Wake Me When It’s Over

The holidays are history, the days are short, the nights are long, and in many parts of the country the weather is cold and forbidding.  If just the thought of all this makes you want to hibernate until Spring, you may be suffering from Seasonal Affective Disorder (SAD) or the winter blues.

“Hibernate” is the right word.  Although the causes of SAD are not fully understood, the condition appears to be associated with disruptions in the daily rhythms of melatonin, a compound secreted by the pineal gland and involved in sleep-induction.  In ground squirrels and other hibernating animals, patterns of melatonin release change dramatically during the low-light months, contributing to a state of suspended animation during which the animal conserves energy by reducing body temperature and slowly metabolizing stored body fat.  Humans don’t hibernate, but some of us produce enough melatonin, or produce it at the wrong times, to make us sleepy and lethargic during the winter months. Other symptoms of full-blown SAD include depression, anxiety, hopelessness, loss of interest in things that usually give you pleasure, social withdrawal, carbohydrate craving, weight gain, and difficulty concentrating.

If you’re a smoker or even an ex-smoker, all this may make you feel like lighting up.  As I point out in Chapter 6 of Life After Cigarettes, a better strategy is to add light to your life.  If a tropical vacation isn’t in the cards, buy a bright full-spectrum lamp (“light box”) and spend 30-60 minutes under it while you read the morning paper or answer your e-mail.  This blocks melatonin secretion and is the standard first-line treatment for SAD.  And whenever you’re tempted to smoke to relieve the symptoms of SAD, give yourself an extra dose of bright light therapy.  Although I don’t know of any scientific studies to support this recommendation – the smoking-SAD connection has received surprisingly little attention by researchers – it makes a lot of sense to me and is definitely worth a try.

SAD is four times as common among women as among men, and many more have mild, subclincal cases of the disorder.  No surprises here, since women are more prone to most forms of depression than men. If your winter blues are seriously interfering with your ability to function in your daily work or family life and don’t respond to phototherapy, seek professional help.  Treatment options may include cognitive-behavioral therapy, carefully timed administration of melationin to re-regulate circadian rhythms, and antidepressants.  “Treating” SAD by smoking a cigarette is definitely a case of the cure being worse than the disease.

For more information about light boxes, and about SAD in general, visit http://www.depressioncenter.org/understanding/sad.asp.  As always, I invite you to share your experience with SAD and approaches you have used to relieve its symptoms with the readers of this blog.

© 2009 All Rights Reserved, Dr. Cynthia S. Pomerleau
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