By Sarah Ellen Rindsberg
Dreidel songs have come and gone, and, soon, Christmas carols will waft through the air. These hallmarks connote joy and good tidings during a time when, ironically, not everyone is cheerful. While most know that joyous family gatherings can sometimes turn into tension filled sagas, many are unaware that this season’s shorter days can also reduce bright outlooks.
There’s a certain Slant of light,
Winter afternoons –
That oppresses, like the Heft
Of Cathedral Tunes –
During the cold winter months in Amherst MA, Emily Dickinson described the effect of decreased sunlight in her poetry. Dickinson’s prescient observations are expanded upon by Dr. Norman E. Rosenthal, who noted a marked decrease in his energy level during the winter, after moving to the United States in 1976 from his native South Africa. As he commenced his residency at the New York State Psychiatry Institute, Rosenthal was stunned by the brilliant color display of autumn but disheartened by the shorter days. In the spring, his energy level rebounded and he began to investigate this phenomenon, known today –largely due to his efforts – as Seasonal Affective Disorder or, by the telling acronym, SAD.
In Rosenthal’s authoritative tome, “Winter Blues,” he elucidates the chemical imbalances in the brain which cause many types of depression including SAD. Communication in the brain is conducted by neurons via several neurotransmitters or chemical messengers. The amount of one of these in particular, serotonin, is inextricably linked to the amount of sunlight on any given day. Methods used to raise the serotonin level are extremely effective in alleviating the symptoms of SAD.
Patients seeking psychologist Stacey Slater’s advice voice common concerns: “I don’t feel like I did over the summer. I’m not myself. I’m more irritable.” Once they share their finding that this cycle repeats annually, treatment for SAD is indicated.
Slater’s clinical approach is a combination of psychotherapy which she defines as, “supportive therapy, talking about it and coming up with solutions,” and cognitive behavioral therapy that which changes “your thought process to impact behavior.”
She is also a huge proponent of Light Therapy, which simulates the effects of sunlight. Light Therapy utilizes devices including light boxes and natural light bulbs, and is best used with professional guidance. Agreeing with Rosenthal’s research (that the amount of sunlight during winter months is unreliable, and that patients who spend time in the sun do not receive the same benefits as those who utilize Light Therapy), Slater suggests patients install the special bulbs before the days get shorter as a proactive measure. There is no need to stare at the light but it is imperative that the eyes be open during treatment. Each case necessitates a different amount of timed lux (units of lamination) exposure. As the days lengthen in the springtime, a program designed to taper treatment is usually put in place.
Are there ways in which caregivers, family and friends may contribute to a brighter outlook as well? Absolutely. Slater stresses the importance of “being compassionate and supportive and helping them to get treatment.”
Psychiatrist Jeanette Cueva sees numerous cases of co-morbidity, “more than one psychiatric disorder,” in her practice. For these patients, “it’s like a double depression, amplified in this time of year.”
She often prescribes a combination of medication and Light Therapy for clients of all ages. In addition, she highlights the importance of sufficient sleep, exercise, healthy eating and follow-up with a professional on a regular basis.
In speaking to the effectiveness of today’s treatments, Cueva expresses gratitude, “patients are very surprised sometimes how medication and light can make such a huge impact and they are very grateful. It does save people’s lives.”
Still, she shares that one disadvantage to current medications is the length of time (often six to eight weeks) required to reap benefits. This is an area where Dr. Cueva’s role as a principal of Bioscience Research, LLC, comes into play. She is particularly interested in exploring potential medications which have a “rapid” rate of effectiveness. Cueva stresses the critical need for such medications, particularly for suicide prevention.
As the days shorten, be mindful of your mood. If you’re among the many who suffer from SAD, do not despair. Take Slater’s exhortation to heart: “It’s fixable and treatable. Reach out.”
Sarah Ellen Rindsberg gets extra sunlight as an avid skier in the winter.
