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Winter depression is real and there are many ways to combat it

As winter approaches and daylight hours become shorter, people prone to seasonal depression may feel it in their bodies and brains.

“It's a feeling of panic, fear, anxiety and fear all at the same time,” said Germaine Pataki, 63, of Saskatoon, Saskatchewan.

She is one of the millions of people estimated to suffer from seasonal affective disorder (SAD). Her coping strategies include yoga, walking and taking antidepressants. She is also part of a Facebook group for people with SAD.

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“I try to focus on helping others,” Pataki said. “It gives me purpose.”

People with SAD typically have depressive episodes that begin in the fall and subside in the spring or summer.

The clocks changing to standard time this weekend can be a trigger for SAD. A milder form, subsyndromal SAD, is recognized by medical experts, and there is also a summer variant of seasonal affective disorder, but less is known about it.

In 1984, a team led by Dr. Norman Rosenthal, then a researcher at the National Institutes of Health, first discovered SAD and coined the term. “I think the acronym stuck because it’s easy to remember,” he said.

What causes Seasonal Affective Disorder?

Scientists are studying how specialized cells in our eyes convert the blue wavelength part of the light spectrum into neural signals that influence mood and alertness.

Sunlight is enriched with blue light. When the cells absorb it, our brain's alertness centers are activated and we feel more alert and possibly even happier.

University of Pittsburgh researcher Kathryn Roecklein tested people with and without SAD to see how their eyes responded to blue light. As a group, people with SAD were less sensitive to blue light than others, particularly in the winter months. This suggests a cause of winter depression.

“In winter, when light levels decrease, this combined with reduced sensitivity can be too low for healthy functioning and lead to depression,” Roeklein said.

Miriam Cherry, 50, of Larchmont, New York, said she spent the summer planning how to deal with her winter depression. “It’s like clockwork,” Cherry said. “The sunlight is weak. The day ends at 4:45 a.m. and suddenly my mood is terrible.”

Does light therapy help?

Many people with SAD respond to light therapy, said Dr. Paul Desan of the Winter Depression Research Clinic at Yale University.

“The first thing to try is light,” Desan said. “If we expose patients to bright light for about half an hour every morning, most patients improve dramatically. We don’t even need medication.”

The therapy involves devices that emit light that is about 20 times brighter than normal indoor light.

Studies show the use of a light intensity of around 10,000 lux, a measure of brightness. According to the study, you need to use it for 30 minutes every morning. Desan said this could help not only people with SAD, but also people with less severe winter illnesses.

Dedicated lights cost between $70 and $400. Some products marketed for SAD are too weak to do much good, Desan said.

Yale has tested products and offers a list of recommendations, and the nonprofit Center for Environmental Therapeutics has a consumer guide to choosing a lamp.

If your doctor has diagnosed you with SAD, check with your insurance company to see if the cost of a lamp might be covered, Desan recommends.

How about talk therapy or medication?

Along with light therapy, antidepressants are the first-line treatment for SAD. Doctors also recommend maintaining a regular sleep schedule and going for walks outside even on cloudy days.

The benefits of light therapy may diminish when use is stopped. One type of talk therapy — cognitive behavioral therapy, or CBT — has been shown in studies to have more lasting effects, said Kelly Rohan, a researcher at the University of Vermont.

CBT involves working with a therapist to identify and change unhelpful thoughts.

“A very common thought that people have is 'I hate winter,'” Rohan said. “Rephrase that to something as simple as 'I prefer summer to winter,'” she suggested. “It’s a factual statement, but one that has a neutral effect on the mood.”

Working with a therapist can help people take small steps toward having fun again, Rohan said. Try planning low-impact but fun activities to break out of hibernation, which “could be as simple as meeting a friend for coffee,” Rohan said.

What else could work?

People with SAD have six months to develop coping strategies, and some have found hacks that work for them – although there may be little scientific support.

Elizabeth Wescott, 69, of Folsom, California, believes contrast showers help her. This is a water therapy borrowed from sports medicine in which hot and cold water is used alternately when showering. She also uses a light box and takes an antidepressant.

“I’m always looking for new tools,” Wescott said.

Cherry in New York dedicates part of her garden to the earliest blooming flowers: snowdrops, winter aconites and hellebores. These bloom in February.

“This will be a sign to me that this won’t last forever,” Cherry said. “Things are getting better and spring is just around the corner.”

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