Will You Help These Elephants?

SAD, the Discontent of Our Winter
How to Beat Seasonal Affective Disorder

By: John Shepler

Sadness. It's a dark, gloomy sea of gray this winter's dayagain. And you're wondering why you're too depressed to sing the blues? Perhaps it's the end of the holiday season. Thanksgiving, Hanukkah, Christmas, New Year's. All gone but the bills. Yet, it seems like we've been off our energy peaks for months. Oh, it's true. There really is something to the winter doldrums. But surprisingly it has little to do with the cold, the dampness, the end of the festivities, or even that eye-popping credit card bill. It has everything to do with solar energy. If someone tells you to "lighten up" in the midst of the gloom, it's probably good advice. But how?

The SAD Truth of the Matter
Poets and writers have clued us into the idea that something is different and downcast about the late fall and wintertime. The trees are barren, the landscape is uniformly drab, the clouds are thick and the air chills you to the bone. What they may have glossed over is the diminishing light and how dramatically that can affect the way people feel, regardless of whether it is hot or cold or what the foliage is doing.

A South African doctor, Norman E. Rosenthal, started making the connection between moods and the seasons in the mid 1970's and even considered writing a novel that would emphasize the changing moods of his character as the seasons transitioned. But when he moved to New York in 1979, he really got a shock. The shortness of the winter days compared to those in South Africa had a profound effect on his energy levels, which didn't abate until spring. Dr. Rosenthal took a research fellowship at the National Institute of Mental Health to study how brain chemistry varied with moods. The research was showing that bright light affected the chemistry of the brain, particularly the secretion of melatonin at night. Changing brain chemistry translated into physical symptoms that affected mood, appetite, ability to sleep, and even sociability.

Dr. Rosenthal and his colleagues experimented with exposing patients who complained of having the "winter blues" to bright lights from boxes that they made with full-spectrum fluorescent bulbs. These look the same as the fluorescent tubes you may have in your home or office, but they are designed to emit more of the electromagnetic spectrum to mimic the color of natural sunlight in the spring and summer. Amazingly, just sitting in front of one of these light boxes for as little as 20 minutes a day restored the pep and feelings of well being that people associated with how they felt in the middle of summer. It mattered not if the real season was dark and cloudy or that temperatures were well below freezing. The duration and intensity of exposure to bright light were the key variables to how their patients felt.

The effects of dimming light and falling moods as summer turns to fall and winter are called Seasonal Affective Disorder or SAD. It's an appropriate label. With less light we really can feel sad. Our bodies react in other ways too. If you are suffering from SAD, you may feel lethargic, have difficulty concentrating, have a hard time waking up in the morning or sleeping through the night, feel irritable and have little desire to socialize, and you may crave sweets and carbohydrates. The cravings are thought to be caused by lower than normal levels of another brain chemical, the neurotransmitter serotonin.

Who gets SAD? In northern latitudes as many as one in five of us may suffer. Four to six percent of the entire population may get winter depression, another term for SAD. Women are four times as likely as men are to experience the symptoms are. Children and teens have much less of a problem than adults. Because SAD is related to the amount of light we get from the sun each day, winter depression is much more common as you go north. Interestingly, people living in Iceland have less of a problem with SAD, although this may be do to less dramatic seasonal changes or a population that has adjusted. Up to 60% of the rest of us will at least experience a mild form of the "winter blues" due to dramatically less light than in summer.

Let the Artificial Sun Shine In
Fortunately, the antidote to SAD is as simple as seeing the light. What we need is a substitute for good 'ole Sol until the days become longer and sunlight more intense. Simple light boxes will do the trick, but they have to be bright. In fact, the treatment is called Bright Light Therapy. How about turning on an extra lamp? Well it can't hurt, but it probably won't help much with SAD symptoms. What we think of as bright indoor lighting is woefully dim compared to even an overcast day outdoors. Light intensity is measured in units called "lux." A single bedside lamp generates 100 lux and a well-lit office is in the range of 500 to 1,000 lux. By contrast, a cloudy mid-day in Alaska in winters measures 10,000 lux. This is also about what you'd receive in most areas about a half-hour after sunrise on a clear day. A sunny day at the beach? That amount of light corresponds to as much as 100,000 lux. No wonder you need sunglasses.

To counteract the effects of SAD, experiments have found that you need exposure to a light source generating from 2,500 to 10,000 lux. You'll need to spend 30 minutes to 2 hours in this environment; 30 minutes a day with a 10,000-lux light box about 3 feet from where you are sitting. Dr. Rosenthal used a light box consisting of a metal case 2 ft by 4 ft, with 6 full-spectrum fluorescent tubes. A shiny metal reflector was located behind the tubes to increase the amount of light projected into the room. A plastic diffusing screen was placed in front of the tubes to spread out the light and make it look like an even glow. You can make a box like this or buy one for $250 to $500.

How complicated is the treatment? Simply sit within a few feet of the light box, perhaps reading a book, for maybe a half-hour every day, preferably first thing in the morning. You don't have to stare at the light. It just has to be aimed toward you. Incredibly, the researchers found that people's moods began improving even a few days into the therapy. Some people needed more time with the light than others, and the amount of extra light needed varied with the time of year, as you might expect.

You can read more about Dr. Rosenthal's experience with SAD and light therapy in his book, "Seasons of the Mind." The links below may also prove valuable. If you feel you've got the winter blues, like most of us where the snow falls, you just might want to consider trying a light box or, yes, you have my permission to print this article and take it to your boss as justification to relocate you to Hawaii ASAP.

Please Note: I'm a writer not a doctor, so take this as interesting information and not medical advice. If you are feeling severely depressed, there may be something more serious going on and you should, of course, consult your physician.

Also visit these related sites:

Dr. Norman Rosenthal's Website - Learn more about this pioneer in the study of Seasonal Affective Disorder.

Seasonal Affective Disorder - A paper by Carol E. Watkins, MD on what is SAD and how it is treated. Includes sections on sleep disorders, jet lag and shift work.

Seasonal Affective Disorder (SAD): About Light, Depression & Melatonin - Gila Lindsley, Ph.D. offers insights into the biochemical aspects of Seasonal Affective Disorder, the depression that responds to light.

Seasonal Depression and Light Therapy - Fascinating information about the mystical "third eye" and the pineal gland, known to secrete melatonin and implicated in the sleep/wake cycle. Written by Michael A. Ferenczi for the National Institute for Medical Research in London.

Attacking Anxiety & Depression - an audio and video program with resources and information relating to stress, anxiety and depression, from Lucinda Bassett.

Books of Interest:

Winter Blues: Seasonal Affective Disorder: What It Is and how to Overcome It by Norman E. Rosenthal. Updated and expanded with the very latest information, this guide is a veritable survival kit for anyone who suffers from the winter blues. The book includes a self-test to help you evaluate your own level of SAD; revised chapters on antidepressant medications, light therapy, St. John's wort, and a helpful nutritional regimen; step-by-step guidance on coping with SAD all year round; resources for SAD sufferers; and much more.

Seasons of the Mind by: Norman E. Rosenthal, M.D. The definitive work on Seasonal Affective Disorder, by the leasing researcher and worldwide authority on the subject. This book is copyright 1990, and not currently in print.

Light: Medicine of the Future by Jacob Liberman

Natural Vision Improvement by Janet Goodrich.

Also visit Books-A-Million for an excellent selection of new books, magazines, e-books, audio books and more at low, low prices. Who is Books-A-Million?

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First Published: January 17, 2001 as part of A Positive Light

Last Updated: June 8, 2009

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