (not!) relative or friend say “Don’t let yourself get so down” or “Put on your Nike T-shirt and just do it,” you have permission to tell them, well, we’ll leave that up to you.
Feeling like you’re wearing a pair of cement boots, or that you need to prop your eyes open with toothpicks, is not your fault. And there is help.
The most trendy treatment is the light box, a fixture fitted with incandescent or fluorescent bulbs with an intensity of at least 10,000 lumens. The patient needs to sit under the box for at least 30 minutes a day, and sometimes up to two hours, preferably in the morning, eyes closed, with the light hitting the eyelids.
Donna Juhl Magruder, who has been in practice for more than 30 years, prefers that her clients use a full spectrum reading light, available for as little as $30.
“I have my patients read under them at any time of the year,” she said. They fit easily into almost every lifestyle.
Both naturopaths and medical doctors offer chemical alternatives to light therapy. The herb St. John’s wort comes in pill form at health food stores. Its side effects include nausea and headaches. It may also interact negatively with other medications, both herbal and synthetic.
Prescription antidepressants improve either dopamine or serotonin levels in the brain, but also come with side effects. Whether you choose a natural or synthetic chemical approach, natural or synthetic, proceed with caution. Ask for help If you don’t get relief in a week or two or the side effects are just too much.
Ms. Magruder also adds another warning: “All depression gets worse in the winter, and, in my experience, seasonal depression has always progressed into regular clinical depression. And people always say that they’re more depressed at Christmas, but I find that more people get depressed in January and February after the hoopla’s over.”
Are you already slogging through yet another High Plains winter? Rate yourself using the following quick depression checklist. Are you:
1. Feeling down, depressed, hopeless.
2. Lacking energy and tired all the time.
3. Sleeping too much, or can’t sleep.
4. Overeating, especially carbohydrates, or no appetite.
5. Having trouble concentrating.
6. Feeling bad about yourself.
7. Having thoughts of hurting yourself, that you would be better off dead.
How often in the past two weeks have you had any of these symptoms? Scale: 0: not at all. 1: several days. 2: More than half the days. 3: Nearly every day.
The higher the score on this quiz, the more you should consider professional help. And don’t wait until you can’t get out of bed. It’s much easier to correct a small downward turn than a full-blown crisis.
If you score anything but zero on question seven, seek help immediately! Call a friend for a ride to the Billings Clinic emergency room; call the Mental Health Center at 1-800-266-7198. If that’s even too much effort, dial 911.
And take heart. Even the longest Montana winter will come to an end. As the poet, Shelley, wrote, “If winter comes, can spring be far behind?”