Re-examining SAD - fact or figment of the imagination?

Re-examining SAD - fact or figment of the imagination?

Over the course of the past 3 months or so, you’ve probably wondered if you’re suffering from SAD – that is, Seasonal Affective Disorder. Maybe you’ve been feeling sluggish, lacking energy or desire to be active. First off, it’s winter, it’s totally allowed. But you may rightly be eager to be able to say definitively if there is an underlying cause beneath your overall feeling of… shall we say, blah.

Interestingly, however, there’s mounting evidence that suggests that SAD may not actually exist. In this article, I’ll look at both sides of the story: those who claim it is very much a real form of depression, and others who, in effect, claim it’s nothing more than a misunderstood scape goat used to bear the blame for the ‘winter blues’.

What is SAD?

Mental Health America defines Seasonal Affective Disorder as a type of depression, classified as a  Major Depressive Disorder (MDD) that affects sufferers around the same time each year, when the seasons change.

Dr. Teodor Postolache, a professor of psychiatry at the University of Maryland reports that it is mostly associated with winter, and symptoms are said to start in autumn. However, although less frequently reported, SAD can also occur in different seasons such as summer. Typically, SAD sufferers feel depressed during the shorter days of winter, while being more cheerful and energetic during spring and summer when brighter days return.

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What to look out for

A note of caution: just feeling down during the winter does not constitute having SAD. You must experience a combination of symptoms, which include the following, for 2 years or more:

  • Feeling depressed almost every day, for the majority of the day.
  • Having no interest in doing things you usually love to do.
  • Undergoing sleep issues – oversleeping or interrupted sleep.
  • Finding it hard to concentrate.
  • Having low energy and feeling sluggish.
  • Becoming irritated easily.
  • Overeating, especially high carb & sugary foods.
  • Having thoughts of death or suicide frequently.

Who’s at risk?

There are several factors that impact on the likelihood of developing SAD, including gender, age, family history and geography.  

Women are much more prone to be diagnosed with SAD than men (some estimates say women are 4 times more likely to have it than men),  and younger adults (typically between 18 and 30 years) appear more susceptible than older ones. It’s believed that if you suffer from SAD you likely have family members down the line who have/had it also, or a different type of depression.

The incidence of SAD also seems to coincide with where you live in relation to the equator. Countries far north or south of the equation experience bigger fluctuations in daylight hours during different seasons. The UK, for instance, is reported to have higher rates of SAD sufferers than people living elsewhere, where daylight hours are long, constant and extremely bright year-round. In fact, a recent British-based study revealed alarming figures – 29% of adults reported experiencing symptoms of SAD, with 8% of these manifesting acute symptoms.

Explanation behind it

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The primary effects of the change in daylight hours on the body are summarised as:

  • The body’s internal clock (circadian rhythm) is disturbed . 
  • Reduced sunlight can cause decrease in serotonin levels, which is a brain chemical (neurotransmitter) that affects the mood.
  • Changes in seasons affects the body's balance of melatonin, which impacts on sleep patterns and mood.

In a Time Magazine article, Dr. Alex Korb, author of The Upward Spiral: Using Neuroscience to Reverse the Course of Depression,  uses the analogy of what shift work or traveling to a different time zone do to your body to explain that, likewise, with the shift in seasons, the body’s natural rhythms get out of wack.  Dr Postolache concurs, affirming that the body’s sleep-wake cycles, internal clocks, and brain chemicals that control mood, appetite and energy levels are all affected by the onset of winter.

The nay-sayers

However, in recent years, there have been a number of experts who’ve said SAD isn’t even a real thing. I know, “Hold up, what?!”. A sudden feeling of desperation grips you as you think that just when you could finally put a name on the reason you feel so down in the winter months and you’ve now figured it all out, there are some who want to take it away. I get it.

Let’s hear them out for a second though, shall we? The most damning evidence seems to come from a large-scale study in the US, which led the scientists involved to conclude that SAD may not be a real thing, and at best, is a very rare condition that few actually have.

The findings of the study showed that levels of depression reported in the winter among the participants were not higher than those reported by participants in the summer months. The influence of latitude likewise seemed negligible in the occurrence of SAD symptoms. These researchers have interpreted the results as giving evidence of depressive tendencies not changing with the seasons and the levels of light that characterise them.

The main criticisms levied against the scientific research pointing to the validity of SAD are:

  1. Traditionally, SAD studies require participants to remember and report on their historic feelings, up to a year in the lag.
  2. The types of questions (including those about mood, weight and appetite) used in diagnosing SAD being leading.
  3. Existence of confirmation bias, that is, participants, self-diagnosing themselves based on popular culture, coming into studies with the pre-conceived notion that they have this disorder.

