The sun also rises: seasonal affective disorder is real—and treatable

Better Nutrition, Jan, 2003 by Rob Morano

Like many Americans, Jane, * a 33-year-old journalist in Atlanta, isn't a winter person.

That's understandable. Icy windshields and dead car batteries can't compete with warm breezes as an ideal way to start the day. Most people would gladly have a little sunburn over bronchitis.

And while children glory in making snowmen and gulping hot cocoa, adults are more likely to focus on high heating bills and expanding waistlines this winter.

But for Jane, the season's short days and gray skies hold even more menace. "I dread the fall daylight saving time change," she says. "Cold and dark isn't a good combination for me."

She's not alone. While for many people January marks the onset of post-holiday letdown, winter blahs and cabin fever, Jane and millions of others endure a more serious and less common condition: seasonal affective disorder (SAD). And for them, the seemingly endless grind of going to work and coming home in darkness induces more than just sighs. It's serious.

Seasonal affective disorder is a form of depression that affects about 5 percent of the adult population in the United States, or nearly 10 million people. Many of those who suffer from SAD experience their first bout, of the debilitating condition in their teens, 20s and early 30s, and the disorder can last a lifetime.

As with other forms of depression, the National Institute of Mental Health estimates that up to twice as many women as men are afflicted with SAD.

Jane is a textbook example of the typical sufferer in many ways. As a woman who grew up in the South, she experienced her first serious attack of SAD at the age of 24 after moving to New England. In fact, SAD strikes more people more severely the farther north they live, but Southerners are more likely to be tortured by the reverse: summer SAD, which affects less than 1 percent of the adult population and manifests itself in fair-weather depression.

Jane says she's not ashamed of the condition, but because of a lack of understanding about SAD and depression in general, she's not ready to go completely public. "I'm not embarrassed by it, but it's not something I talk to my coworkers about," she says. "If you haven't experienced it, you can't really understand it."

out of balance

People with SAD bear a variety of depression-related symptoms, usually starting in the months of October or November and lasting until March or April, when symptoms can disappear as quickly as morning frost in the spring thaw. Experiencing two consecutive winters of such discontent is the standard for a clinical diagnosis of SAD. As most patients have a family history of depression and other related disorders, SAD is likely to have a genetic origin and may actually be hereditary.

Norman E. Rosenthal, MD, and other researchers at the National Institute of Mental Health, first identified SAD in 1984. Now a psychiatrist in the Washington, DC, area, Rosenthal says the research is progressing incrementally. While scientists have yet to determine the precise causes of SAD, it appears to result from problems in the complicated ways the body responds to seasonal light changes. In victims of SAD, winter's increased darkness seems to upset the delicate balance of biorhythms and brain chemicals that regulate everything from hunger and libido to body temperature and sleep.

SAD triggers a hibernation-like response, causing a strong desire for slumber--a craving for going to bed early in the evening and staying under the covers as late as possible in the morning. Jane, who says she usually stays up until around midnight during the summer, often climbs into bed as early as 7:30 p.m. during the winter and has a hard time getting up in the morning. "I guess, in one sense, I feel like I'm more in tune with the seasonal patterns than people who go to bed at 11 and get up at 7 year-round," she jokes. "I don't know how they function."

When they're awake, people afflicted with SAD tend to be depressed, exhausted and downright miserable. Common symptoms include mental anguish, despair and irritability.

"It's just debilitating," Jane says. "Having an understanding partner helps, but sometimes it's really hard even for him to understand how I could be so upset for no apparent reason."

SAD sufferers also tend to have difficulty concentrating at work and can find it hard to maintain their usual routines. As a writer and editor, keeping a sharp mental edge is critical for Jane. During the winter--to compensate for her SAD--she tries to be as productive as possible in the limited number of hours each day in which she's able to function near full capacity.

Like others enduring SAD, Jane craves starches and sweets in winter, and says her culprits are "any kind of bread, cake, donuts. But I do try to avoid drinking too much alcohol." While Jane has been successful in controlling her weight, many victims of SAD put on excess pounds during the winter, which further contributes to their cycles of low self-esteem.

beating deep depression

Those diagnosed with SAD may lose interest in sex and other once-passionate pursuits and hobbies. Ultimately they can grow indifferent to close friends and family members--even life itself. It happened to Jane in 1993.