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Shining light on winter blues

Thursday, January 17th, 2008

Becky Foerschler used to consider wintertime a torment.

For years, when the season shifted, so did her mood. Like clockwork, her three children shuttled back to school after Christmas break, fatigue settled in and she felt a tug toward a sedentary lifestyle.

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A simple trudge down the street with Meg, her black lab-mix, was a daunting task.

“I remember days walking my dog and I’d think to myself, ‘I could just lay down on the sidewalk and go to sleep,'” Foerschler said. “I felt like a bear that needed to go into hibernation. I just wanted to take a giant bag of carbohydrates, curl up into bed and sleep for three months.”

Two years ago, a string of stresses – an ill mother and a move to a new neighborhood – tumbled into a messy tangle, causing Foerschler’s mood to plummet even further. But when concerned friends and family approached her, Foerschler decided to pursue help.

Once connected with a psychologist, Foerschler discovered the culprit: seasonal affective disorder, or SAD.

“It’s a form of a major depressive illness that follows a typical pattern of onset of symptoms in winter and a full remission later in spring or early summer,” said Steve Ilardi, Kansas University associate professor of psychology. “It’s identical to clinical depression in terms of the core diagnostic criteria, but it’s a subtype characterized by a distinct seasonal onset pattern.”

A slump in mood during winter is common. Nearly 500,000 Americans have SAD, according to the American Academy of Family Physicians.

With symptoms mirroring that of depression, SAD is characterized by a craving for carbohydrates, a pull toward sleep and tendency to gain weight, usually because of increased carbohydrate cravings. Fatigue, sadness, irritability and a disrupted sleep cycle are common.

Those afflicted struggle to climb out of bed and have difficulty staying awake once up.

Many jerk away from social involvement. Normally gregarious, Foerschler felt her desire to interact socially drop.

“I found myself withdrawing and not being involved in activities I usually found pleasure in,” Foerschler said. “I just wanted to plop onto the sofa in front of the TV and veg out.”

Causes

The biggest factor contributing to SAD is lack of exposure to sunlight, Ilardi said. During the winter, sometimes the most available light comes from a computer screen, lamp or fluorescent office lighting.

“Our internal body clock gets recalibrated every day based on exposure to sunlight,” Ilardi said. “During the short, cold, cloudy days of winter, people get much less light exposure – a deficit that can disrupt the circadian rhythms that regulate sleep, energy and mood.”

Sunlight triggers the production of a chemical called melatonin, which is a natural antidepressant and important mood-influencing hormone. Less light means less melatonin, which can lead to depression.

Treatment

Disinterested in medication, Foerschler searched for alternative treatments. She stumbled onto Therapeutic Lifestyle Changes – TLC – a KU program designed to alleviate symptoms of depression.

“I was reluctant to go to the doctor and get on a medication for who knows how long,” Foerschler said. “I was really looking for other ways to deal with the depression.”

TLC concentrates on six areas: exercise, sunlight, fish oil, sleep, social interaction and positive thinking.

The most frequently recommended treatment for SAD used in TLC is light therapy. On days when the sun is out, Foerschler takes walks. And on dreary days, Foerschler uses a 10,000-lux therapy light (lux is a measure of illumination). The light is designed to emulate light supplied by a sunny day. The light box sits on a stand Foerschler props onto a table, allowing the light to shine down onto her face as she thumbs through a newspaper for at least 30 minutes.

The light stimulates the retina and the brain, triggering the release of melatonin and elevating mood.

“Light boxes are very efficient at simulating the bright light of a sunny day outdoors,” Ilardi said. “In clinical trials, they’re at least as effective as antidepressants in treating SAD.”

Ilardi also has found that increasing vitamin D levels can benefit patients.

“People with seasonal affective disorder are often dramatically deficient in vitamin D – a vitamin synthesized by our skin when exposed to the sun’s ultraviolet rays,” Ilardi said. “And vitamin D supplementation helps alleviate SAD symptoms.”

Foerschler takes vitamin D supplements, as well as fish oil and a multivitamin. Getting more sleep, more social interaction and preventing negative thoughts also help.

Seeking help

Not seeking help when afflicted with SAD – as with any form of depression – can be dangerous, Ilardi said.

“Untreated depression can rob you of your energy, your concentration, your social life, your work – even your will to live,” he said. “So I would advise anyone experiencing depression to seek the help of a mental health professional.”

Foerschler also encourages people experiencing SAD symptoms to implement the TLC protocol into their daily routines.

“They’re all pretty easy to incorporate into your lifestyle, and they seem to help a lot. Within three to four weeks, I was really feeling change,” Foerschler said. “I no longer feel like I want to be like a bear in hibernation.”


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