Those winter blues

I have written about SAD (or seasonal affective disorder) many times for various publications – and it has been good to see how over the years this problem has moved on from one attracting scepticism to one that attracts serious medical concern.

SAD is now recognised by the World Health Organisation as a medical condition that affects people in the darker winter months. The problem is caused by a biochemical imbalance in the brain that stems from the shortening of daylight hours and the lack of sunlight.

When daylight hits our eyes, it is picked up by our brain and has affect on the control of various chemicals which help to control our body’s daily rhythms and mood. One example is melatonin; its levels increase as it gets dark and this makes us sleepy. When the sun rises again in the morning, levels of melatonin go down to prepare us for an active day. On dark winter mornings and dull grey days, melatonin levels can stay too high and this can cause a number of problems such as that feeling of “I just couldn’t get out of bed this morning”.

SAD is often known as the winter blues illness because it can cause general depression and lack of enthusiasm in everyday life. Symptoms vary from person to person; some have sleep problems, anxiety and lethargy while in others the problem can manifest itself in overeating, social problems or mood changes. For some people, the problems are minor, but for others SAD can have a serious affect on life.

It has been shown that light therapy really can help – in fact recent reports show that 85 per cent of diagnosed cases have benefitted from light therapy. But this is not simply a question of sitting under a bright light. For results, you need exposure for two to four hours every day under a light that is at least ten times the intensity of ordinary domestic lighting. An average home light will give out around 200-500 lux (the measurement of light). In summer, on a bright day, you will be receiving around 100,000 lux. That is quite a difference. It is recommended that to treat SAD you need a light that gives out at least 2,500 lux.

Light treatment needs to be done carefully with authorised equipment. The whole idea is to let the high levels of light enter through your eyes, and therefore levels need to be controlled to ensure your eyes are safe while you are still getting high enough levels of light to have positive effect.

A variety of light boxes are available to give out the required “doses” of bright light, and usually these are designed to sit on a table or a desk. Instead of staring at the light, you can continue to carry out normal activities such as reading, working on a computer, cooking etc while in front of the box. If you wear dark glasses, you defeat the objective as the light won’t be able to enter into your brain. Treatment is usually effective within a few days and continues as long as you continue to use the light.

Special light boxes to treat SAD are available at a huge range of shops now, from major department stores such as John Lewis to small beauty therapy shops. There is also a national organisation called SAD (www.sad.org.uk) which is a registered charity to help support patients and research into SAD. They recommend that any light you buy should be certified as a medical device and there should be a screen to filter out harmful UV light.

You can buy on line as well. Lumie (www.lumie.com) is one of the oldest and most respected light box manufacturers – they pioneered dawn simulators nearly 30 years ago – and as well as having a good online shop, they also offer free trials of certain products to ensure you choose the light box that is best for you.

An additional aspect in treating SAD is vitamin D. Problems from SAD may be exacerbated by changing levels of vitamin D3, a nutrient made by the action of sunlight on the skin which can have effect on the brain chemical serotonin. There have been reports that people with severe SAD have been greatly assisted by taking 400-800IU of vitamin D3; but it would be best to check with your doctor first.

The main thing is that if we get depressed in the winter months, we now know there could be good reason, and today there could also be treatment that is really effective to lift our spirits and wellbeing until spring returns.

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