Ain't no sunshine....

We continue with our monthly advice columns written by experts from the Jewish Family Services Agency (JFSA). Each month we tackle a new topic, based on questions sent in by readers (anonymity is assured). Please send your questions to [email protected].

Dear JFSA,
I am a 41-year-old mother of two. We immigrated to Vancouver approximately four years ago from San Diego, Calif. For some reason, the winters here have become a terrible time of the year for me and, as a result, for my family as well. I am feeling down, depressed, tired most of the day and just out of it. I find it very hard to get up in the mornings, send the kids to school and go to work. I just want to stay in bed all day.

A friend says I might be suffering from winter depression. Could you please help me with some information and advice?
Sincerely,
Depressed Mother

Dear Depressed Mother,
First, thank you for highlighting this important issue. Seasonal depression, often called seasonal affective disorder (SAD), is a depression that occurs each year at the same time, usually starting in fall or winter and ending in spring or early summer. It is more than just the "winter blues" or "cabin fever."

Symptoms include fatigue, an increased need for sleep, decreased levels of energy, weight gain, increase in appetite, difficulty concentrating, an increased desire to be alone, irritability and low mood.

What causes SAD?

Researchers believe that SAD results from the shorter length of the day in winter. The exact cause of this condition is not yet known, but the influence of latitude on SAD strongly suggests that it is caused mainly by changes in the availability of sunlight. One theory is that with decreased exposure to sunlight, the biological clock that regulates mood, sleep and hormones is delayed, running slower in winter. Another theory suggests that neurotransmitters – the brain chemicals that transmit information between nerves – may be altered in individuals with SAD.

How common is SAD?

Recent studies estimate that SAD is more prevalent in northern countries because the winter day gets shorter as you go further north. Studies in Ontario suggest that one to three per cent of the population has SAD. This suggests that up to 120,000 people in British Columbia may have difficulties in the winter due to significant clinical depression. Another 15 per cent of people suffer from "winter blues," with symptoms that are similar to SAD, but not to the point of having clinical depression.

How can I tell if I have SAD?

It is very important that you don't diagnose yourself. If you have symptoms of depression, see your doctor for a thorough assessment. A health professional should be the person to determine the level of depression and recommend the most suitable form of treatment.

How is SAD treated?

Research now shows that light therapy or phototherapy is one of the most effective treatments for SAD, especially when used in the morning. Sometimes antidepressant medicine is used alone or in combination with light therapy. Light therapy is administered by a device that contains white fluorescent light tubes covered with a plastic screen to block ultraviolet rays. The person does not need to look directly into the light, but reads or eats while sitting in front of the device at a distance of two to three feet. Using the 10,000-lux light box for about 30 minutes a day is usually enough for a beneficial response. Light therapy is safe and generally well tolerated; however, minor side effects may occur. Some of these effects may include eye strain, headache, irritability, fatigue and insomnia.

Can I prevent the onset of SAD?

If you have been diagnosed with SAD, there are some useful things you can do to help to prevent it from coming back. Try to spend some amount of time outside every day, even when it is very cloudy. The effects of daylight are still beneficial. Eat a well-balanced diet and include sufficient amounts of vitamins and minerals as recommended by the Canada Food Guide. This will help you have more energy.

Begin using a light box upon the onset of low sunlight (fall season), even before you feel the onset of winter SAD. Try exercising for 30 minutes a day, three times a week.

Stay involved in your social life and regular activities. This can be a tremendous source of support, especially during winter months.

Seek professional counselling, if needed. As mentioned before, it is very important for you to see your doctor if you are experiencing symptoms of depression.

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