By Beth Sjoblom, M.D.
Internal Medicine Specialist
St. Anthony’s Medical Center

The holidays are over for another year.  Winter has moved in for three long months, bringing short days, colder weather and those “cabin fever” blues.

It’s not an uncommon occurrence to experience winter depression.  In its more serious form, this is known as Seasonal Affective Disorder – SAD.  It generally strikes in the late fall to early winter, causing fatigue and irritability.  

Common symptoms of SAD – which may come back, year after year – include:

• Feelings of depression, lethargy and/or fatigue
• Feelings of guilt, hopelessness, pessimism
• Increased sleep and daytime sleepiness
• Cravings for sweet or starchy foods
• Loss of interest in work or other activities
• Weight gain or loss
• Headaches, restlessness, irritability, unhappiness
• Increased sensitivity to social rejection and avoidance of social situations
• Difficulty concentrating.

While the specific cause of seasonal affective disorder is unknown, doctors recognize some factors that may influence the development of the illness.  The reduced level of sunlight may disrupt your body’s internal clock, so that you don’t know if you should be sleep or awake.  This disruption of your circadian rhythm may lead to feelings of depression.  Reduced sunlight also may cause a drop in your brain’s level of serotonin, a chemical that affects mood.  Additionally, the change in season can disrupt the balance of melatonin, a natural hormone that plays a role in sleep patterns and mood.

Seasonal affective disorder is about four times more common in women than in men, but men may have symptoms that are more severe.  It is more common in people who live in places with long winter nights and in people who have a close relative with SAD.  It affects people mainly between the ages of 15 and 55. The average age of people when they first develop this illness is 23, and the risk of getting SAD for the first time goes down as you age.  It affects about five percent of adults in the United States. 

Symptoms of SAD may come back year after year, and they tend to come and go at about the same time every year.  Although there is no cure for SAD, there are treatments that can help you “weather the winter” in relative comfort.

Light therapy is one option for treating SAD.  You can purchase a specially made light box that you sit in front of or a light visor that you wear on your head for a prescribed amount of time each day, usually 30 minutes.  Most patients use light therapy throughout the fall and winter, until more sunlight is available in the spring. 

Outdoor light, even when the sky is overcast, can be even more effective in treating SAD than artificial light therapy.  Spending an hour outdoors each day can help alleviate the symptoms of SAD; and, coupled with daily exercise, may be particularly helpful in chasing away depression.

Other treatment options for SAD include medication and/or behavior therapy.  First, see your physician to rule out any medical conditions that might be responsible for your depression.  Then, follow your doctor’s recommendations for treatment.  No one should have to be SAD all winter long – help is available. 

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Dr. Beth Sjoblom, an internal medicine specialist who is board-certified in geriatrics, is a member of St. Anthony’s Physician Organization.  She practices at St. Anthony’s Medical Plaza, Suite 270, 12700 Southfork Road, 314-525-4678.  For a referral to any St. Anthony’s physician, call 314-ANTHONY (268-4669) or 1-800-554-9550 or visit http://www.stanthonysmedcenter.com/sapo/pim.asp.