How to tackle that SAD feeling – Dr Jonathan Bloomfield

Each year as we head through October, there comes a clear sense of the nights closing in. You’ve probably lost count of how many times you’ve said, “I can’t believe how dark it is already and it’s only 7pm.” Add in some gale force winds, a drop in temperature and some icy rain and at times we’re all left wondering why we live in the UK!

For millions of people in the UK, the changing of the seasons can bring on a condition known as Seasonal Affective Disorder or SAD. According to the NHS, this form of seasonal depression causes sufferers to have the following symptoms:

  • a persistent low mood
  • a loss in pleasure or interest in everyday activities
  • irritability, especially in teens
  • stomach problems
  • lowered immune function
  • feelings of despair, guilt and worthlessness
  • feeling lethargic and sleepy during the day
  • sleeping longer and finding it difficult to get up in the mornings
  • higher cravings for carbohydrates leading to weight gain

SAD can present itself in both mild and major forms, as the lack of bright daylight impacts on our brain chemistry. The absence of the sun inhibits the release of the neurotransmitter, serotonin, in the body, while allowing the continued production of the “sleep hormone”, melatonin.

The combination of these two factors can disrupt the body clock (circadian rhythm), as well as affecting mood, energy and appetite. Over time this hormone imbalance can lead to depression.

SAD is typically experienced by people who live North or South of 30∞ latitude. The UK is situated at 55∞ North and experiences as little as 8 hours of daylight in winter, which is why SAD is common in this country.

It is also worth noting that the strength of that daylight can vary significantly, depending on the angle of the sun and the weather. In the UK, we can experience as little as one hour of “bright” sunshine as can be seen in red on this graph.

Glasgow: Weather & Climate

This seasonal variation is further complicated by the fact that more of us now work indoors and spend many hours a day under artificial light. Two hundred years ago, approximately 75% of the UK worked outdoors. In 2017, that figure has dropped to below 10%.

Who is affected by SAD

According to research commissioned by YouGov and The Weather Channel in 2014, one in three people in the UK suffer from at least mild SAD. The study also showed:

  • Women are 40% more likely to experience symptoms than men
  • 8% of the adult population suffer from acute symptoms
  • 21% of adults suffer mild or subsyndromal SAD.

Despite SAD and SAD-related depression being recognised as an illness by major health organisations, the number of people who seek treatment is still relatively low. Given that depression and other mental health conditions are estimated to cost the UK economy £100bn a year, it is quite right that work is now being done to raise awareness of conditions like SAD.

It is thought that SAD can be passed on genetically. No matter where on the planet people live, those with relatives who suffer SAD or other types of depression are at an increased risk of suffering themselves. In particular, those who naturally have higher levels of a serotonin transporter protein (SERT) in their body are also higher risk due to the greater drop in serotonin during winter months.

As these statistics show, Seasonal Affective Disorder is a significant issue around the globe. Yet many cases of SAD go undiagnosed each year and are even misinterpreted as laziness. Despite SAD being recognised as an illness by major health organisations, it not something we hear about much and awareness of the risks and treatments are relatively low.

In recent years, progress has been made in changing attitudes towards mental health conditions, however. As society tackles the stigma attached to depression, perhaps we should be learning more about the impact of our changing seasons? Given that depression and other mental health conditions are estimated to cost the UK economy £100bn, being more attuned to issues like SAD should certainly be considered a priority.

Overcoming SAD

If you feel like you have any of the symptoms mentioned above and suspect they could be linked to SAD, it is important that you talk to your doctor. There may be other reasons for experiencing these symptoms and they can help diagnose any condition. Treatments for SAD include:

 

Light Therapy: use a specialised SAD lamp that has at least 2,000 lux and ideally 10,000 lux for 30-60 minutes in the morning
Lifestyle: maintain a healthy diet, manage stress, keep regular sleep patterns and gain plenty of outdoor exercise in daylight hours wherever possible.
Counselling: Use talking therapies such as Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT)
Medication: your doctor may decide to prescribe you with anti-depressants or selective serotonin reuptake inhibitors (SSRIs)

Tips for this coming winter

  • Replace your alarm clock with a dawn-awakening lamp
  • Often eat your lunch outside and in broad daylight
  • Organise your diary so you can get out of the office at times to receive natural light
  • Pull your curtains
  • Invest in a portable SAD light if necessary
  • Trim back any overhanging branches around your home so to maximise light exposure to your house
  • If indoors, aim to sit near a window.
  • Make a habit to arrange walking meetings when possible
  • Aim for 150 minutes of moderate to vigorous exercise per week
  • Manage your stress appropriately
  • Cut back on alcohol
  • Pay attention to the foods you consume, you may be craving more carbohydrates, fat, and salt.
  • Plan a winter sun break

Remember, the clocks go back on October 29th this year.

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