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Dealing with the winter blues

Why many people feel depressed during the cold, winter months

By Rashida Mustafa
On February 12, 2013

  • 'In Red and Brown Water' will be performed at the Allen Theatre from Feb. 7-17. It is one of the many events the Black Studies Program has planned for Black History Month. Photo courtesy coolcleveland.com

Cleveland is not the sunniest city in America, therefore many Clevelanders enjoy staying inside their warm homes on a cold, cloudy day. Who or what can people blame for Cleveland's dreary weather: Mother Nature, the lake or bad luck?
When there is limited sunlight, some people can fall into a type of depression that affects how they function on a day-to-day basis. Although the depression is relatively new to the field of mental illness, it is recorded to have been around since Hippocrates' era in 400 B.C. This depression is called Seasonal Affective Disorder.
Seasonal Affective Disorder (SAD), also sometimes referred to as the 'winter blues' or winter depression, is a type of depression that generally occurs in the fall and winter seasons. It can affect anyone from adolescence to adulthood.
Dr. Toni L. Johnson, psychiatrist at MetroHealth Hospital, said there is a distinction between those terms. SAD is a clinical diagnosis - a clinical depression with signs and symptoms - and it impacts someone's functioning, and their ability to work, focus and concentrate. The 'winter blues,' however, is not a true medical diagnosis. Changes such as temporary moodiness, having less energy and sleeping a little more are all minor.
According to Paul Snowball, professional clinical counselor at Cleveland State University's Counseling Center, there is not an exact number of students who come in with SAD versus depression, but a significant number of students come in with depression. SAD is not very high in prevalence.
"Out of maybe 20 people, about two or three of them had symptoms of what I would address as SAD," Snowball said.
College students affected by this type of depression often do not involve themselves in student activities and family occasions. Snowball also said students oftentimes harbor themselves in their dorm rooms rather than being outdoors.
In "Seasonal Affective Disorder," an article by Tatia M. C. Lee, Eric Y. H. Chen, et al., the researchers discovered, "Depression linked to SAD is usually mild to moderate, although cases of severe depressions may be observed. SAD is characterized by clinical symptoms such as hypersomnia, hyperphagia, anergia, carbohydrate craving and weight gain."
This means people affected by SAD, such as college students, often socially withdraw themselves from student activities. Most times college students get too much sleep or more commonly too little sleep, which causes them to have less energy and lose the ability to concentrate in class. In turn, this affects their class participation and studies. Students and others alike who suffer from SAD often indulge in high carbohydrate foods, causing an increase in weight gain.
According to PR Newswire, people "may feel isolated, anxious and depressed because family ties and emotional support may have been severed or compromised." This is often the case since many people who suffer from depression sink into alcoholism and substance abuse. Johnson said alcohol is a depressant for people with SAD and other clinical depressions.
A research study conducted in "Seasonal Affective Disorder" found that a clinical inclination of SAD exists in many eastern and western countries, affecting 5 percent of the population.
However, that percentage is higher at about 25 percent in more northern areas in the world. In a population survey conducted in 1988 in New York City with more than 200 responses, about 25 percent of those people reported significant seasonal mood changes. In Maryland during the same year, the survey was conducted and 80 of the 138 surveyors reported depressive symptoms associated with a particular season.
Although research on SAD has not been conducted in Cleveland, Johnson said people who live in more northern parts are affected. For people who live in Cleveland where there is more of an overcast of clouds due to the lake, there is a high risk of depression because of the limited sunlight.
"It's not the cold, it's the sun," Johnson said.
However, Johnson added if one were to take people from Cleveland and place them in states such as Arizona or Florida, SAD will not remain with them. Anyone living in a place where sunlight is rare is at higher risk of the disease.
Johnson explained that when looking at the entire category of clinical depression, about 10 percent of people are affected by depression. But of that 10 percent, only a fewer amount of those people are actually affected by SAD. Of those 10 percent, their depression increases in the fall and winter. Research has also found that women are more likely to fall into SAD due to the differences in biochemical responses to climatic variables.
However, Boaz Kahana, professor of Abnormal Psychology at CSU, said other factors not linked to sunlight can trigger SAD. Certain socioeconomic backgrounds can also transfer into the disorder.
"People who come from poor socioeconomic backgrounds generally are more likely to have stress on them," Kahana said.
If someone has a lot of stress, it can affect serotonin in the brain, which links to depression. Serotonin and dopamine are neurotransmitters that some researchers believe play a significant role in triggering SAD. Serotonin is essential in initiating sleep, weight and eating regulations.
But Kahana said there are exceptions. Just because someone is living on a low income does not mean they are depressed, and if they are close to friends and family, they are less likely to become depressed.
There are few treatments for those suffering from SAD, with one of those being light therapy. Research in "Seasonal Affective Disorder" claims that the melatonin model was "developed based on the observation that bright light can suppress nocturnal pineal melatonin secretion, believed to be the conductor of the human biological rhythms." The melatonin model shows how much light is needed to create a therapeutic effect for SAD.
Through the idea of the melatonin model was the creation of a light box used as light therapy for those who need a supply of light when the sun is unavailable.
Most light therapy devices are made of fluorescent light bulbs. Each light box can transmit different amounts of light. Some may range from an intensity of 2,500 lux (a unit of illuminance), and other light boxes can emit 10,000 lux of light. The more lux the box can produce, the higher amount of therapy will be achieved.
But the amount of necessary therapy depends on the person. Johnson noted that students are more likely to use the light therapy regularly. For it to work effectively, people need to use it daily. She also said most students will set up the light in the morning before class, and some may study with it on in front of them. It will typically last them the rest of the day. Johnson added if the student feels like they need to use it again, most will use treatment for another 15 minutes for an extra boost for the day.
Snowball has seen many different kinds of light therapy boxes. Some are large while others are portable and small enough to put on a desk while studying. This is especially convenient for students.
Another treatment many psychologists recommend are anti-depressants, but sometimes the best way to help someone with SAD is encouragement. Because the person with SAD is depressed, it is hard for them to go out and be in public. Snowball explained one of the ways he gets students to self-medicate is by telling them to go outdoors, even if it is only for 20 minutes.
A few ways those who suffer from SAD can manage their depression are to eat a healthy diet, practice good sleeping habits, exercise more and learn how to look for early signs of their depression getting worse. Using all or any of these methods along with either treatment should get the person with SAD to a better state of mind and physicality.
Although SAD was not examined until the 1980s, research shows this to be a true clinical depression experienced by a substantial number of people around the world. When people do not get enough sunlight their attitudes toward everyday life can be tremendously affected in the same way people with any other kind of depression are affected.


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