By Leanna Coy, FNP-BC
It’s 4:30 p.m., and the sun is already going down. Welcome to the dark fall and winter months without daylight saving time. For some Oregonians, the short days are more than just gloomy. The lack of sunshine triggers a depression that returns every year.
Oregon’s latitude is the problem. The state sits further north than most people think. With Tillamook at 45 degrees latitude, it sits farther north than Chicago and Boston. Studies consistently show the further north you live, the greater the risk of seasonal depression. Oregon is on the high end of that spectrum. Here’s what you need to know to manage symptoms.
What SAD is (and isn’t)
Seasonal depressive disorder (SAD) is a type of depression that typically begins during late fall or early winter. Much less commonly, some people experience episodes of depression starting in the spring or summer. A person may feel “down” or have “winter blues” as the days get shorter, with symptoms improving in the spring when there is more daylight.
This type of depression is different than feelings of anxiety or sadness triggered by stressors during the holiday season, family visits, or changes to work or school schedules. SAD is triggered by changes to daylight, not stress. Symptoms of SAD typically last 4 to 5 months, and, for some people, the mood changes they experience can become severe. The depression can negatively impact how they think, feel, or behave.
The symptoms are similar to other forms of depression, including:
- Persistently feeling sad, anxious, or down nearly every day for at least 2 weeks
- Feeling guilty, worthless, helpless, hopeless, restless, or irritable
- Having no interest in hobbies or pleasurable activities
- Difficulty concentrating or making decisions
- Physical pains, headaches, or digestive issues that don’t have a clear cause or go away with treatment
- Thoughts of death or self-harm
Additional symptoms for SAD include:
- Social withdrawal or “hibernating”
- Overeating or strong craving for carbohydrate-heavy foods
- Oversleeping
Who gets SAD and why
SAD episodes can begin in young adulthood, occurring more commonly in women than men. People with a history of depression, bipolar disorder, or a family history of depression are more likely to experience SAD. Also, people with SAD tend to have other mental disorders, such as ADD/ADHD, anxiety, or an eating disorder.
Researchers have found that people with SAD have lower levels of serotonin, a brain chemical that helps regulate moods. Sunlight exposure can affect and help maintain serotonin levels. With less daylight, serotonin levels decline. Because vitamin D helps promote serotonin, low vitamin D levels are believed to worsen winter SAD. Low vitamin D levels are common for Oregonians.
Why SAD is more common in Oregon
In the winter, you may leave for work in the morning in the dark and end up driving home in the dark, feeling like you never see daylight. That’s because at the winter solstice, Tillamook County has approximately 8 hours and 45 minutes of daylight. This is almost half of the 15 hours and 40 minutes we get in June. Add in the gray coastal skies and rain, and you’ve got a perfect recipe for SAD.
Many retirees head south in the winter for a reason. It isn’t just the warmer weather. Southern cities get more daylight and tend to experience lower levels of SAD. For example, Miami has about 10 hours and 30 minutes of daylight at the winter solstice. Both Phoenix and Los Angeles get about 10 hours.
How to manage symptoms
For mild symptoms, you can manage treatment at home. Light therapy is consistently recommended as a first-line treatment. Light therapy exposes the user to bright light using a light box. This special light is about 20 times brighter than the average light. To use it, sit in front of the box for about 30-45 minutes each day, usually first thing in the morning. If you have an eye disease or take a medication that makes you sensitive to sunlight, speak with your healthcare provider before trying this treatment.
For more severe symptoms or symptoms not improved with light therapy alone, psychotherapy is the next step. Psychotherapy or talk therapy can help manage symptoms by teaching new ways of thinking and helping change habits that contribute to depression. This is done with a type of psychotherapy called cognitive behavioral therapy (CBT). Research has shown symptoms can improve faster with light therapy, but the positive effects of CBT tend to last longer.
Antidepressant medications can effectively manage SAD symptoms. These medications work by changing brain chemicals that affect mood or how the brain makes them. People may use these medications alone or in combination with CBT. Medications typically take 4-8 weeks to work and may need adjusting to find the right dose or medication. As with any medication, side effects can occur. Patience is key when using antidepressants.
Recognize the warning signs that you cannot manage the depressive symptoms on your own. It’s always helpful to discuss any symptoms or concerns with a healthcare provider. They can help find the best treatment option. If you are having difficulty with your normal day-to-day functions, thoughts of self-harm, or suicidal thoughts, seek immediate help. Call, text, or chat 988, or call 911.
