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Don't be sad it's winter


November 2013

My goodness, it is winter again! Every year Christmas seems to come around more quickly and this year especially the dark nights seem to have suddenly appeared.

The clocks have changed, the weather is getting colder, and we will have to get used to dark mornings and short days for many months ahead. For some, winter can be a very difficult time because they suffer from SAD. This stands for Seasonal Affective Disorder, often known as winter blues, and it is now recognised as a medical problem.

Most SAD sufferers are fine throughout most of the year, but as the nights draw in and the days become darker, they begin to experience mood variations including serious depression. SAD can also cause a range of other symptoms including lethargy, overeating and sleep problems.

The exact causes of SAD aren’t fully understood but it is thought to be related to light rather than temperature. It is not only the amount of light we are exposed to but also the brightness of the light that matters. SAD hardly exists in the tropics, but is quite prevalent at latitudes of 30 degrees N (or S) and higher. The further north or south away from the equator you get, the more incidents of SAD seem to occur and interestingly prolonged periods of overcast weather can also cause levels of SAD.

It is thought the cause of SAD is based around the fact that light stimulates a part of the brain called the hypothalamus. This is involved in the body’s production and use of:

  • the hormone melatonin (involved in our sleep patterns)
  • the hormone serotonin (this has a role in lifting mood)
  • the body's circadian rhythm (the body's internal clock, which regulates several biological processes during a 24-hour period)


Therefore diminishing the activity of the hypothalamus will have effect on all these areas and this is thought to result in certain cases in SAD.

Today the problem is well recognised and it can usually be treated well using a variety of treatments including cognitive behavioural therapy and antidepressants as well as the traditional light therapy.
Some people will need a combination of treatments.

Cognitive behavioural therapy will involve a number of sessions with a specially trained therapist. The preferred type of antidepressants used for SAD are SSRIs, or selective serotonin reuptake inhibitors. They increase the level of the hormone serotonin in your brain which helps to life your mood.

Light therapy involved special lamps that produce a very bright light. By exposing yourself to bright light, the production of melatonin should be reduced and the production of serotonin increased. The aim is to obtain summertime levels of light during winter, and benefits are fast; most people feel better within 7-10 days of using light therapy.

Today there are a range of medically certified “SAD” lights available from health shops and other specialist centres that are designed to alleviate the symptoms of SAD.

The light used in these light boxes do not give a suntan or emit dangerous levels of uv. However, the light does need to be suitably bright – at least 2500 lux.  Lux is the technical measurement of brightness and 2500 lux is around five times brighter than a well-lit office. Many recommend the light should be 10000 lux for real benefit to SAD; this is a very bright light indeed.

Historically, only full spectrum “white light” was thought to give the most positive response to people lacking sunshine;  however recent research has shown that a particular bandwidth of blue light can also be effective.

There are also different lights and lightboxes for different situations; some are designed to sit on your office desk; others on your breakfast counter or in a convenient place in your home. A SAD light has to be registered with the Medical Devices Agency as required by European Union legislation (CE 0120, designed and built to conform to EN60601-1/-2, EC93/42, EC89/336, EN60598 and EN46002).

The best way forward if you think you are suffering from SAD is to talk to your doctor.

There is also a lot of information at www.SAD.org.uk. This is a national voluntary organisation set up to support people suffering from Seasonal Affective Disorder.






 

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