Winter Blues

Winter Blues: 

Winter Blues Shining Light on the

Winter Blues? or SEASONAL AFFECTIVE DISORDER? : 

Winter Blues? or SEASONAL AFFECTIVE DISORDER? Both describe the body’s physiologic response to the low light of winter.

What is the difference?: 

What is the difference? Winter Blues describes a loss of function that is mild to moderate. Season Affective disorder has the same features, but is more pronounced, and meets the diagnostic criteria outlined in the diagnostic guide, the DSM IV. When we actively prevent or treat winter blues, we can often avoid seasonal affective disorder.

Symptoms of Winter Blues and Seasonal Affective Disorder: 

Beginning in autumn and worsening in winter, any or all of the following: Symptoms of Winter Blues and Seasonal Affective Disorder

Drop in energy: 

Drop in energy

Drop in mood: 

Drop in mood Sad Irritable Empty Reclusive

Drop in Motivation: 

Drop in Motivation Feeling disinterested and unmotivated, often with loss of productivity.

Sleep disturbances: 

Sleep disturbances Too much Not enough Feeling unrested despite adequate sleep

Carb Craving, Weight Gain: 

Carb Craving, Weight Gain

Light Craving: 

Light Craving

Decreased Libido: 

Decreased Libido

It could be SAD if …: 

It could be SAD if … Functioning is impaired to a significant degree. Can’t get to work on time, or complete tasks. Depressive feelings are significant, feeling guilty, pessimistic or without hope. Physical function is quite impaired, with significant sleep disturbance, eating disturbance or low energy. Joy’s rule: If you wonder if you need help, call someone. We will talk about this more.

Diagnostic Criteria for Seasonal Affective Disorder (paraphrased): 

Diagnostic Criteria for Seasonal Affective Disorder (paraphrased) Significant depression symptoms are in the winter. Depressive symptoms go away at other times of the year. This pattern has occurred for two consecutive years This seasonal pattern is not due to other factors, such as loss of employment in the winter months.

What exactly happens in the body?: 

What exactly happens in the body? There are specialized cells in our eyes that “read” the amount of light, setting in motion a cascade of reactions that affect neurotransmitters in the brain, including Serotonin Dopamine Melatonin These neurotransmitters are necessary for thinking, feeling happy, sleep and energy.

Who gets the Winter Blues? : 

Women more often than men, especially between 20 and 45 years old. Men tend to report more severe symptoms . Children and adolescents. People of Northern heritage. (Morketiden). People with a certain genetic marker. Who gets the Winter Blues?

Who gets the Winter Blues? : 

Who gets the Winter Blues? People who live a distance from the equator. The farther from the equator, the higher the incidence. People who move from a sunny area to a less sunny area. And many more, regardless of national origin or other factors.

When do symptoms occur?: 

When do symptoms occur? As early as August, with increasing incidence through February, March, or even April. Dramatic change for many with daylight savings time change. Seasonal symptoms are not at their worst on the darkest days. Time in prolonged dark worsens the symptoms as winter progresses.

What makes the condition worse?: 

What makes the condition worse? Low light, especially if prolonged. Emotional stress Work School Visitors Winter holidays Physical stress Getting cold Poor diet Illness

What helps?: 

What helps? We will cover Light Nutrition in brief Supplements Activity Travel/Relocation Neurofeedback Cognitive Behavioral Therapy Medication

Shining Light on the Blues First: Real Sunshine : 

Shining Light on the Blues First: Real Sunshine

Real Sun : 

Real Sun We benefit from contact with the sun, but only if we actually come in contact.

Real Sun: 

Real Sun Real sunshine provides UV exposure which awakens the brain and allows our bodies to make Vitamin D BUT We must protect our eyes and skin from too much ultraviolet exposure.

Shining Light on the Blues: 

Bright Light Therapy The right amount 10,000 lumens About 45 minutes a day At a distance of about 24 inches The right spectrum Not full spectrum. UV should be shielded The right timing Usually in the morning Shining Light on the Blues

Fluorescent Light box: 

Fluorescent Light box Pros: Best researched More diffuse light may be better for office or reading, close work Replacement bulbs readily available. Cons: Bulkier

Visor LED: 

Visor LED Pros: Portable Useful while doing other tasks (not driving!) Effective blue-green LEDs Rechargeable Useful for jet lag Cons: Hard to do detail work (read, knit, computer) while wearing

LED Light box : 

LED Light box Pros: Portable & rechargeable Uses blue light which has promising research Less bright, has timer Cons: Small intense light doesn’t add to room light, can cause glare

Dawn Simulator: 

Dawn Simulator Provides a gradual artificial dawn before awakening. Allows a gradual transition to awake state.

Shop wisely: 

Shop wisely Check list: How bright is the light and at what distance? If it is called “full spectrum”, is it UV shielded? In comparisons, what are they comparing?

Where do I get a light?: 

Where do I get a light? In town, try Living Green Stone Drug Direct Health Solutions Jackson Whole Grocers Online, many options. Amazon.com has most lights I have shown.

What will people think?: 

What will people think?

Add Light to Home/Office: 

Add Light to Home/Office Windows, skylights Lamps Mirrors Light colors

Microsun Lamp: 

Microsun Lamp Not marketed as a therapeutic lamp, however Light is very much like sunshine Over 6000 lumens Lot of light, low energy consumption Uses specialized halide bulb which lasts years

Nutrition + : 

Nutrition +

What to consume if you want to feel worse.: 

What to consume if you want to feel worse. Caffeine Carbohydrates Alcohol (and cannabis) These deepen depression, lower motivation and increase the body’s perceived stress.

What to consume to feel better: 

What to consume to feel better Low carb, high antioxidant diet Limited alcohol. Multivitamin with minerals, Omega 3, Vitamin D Consider supplementing with SAM-E 200-4000mg in AM 5HTP 50-100mg at night. Use with care if taking SSRI antidepressant

Activity: 

Activity

What about travel?: 

What about travel? Travel can quickly reverse the winter blues during the time you are gone and for about four days after you return. Plan to not cross too many time zones, and resume light therapy when you return.

What about relocation?: 

What about relocation? For light sensitive people, the location is more about light and sun, and less about warm. But, yes , it can work.

What else helps?: 

What else helps? Neurotherapy: This biofeedback teaches the brain to wake up and to relax at the same time, without drugs.

What else helps? : 

What else helps? Cognitive Behavioral Therapy is a well researched, effective adjunct to therapeutic light.

Medication: 

Medication Antidepressant medications (Prozac and newer) act on the brain to make certain neurotransmitters more available. All of the antidepressants have been effectively used for SAD, and your prescriber will determine what medication might be best for you. Often these are taken during the winter months only.

Take home message….: 

Take home message…. Winter Blues is a common and treatable condition. It is often tolerated because we don’t consider it serious. Winter Blues causes months of lost enjoyment, productivity and quality of life. Winter Blues can be severe enough to be Seasonal Affective Disorder, and this can be serious. Light is usually the first and best help, and there are other options which can mitigate or eliminate the symptoms of Winter Blues/SAD.

How do I learn more?: 

How do I learn more? Recommended reading: (Get this edition, if you can.) I teach individuals or groups, also.

Who do I call?: 

Who do I call? Primary health provider (nurse practitioner, doctor, physician’s assistant) Psychologist Licensed mental health provider (private, community counseling center) Psychiatrist (doctor specializing in disorders including depression) You can make an appointment with me (I am a Behavioral Medicine Practitioner)

Enjoy Your Winter!: 

Enjoy Your Winter!