Winter depression, or Seasonal Affective Disorder (SAD), is a form of depression that is related to the change in the seasons. It is estimated to affect one in 15 people in Ireland and for most people, SAD begins and ends at roughly the same time each year. Symptoms usually arise at the beginning of autumn. As autumn continues on into winter and sunlight decreases, symptoms tend to get worse. There are a whole range of causes, symptoms and treatments, with everyone’s experience of the disorder being unique.
The geographic region in which you live has been proven to have had an impact on your likelihood of being affected by this disorder. The closer a country is to the Equator, the less likely individuals are to suffer from SAD, with countries who are within 30 degrees from the Equator observing very low rates of people affected by the disorder.
A doctor’s voice
To gain a better insight into this now medically acknowledged illness, I spoke to Dr Freja Petersen, a medical professional who works within the area. Petersen is a chartered psychologist and works in the Trinity Student Counselling Service (SCS), where she frequently comes across people who are affected by winter depression. Speaking of the effect of where you live can have, she said: “From research conducted in different countries, we know that the further a place is from the equator, the more likely its inhabitants are to suffer from the decrease in light in winter months.” Ireland stands at 53 degrees north and has seven to eight hours of sunlight on average during the winter months. This combined with Ireland’s dark, cloudy and rainy climate makes SAD particularly prevalent in this country.
The nature of our modern lifestyles can also contribute to high levels of winter depression within our society, as we have dramatically altered nature’s cues. Petersen explained that “Access to outdoor activities…[is] also relevant.” Historically we have worked outside, however the percentage of those working outside in natural daylight has decreased from 75% to just 10% over the past 200 years. This has a major impact during the winter months as we often go to work early in the morning when it is dark and do not leave until evening when it is again dark, resulting in many of us receiving very little natural daylight.
I, like many others, have heard of SAD in the past and know people who are affected by it. However, my knowledge is limited and I wanted to find out what this disorder entails and where the root of the causes lies. Peterson explained to me that “SAD is the seasonal version of recurring episodes of depression…The decrease in light affects the neurological processes in the brain in such a way that some of the substances normally regulating mood and activity are disturbed.“ Two of these substances include serotonin and melatonin. Serotonin affects mood and social behavior, appetite and digestion, sleep, memory, and sexual desire and function. Melatonin, on the other hand, helps to control your sleep and wake cycles. The levels of melatonin your body produces is correlated to the levels of daylight you are exposed to, with levels increasing once the sun sets.
Some of the causes of SAD often mirror those of “regular depression” and, as well as irregular levels of melatonin and serotonin, causes include psycho-social factors such as “one’s personal history, social supports [and] physical health” which “play a role in when/whether a SAD episode starts, how severe it becomes, and how long it continues for”.
An Irish disposition?
Irish people often feel grouchy, have difficulty sleeping and generally get fed up during our cold and grey winter months. There is, however, a difference between a case of the winter blues and suffering from winter depression with many saying it is similar to the difference between being clinically depressed and feeling down from time to time. As Petersen explained to me, there are distinguishable symptoms of SAD which include “a consistent and pervasive drop in mood, decreased energy, problems with motivation and concentration, social withdrawal, less engagement and enjoyment of activities that normally feel rewarding, changes to sleep and appetite, and increased tiredness and apathy”.
While there is a strong link between the two, Petersen distinguished the difference between winter depression and “standard” depression: “SAD and depressive disorder are two separate diagnosis, but of course they overlap, and it can be hard to distinguish. In general, it seems that SAD is more severe than ‘standard’ depression.” Most cases begin in autumn and end as winter ends, however there are exceptions to this as “once an episode of SAD is there, it may go on into the spring and summer months if it isn’t treated, or the psycho-social influences are not addressed. There is some evidence for seasonal mood disorders that occur in summer, but much less so than winter.”
As Petersen works with students on a daily basis, I was interested to see how this disorder affects young people. Petersen admitted to me that “evidence is scarce [however] students coming to Ireland from closer to the equator are more likely to suffer”. According to a survey undertaken by the Journal of American College Health, which was carried out in New England, students who had moved from southern latitudes to northern New England were the most likely to experience increased depression in winter.
Speaking of her own work as a student counsellor, Petersen explained the diversity that exists in cases of SAD: “The causes are various, as are the types of issues that students present with. It is my job to assist students in understanding their distress, and helping them figure out what they need in order to change how they feel.” Ultimately Petersen’s job is to help students understand their distress, and figure out what they might need in order to change how they feel. This can involve “discussing in depth the types of situations that cause them upset or that they struggle with, any historical and current triggers or causes, and any attempts they’re already making to address the problems.” As is the case with many illnesses, no two individuals stories are the same and Petersen emphasises that getting help is “something that’s a very intricate and unique process for each person”.
Seeking treatment
Once a diagnosis of SAD is made, what resources are available, and how can one go about accessing them? Petersen informed me that there are numerous supports and treatment available to help treat SAD. Whilst therapy and antidepressants also often help individuals who suffer from depression, there are several supports which are unique to SAD. “In the case of SAD, an important part of therapy would be to gain access to light treatment,” Petersen advised. The SCS does not provide this treatment, however Petersen told me that the best way to gain access to light treatment is through the HSE or private medical channels. She also added that this particular treatment has no known side effects so “if SAD is suspected there is no harm in trying light treatment”.
While those reading this may not feel the effects of winter depression, many people know friends or family members who are affected by the disorder. When I enquired as to how best help support a loved one with SAD, Peterson advised to “be patient, kind, and supportive”. Giving an insight into how an individual may feel, Peterson explained that “it may be very hard for them to find the motivation to go out and engage with others,” however she urged not to “give up on them if they’re withdrawing” as well as to “invite them to talk, but accept if they don’t want to”.
