HCA Houston Healthcare - January 31, 2022

Do you start dragging as the days get shorter? You're not alone. Many people start feeling tired, less motivated and a little down in the dumps as the sunlit hours start to dwindle. Some people even experience crying spells or feelings of deep sadness. When those symptoms start to get in the way of regular activities, it could be a sign of seasonal affective disorder, or SAD.

The good news is that effective treatment is available, and seasonal affective disorder self-care is a great place to start. As Dr. Frank Drummond, national medical director for Behavioral Health at HCA Healthcare notes, "Self-care can minimize or mitigate the symptoms associated with seasonal affective disorder."

What is SAD?

Seasonal affective disorder affects about 5% of the population. SAD looks a lot like depression, but it starts and stops with significant changes in the amount of daylight a person experiences during the day. "There is nearly a 100% overlap between the symptoms of SAD and symptoms of depression," says Drummond. "The main difference is the seasonal component."

  • SAD symptoms include:
  • Feeling sad, gloomy, hopeless, worthless or irritable
  • Low energy
  • Loss of interest in activities you usually enjoy
  • Difficulty with sleeping or sleeping too much
  • Craving sweet or starchy foods
  • Thoughts of death or suicide

If you are already stressed, anxious or feeling low, you may be particularly susceptible to SAD symptoms. Most people with SAD experience symptoms during the winter months, but a small percentage actually feel worse as the days get longer. Symptoms usually last a few months, but some people are affected more than 40 percent of the year. That's a lot of time to feel down.

Doctors aren't sure what causes SAD, but they believe it traces back to an overproduction of melatonin in the pineal gland of the brain and an underproduction of vitamin D by the skin.

Melatonin is a hormone your body produces in response to darkness. It's what makes you feel sleepy and ready for bed. If your body produces too much, you can feel sleepy and down all day. People with SAD may also have lower levels of vitamin D, which the skin produces when it's exposed to the sun.

SAD is directly tied to sunlight exposure, which your body perceives through the eyes but also through the pineal gland, Drummond explains: "You actually have another sunlight sensor in your brain inside the skull. Both it and the sensors in the eyes are very sensitive to changes in light, particularly decreases."

Steps to Seasonal Affective Disorder Self-care

Eat lighter, feel lighter. What you eat has a lot to do with how you feel. If you eat a lot of heavy, fatty foods, you likely won't feel that you're at your best. The answer? Eat like you live in the Mediterranean. You might not be able to jet off to Greece or Italy this winter, but eating a Mediterranean diet can help improve mood, says Drummond. Emphasizing plant-based foods (fruits and vegetables) and cutting down on heavy fats, meats and carbohydrates can have other health benefits too, such as a lower risk of heart disease and cancer.

Get moving. When you exercise, your body releases certain brain chemicals called endorphins that improve mood and increase energy. Thirty minutes of aerobic exercise three times a week can help prevent or relieve symptoms of SAD. "It can be anything from brisk walking to high-intensity interval training," says Drummond. It can be hard to exercise when you feel down, but starting small can help. Drummond points out that a walk outside during the day has double benefits, as it can allow you to get some exercise and a dose of daylight simultaneously.

See the light. Another effective treatment for SAD is light therapy using specially made lights that produce full-spectrum light waves which mimic sunlight (without the harmful UV rays). These are not medical devices approved by the Food and Drug Administration, but using these lights for about 20 minutes each morning helps many people. "They give your brain the extra sun-like time to prevent it from going into a seasonal aspect of depression states," Drummond explains. The lights are available in a desktop version that you can use while you're working or in an alarm version that mimics the rising of the sun, which can make waking up easier. The lights are inexpensive, and often adding one of these to your daily routine can make a big difference in counteracting SAD.

Ten years ago, Kimberly Mathes, assistant vice president of community engagement at HCA Healthcare Gulf Coast Division and chair of the HCA Healthcare Gulf Coast Division Mental Health and Wellness Colleague Network, was diagnosed with SAD.

“I had experienced cyclical seasons of depression during the winter months when a professional recommended I try light therapy,” says Mathes. “I purchased a standing light therapy lamp that produces full-spectrum light waves that mimic the sunlight. During the winter months, my goal is to sit under it for at least 20 minutes a day. It also is a great reading light, so I like to read my devotions while sitting under the lamp.”

Other Tips for SAD

Diet, exercise and light therapy aren't the only forms of seasonal affective disorder self-care that can help you feel better during the darker months. Other steps you can take to combat SAD include:

  • Avoiding or minimizing alcohol use. Alcohol is a depressant, and excessive intake can make SAD symptoms worse.
  • Engage in mindfulness exercises, such as meditation or yoga, which can help to lift your mood.
  • Don't forget the healing power of positive social interaction with friends or family members. Volunteering in your community can also have an uplifting effect, as doing something good for others often does something good for you too!

Mathes also listens to upbeat music as a way to help her cope with the effects of SAD.

“It’s just a fact of life for me that during the winter months my depression can creep in, so I am keenly aware of my self-care priorities during that time,” says Mathes. “For others who are struggling with SAD or depression, I would like for them to know that it isn’t their fault. Just as we all have to maintain our physical health, we must maintain our mental health.”

Self-care is a great place to start if you notice symptoms of SAD, but if you continue to feel down or if symptoms worsen, it's important to check in with your doctor, says Drummond. "If people are noticing that they're having a significantly different feeling, or energy level, or attitude, or a sadness that lasts most of the time, they should talk to a physician about it."

Psychotherapy can help address symptoms of SAD, and anti-depressants can also be effective in treating SAD. Your provider can help identify the best steps for you.

"The important message is that there are lots of treatment options for SAD," says Dr. Drummond. "Some are easy, and some require the intervention of a physician. But effective treatment is available."

Kimberly Mathes, assistant vice president of community engagement at HCA Healthcare Gulf Coast Division and chair of the HCA Healthcare Gulf Coast Division Mental Health and Wellness Colleague Network.