What do I make of this?

All things considered, I do understand that sometimes in trying to pinpoint the cause of a problem, even experts, although well-meaning, may be precipitous in drawing conclusions. Under pressure to solve the mystery as to why people feel the way they do, research may not be as unbiased or rigorous as it out to be.

Don’t get me wrong, I’m not trying to oversimply matters- there are plenty of factors in play, a big one being that proper research requires funding, and lots of it!

But there’s also the fact that there is plenty to be discovered about the workings of the mind, and that mental health research still has a long way to go as I’ve discussed in greater detail here. Some of what was thought to have been known as fact half a century ago has been now roundly debunked. The point being, this is very much still a work in progress, and the conversation should be kept open because the reality of how many people feel should not be disregarded.

My reality (and probably yours too)

When I moved to Britain a few years ago, it was a big change for me: culturally and socially. I arrived in September and was rearing to go in confronting the challenges of adjusting to my new life that lay ahead.

But then, November rolled around with its 7:30am sunrise and 4pm sunset. That was very different to what I had been accustomed to. Coming from a tropical climate, we have a fairly consistent number of hours of daylight throughout the year.

December came, and I found myself going to school in the dark for my early classes and exiting the campus just after 3:30pm in pitch darkness. It gave me an odd, off-putting feeling, but I told myself it was all a part of the new adventure, I’d soon get accustomed to it. My studies kept me busy, and the large international gang of classmates was a constant source of fun and entertainment.

Nevertheless, as my first winter trudged on, I felt an increasing amount of energy being sapped from my body with every passing day. I felt lethargic and found myself sleeping much longer than usual (up to 10 hours a day) but still waking up feeling like an elephant was sat on top of my head!

My concentration was fleeting and it took real effort to complete a task in one go; everything felt mammoth-sized, down to getting a shower. I felt indescribably miserable, cried frequently and was this close (picture fingers one inch apart) to giving it all up and jumping on a plane back home.

Thank goodness, I didn’t, and somehow made it to Spring, which was the biggest relief ever. But, even before that, from the end of February, as the days started to get longer, I felt re-born.

For 4 winters in a row, I had that experience.  Three years ago, my GP casually mentioned something to me that I wish was part of some sort of ‘Welcome to Your First Winter: Here’s Your Induction Guide’. She asked if I was taking Vitamin D supplements and continued to explain that especially people like myself who are raised an environment abundant in sunlight, feel the effects of Vitamin D deficiency particularly strongly and it was important to take these supplements to make up for the limited sunshine.

If only I had known that from the beginning of my journey here. My ‘winter blues’ have by no means disappeared but armed with the knowledge I now have about the serious effects of a lack of Vitamin D and sunshine, I feel much more in control of my emotions and how I deal with myself during the winter months. Wherever possible, I take a sun-filled winter vacation, and of course, I have a stash of Vitamin D on my kitchen counter.

But apart from that, I’ve found other things that help me survive the winter.

Coping mechanisms

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Here are my suggestions, based on my own experience.

  • Get outdoors, every day if possible, no matter how cold or adverse the weather conditions. Fresh air does wonders.
  • Don’t clear your social diary- have your meet-ups with your friends as you normally would in different seasons.
  • Glimpse the sun? Go walk/sit in as long as you can (with your sunblock on, of course!)
  • Try foods and participate in activities only available at this time of the year.
  • Volunteer for a cause you believe in. This year I’ve volunteered at a language centre that teaches refugees English, and the it’s filled me with incredible joy.
  • Exercise frequently- can’t bear the thought of jogging or facing the gym with all that equipment? Book yourself into an exercise class- the upbeat music, active people around you will get you motivated. Have you tried Zumba? It’s so much fun!

If you do feel like your symptoms are severe, don’t be afraid to talk about it with your GP. There are medical treatments available that can help, such as light box therapy and cognitive behavioural therapy.

Final thoughts  

I can’t say with certainty whether or not I have SAD; I do know however, how I feel when sunshine is lacking, particularly in winter.

While some research might say otherwise, I’m with Dr. Korb who’s said “SAD is definitely a real thing”. Yes, I do believe the disorder exists, and is all too real for the many people who suffer from it.  

The good news is spring’s just round the corner! So you just hang in there, buttercup - blue skies, sunshine and beautiful flowers are on their way.

I'd love to get your thoughts on this topic friends. Is SAD something you feel you may have/have had? What's your experience been?

One Love,

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