More Than Just the Winter Blues?

With 5 p.m. sunsets, erratic temperatures and plenty of snow and ice, winters in Chicago and other northern cities are not for the faint of heart.

And winter is far worse for people with the winter blues and seasonal affective disorder (commonly known as SAD).

Is it the winter blues or SAD?

The winter blues are very common, with many of us experiencing a mood shift during the colder, darker days of winter. You may find yourself feeling more lethargic and down overall. Although you may feel more gloomy than usual, the winter blues typically don't hinder your ability to enjoy life.

But if your winter blues start permeating all aspects of your life — from work to relationships — you may be facing SAD. SAD is a recurrent type of depression associated with the change in seasons. It typically starts in the fall and persists through the winter months.

SAD is more complicated than wanting to hunker down and stay in for the night. It's more than simply cursing another blizzard. And it's more than longing for those first days of spring. Basically, it's much more than the winter blues.

"SAD can be debilitating for some people," says Joyce Corsica, PhD, a clinical psychologist at Rush. "And if you're suffering from it, it's important to get help."

Sun power

The primary culprit of both the winter blues and SAD is the lower level of natural sunlight we are exposed to in the fall and winter. Less natural light can cause the following problems:

• Dips in serotonin, a neurotransmitter that regulates mood
• Disruptions in circadian rhythms (your body’s internal clock), which help control sleep-wake cycles
• Alterations in melatonin, a hormone associated with both mood and sleep

"All of these factors can have a direct impact on your mood," Corsica says. "And if you're having mood difficulties, other things can start to fall apart too. You may find less enjoyment in your life, your work performance may suffer and you may start struggling with your relationships. None of this happens in a vacuum."

Here are four ways to get a leg up on the winter blues and SAD:

1. Recognize the signs

The most common symptoms of the winter blues are general sadness and a lack of energy. Other symptoms of the winter blues include the following:

• Difficulty sleeping
• Feeling less social than usual
• Difficulty taking initiative

The hallmarks of SAD are sleep too much and overeating. Other common SAD symptoms include the following:

• Mood that is down or depressed most of the day, nearly every day
• Loss of interest in activities you typically enjoy
• Withdrawing and isolating yourself from friends and family
• Struggling to focus and perform at work or home
• Feeling constantly fatigued and lethargic
• Feeling hopeless about the future
• Having suicidal thoughts

Often people with the winter blues or SAD first [see a doctor] because they aren't feeling well — they're lethargic, easily fatigued and aren't feeling like themselves."

2. Don't ignore your symptoms

If you're experiencing depressive symptoms — even mild ones associated with the winter blues — it is important to talk to your primary care doctor or a psychologist to discuss your options.

Often people with the winter blues or SAD first go to their primary care doctor because they aren't feeling well — they're lethargic, easily fatigued and aren't feeling like themselves. They think there is something wrong physically.

Diagnostic tests, such as a blood test to check your vitamin D levels or a complete blood count, can rule out other causes of these symptoms.

After that, your clinicians will ask you some questions to help determine if you're facing the winter blues or SAD. According to Corsica, the most telling question is: Do your symptoms interfere with your function at home, work and/or relationships?

If they do, it's time to take action.

3. Find a treatment that works for you

While symptoms of the winter blues and, to some extent, symptoms of SAD may dissipate in the spring, you shouldn't suffer silently, Corsica says.

The good news about both the winter blues and SAD is there are a number of evidence-based treatments that can be quite effective in alleviating your symptoms. Discuss the following treatments with your clinician:

• Sunlight: It's important to get outside whenever the sun is out during these darker days. Take a walk during your lunch break, play with your kids in the snow or try an outdoor winter activity like snowshoeing, skiing or ice-skating. Exposing yourself to natural light will help boost serotonin production and your overall mood.
• Light therapy: As the current standard of care for SAD, light therapy replicates natural light with light boxes, which use white fluorescent bulbs to mimic sunlight. Light therapy can be particularly helpful in regulating the release of melatonin, which increases when the sun goes down. When undergoing light therapy, you will spend a prescribed amount of time looking at the light box each day. It is important to follow your clinician's orders to ensure you are using an appropriate "dose." This will help the treatment be most effective, while also lowering your risk for side effects (e.g., agitation and headaches).
• Exercise: Research consistently shows a strong exercise-mental health connection, particularly for those with depression and anxiety. That's why experts often refer to exercise as nature's antidepressant. Exercise can increase serotonin and endorphins, which both affect mood. Moderate exercise of at least 30 minutes most days of the week may provide the biggest mood boost.
• Cognitive-behavioral therapy: A recent study in the American Journal of Psychiatry suggests that cognitive-behavioral therapy can actually be a more effective long-term treatment for SAD than light therapy. While more research is needed in this area, cognitive-behavioral therapy is clinically proven to be extremely beneficial for all types of depression.
• Medication: If more conservative treatments are not providing adequate relief, you may need antidepressants to regulate the chemical imbalances associated with the winter blues and SAD. While you may be able to taper off the medication as you head into spring, it is important to talk to your prescribing doctor before making any changes to your medication or dosage.

4. Embrace a healthy lifestyle

Maintaining a regular schedule during the winter months can help keep your hormones in balance and regulate your mood — whether you suffer with the winter blues or SAD. Follow these tips to help manage your winter mood:

• Go to sleep and wake up at the same time every day to help normalize your circadian rhythms.
• Structure your eating patterns by eating three meals a day, around the same time every day.
• Avoid the common urge in the winter to overindulge in simple carbohydrates, such as starchy or sweet foods; eat a balanced diet of proteins, fruits and vegetables, and whole grains (e.g., brown rice, quinoa).
• Make (and keep) plans with friends and families to help you stay connected to your loved ones.
• Take time for yourself and engage in activities you enjoy.

SAD fast facts

• Women and young adults ages 18 to 30 are more likely to suffer with SAD than men and older adults, respectively.  
• On average, about 6% Americans (most commonly in Northern climates) experience SAD, while about 14% of Americans experience the winter blues.
• Rates of SAD vary depending on where you live. About 9% of Americans who live near the Canadian border experience SAD symptoms, compared to just 1.5% of people in Florida.