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Published on February 14, 2016

The outlook can be sunny for winter bluesThe outlook can be sunny for winter blues

The snow and cold temperatures are here, telling us we’re in the throes of winter. On Cape Cod that means less sunshine, and for the up to 10 percent of people who suffer from Seasonal Affective Disorder, less light means decreased quality of life, if they don’t seek treatment.

Seasonal Affective Disorder, otherwise known as SAD, is a type of depression that is triggered by the changing seasons of the year. Most people begin to get symptoms in the late fall or early winter, but a small subset have summer-onset depression that begins in the late spring or early summer, explained psychiatrist Timothy Breitholtz, MD, of Cape Cod Healthcare Centers for Behavioral Health.

“Incidence of Seasonal Affective Disorder increases in people as you move further from the equator and it is four times more prevalent in females than in males,” Dr. Breitholtz said. “The average age of developing SAD is in the mid-20’s.”

Dr. Breitholtz has only been practicing on the Cape for two months, but he is already treating three or four patients who suffer from it.

Symptoms of SAD include:

  • Decreased energy
  • Fatigue
  • Bouts of depression
  • Frequent tearfulness
  • Poor concentration
  • Irritability
  • Loss of sex drive
  • Poor sleep
  • Decreased activity level
  • Suicidal ideation

“Seasonal Affective Disorder is thought to be triggered by the changes of the seasons, causing a shift in our biological internal clock,” Dr. Breitholtz said. “And as a result of decreased sunlight and increased darkness, there is an increased production of melatonin, a sleep-related hormone secreted by the pineal gland in the brain. Melatonin helps regulate sleep and body temperature.”

To compound the problem, a lack of sunlight has also been found to decrease serotonin blood levels. Serotonin is a neurotransmitter that is responsible for maintaining mood balance and contributing to a sense of well-being and happiness. A deficit can lead to depression.

Many people who have SAD don’t know they have it, but the treatment is simple, effective and doesn’t have any side effects for most people. The exception is people with bi-polar disorder because it could trigger an episode of mania and destabilize their mood.

Psychiatrists often prescribe anti-depressants, usually drugs known as selective serotonin re-uptake inhibitors, or SSRIs, as well as light therapy, also known as phototherapy.

“Studies have shown that phototherapy is effective in up to 85 percent of the cases. The adequate intensity of the light is 10,000-lux and the amount of time required is 30 minutes per day, most often in the morning hours,” Dr. Breitholtz said.

The person should have their eyes open during the light therapy so that the light reaches the retina in the back of their eyes, and they should sit approximately 12 to 18 inches away from the light, he added. “It’s pretty easy really. They can read or do crossword puzzles or other activities they enjoy while doing this treatment.”

Other important considerations, if you are prone to seasonal mood changes, include refraining from drinking alcohol and maintaining a good level of Vitamin D in your system, as both can exasperate the symptoms of SAD. Lifestyle changes, with increased attention to one’s nutrition, and getting outside for walks and stress management, also help us maintain a positive mood in the winter, according to Dr. Breitholtz.