How to banish winter blues

When Ted Jablonski was growing up in Winnipeg, Canada, he could often be found on winter days hanging out in the sun. “I would always sit at the top of the staircase by the window—it was my favourite place,” the 58-year-old remembers. “And even on the most frigid days, I would insist on walking to school.”

As he grew older, what had started as a seemingly benign preference for sunlight took a darker turn. By the time he was an adult, Jablonski began to go into every winter with a sense of dread. “It was a visceral feeling of gloom,” he says. “I’d work longer hours in order to distract myself from my feelings; I just tried to hang on until it passed in the spring.”

Then, in the winter of 2002, Jablonski slid into a depression. He recognised then that he’d been struggling with seasonal affective disorder (SAD)—depression that occurs every year, most often in the darker months—for most of his life. Ironically, Jablonski, who is now a family doctor in Alberta, treated many people with the disorder before he accepted that he suffered from it too. “It took me a long time to admit that this was more than just hating winter.”

A lot of us go into hibernation mode every time the cold comes around, socialising less and feeling like we only have enough energy for binge-watching TV shows. But for the 1-15 per cent of Britons who suffer from SAD, it goes beyond that—they oversleep, overeat, and feel guilty, irritable and hopeless. The symptoms usually come on in autumn, peak in January, and go away in the spring.

About six per cent of Britons acquire a more severe form of SAD, which can have a devastating impact. Before Diana Lillo, a 54-year-old entrepreneur, sought treatment for her more serious case, the effects of SAD on her everyday life were debilitating. “My life was just falling apart,” she says, explaining that both her marriage and career deteriorated, and she was plagued with overwhelming suicidal thoughts. After the sun went down every day, simply going outside was a struggle; most of the time, she says, “I would get to the door or to my car and just turn around and go back home.”

In 1981, the Washington Post ran a story about a 29-year-old woman who suffered from depression every winter, only to have it disappear in the spring—or two days into a holiday to Jamaica. Researchers explained how they had helped her with light therapy—a treatment during which a person sits in front of a light-emitting box for a set time every day—and invited stories from others who experienced a seasonal drop in mood. More than 2,000 people responded, which informed the first paper to identify SAD in 1984.

But while the condition is now widely known more than 30 years later, we still don’t know exactly what causes it. The prevailing theory is that long winter nights throw off your circadian rhythm—the internal clock that regulates when you feel sleepy and when you’re alert. “As the days get very short, some people have difficulty adapting to that change, and the body’s rhythm is thrown out of sync,” says Robert Levitan, a psychiatrist at the Centre for Addiction and Mental Health and professor of psychiatry at the University of Toronto.

That would explain why people who live closer to the equator, where the days are the same length year-round, are much less likely to acquire SAD; only one per cent of people living in Florida have it, for instance.

Another hypothesis is that the lack of sun changes your brain activity. “When light touches your retina, all kinds of chemicals are released that make you behave differently,” says Jablonski. If you don’t get enough light, your body produces fewer neurotransmitters like serotonin, which helps keep your mood stable, and too much melatonin, the hormone that makes you feel sleepy.

SAD may also be hereditary; having a relative with the condition increases your chances of getting it by up to 17 per cent. And a University of Iceland study that screened Winnipeggers in Canada for SAD found that those with Icelandic genes were significantly less likely to have the disorder, suggesting that people whose ancestors are from climates with less sun may have built-in resistance.

There is light at the end of the tunnel—and not just spring. For people who suffer from SAD—and really, for anyone made grumpy by 4:30pm sunsets—a combination of lifestyle changes and doctor-recommended treatments can reduce symptoms and provide lasting relief.

Let in the light
Ted Jablonski was onto something with his favourite spot by the window: exposure to as much sun as possible helps. Keep your curtains open all day, and rearrange your furniture so you’re regularly in bright places in your home. Install skylights if you can. Also, while artificial light isn’t as good as the real thing, adding more lamps to dark areas in your home is better than nothing.

If you can afford it, head to the lands of minimal SAD near the equator. A sunny holiday will offer a welcome, if temporary, respite from the winter blues.

Rely on routines
Winter’s long nights throw off your sleep cycle, but keeping a regular bedtime and wake time can help regulate it, and prevent both insomnia and oversleeping. Also, dim your lights at night and avoid screens for about two hours before heading to bed.

During the day, regular aerobic exercise can help you manage stress, feel more alert and increase your emotional resilience. “When you exercise, your dopamine and serotonin levels rise,” explains Jablonski. “Just 20 to 30 minutes, five or six days a week, can really change the chem­istry in your brain.” A brisk noon-hour walk can do double duty, as you’ll get some sunlight, too.

Connect with others
“When people become depressed, they also start to pull away from things in life that they like doing, and the more they withdraw, the less pleasure and sense of accomplishment they are able to feel in general. It’s a downward spiral,” explains David Dozois, who is a psychologist and chair of clinical science and psychopathology at Canda’s Western University in London, Ontario.

He suggests making a point of finding wintertime ways to do whatever brings you joy during the summer, whether that’s socialising, playing a sport or being in a band. “I encourage patients to “fake it ’til you make it.” Just do it, even if you don’t feel like it at first,” he says.

Go with the glow
Light therapy using an ultraviolet-filtered lamp is the most common treatment for SAD. “Patients prefer it, and doctors like it because it works quickly and it’s very potent,” says Levitan. People typically are encouraged to use their illuminated unit for at least half an hour a day in the morning, which essentially tricks their body into thinking it’s already spring. “I found immediate relief with my light box,” Lillo says. “When I sit in front of it, my mood changes, I feel more energetic and more at peace. The anxiety and depression seem to just slip away.”

Some people with SAD also find “dawn simulation” helps—this is usually accomplished with a custom alarm clock connected to a light that gradually becomes brighter before your set wake up time. Its effectiveness has not been studied as much, but it works for many people and is easier to squeeze into a busy schedule.

Make a therapy appointment
Cognitive behavioural therapy (CBT) is an effective way to combat SAD, or any depression, says Dozois. The treatment usually takes between 12 to 16 weeks to complete, and involves setting up tasks that challenge your behaviour—resisting the natural tendency to socialise less during the winter, for instance.

CBT practitioners also coach people to address the negative automatic thoughts that might, for example, keep a person from staying connected. “If someone passes me at work and doesn’t say hello, my thought might be, He doesn’t like me. OK, that’s one possibility, but what’s another? Maybe he’s stressed about a deadline or maybe he didn’t see me,” explains Dozois.

“It’s putting that thought on trial, and coming up with an alternative, more valid one.”

Find effective medications
Antidepressants are also used to treat SAD, often alongside light therapy and CBT. “Typically we use medications that are activating, rather than those with a sedative effect,” explains Jablonski. He usually prescribes Bupropion—which, unlike many other antidepressants, doesn’t usually cause sleepiness or weight gain—but selective serotonin reuptake inhibitors (SSRIs) are also common. Those people who are already taking these drugs may simply increase their dose starting in the autumn.

Combining all three of the above treatments has turned winters around for Diana Lillo. “My depression will always be with me, but having a toolbox that helps me feel better and deal with my emotions makes a huge difference,” she says.

Jablonski, who swears by his light box and regular exercise, tells his own SAD story often in the hopes that it will inspire others to seek help. In 2010, he even ran and biked all the way across Canada to raise awareness of the disorder.

“The existence of SAD is well-known now,” he says. “What isn’t as well-known is the extent of how disabling it can be—and that you can treat it. My plea to those with SAD is: you don’t have to dread winter and lose months out of every year. You don’t have to suffer unnecessarily.”