Friday, 2 December 2016

Winter SADness

Dreaded Jack Frost:
With daylight savings now behind us and Christmas less than a month away, it is safe to say that winter is nearly at our doorstep. For some, the approach of another frigid Canadian winter comes with many seasonal pleasures such as skiing, making snowmen and of course, a Canadian favourite, outdoor hockey. However, for others, whom these winter related activities do not appeal, the transition from fall to winter brings about desolate feelings rather than ones of excitement. A lack of enthusiasm for this snowy season is often due to the reduced amount of daylight that winter brings, as going to and leaving work in darkness is anything but energizing. How do you react to the changes to the winter season?

A lucky few are able to escape our cold northern climate and migrate south for the winter. Often referred to as snowbirds, these flightless birds have year round exposure to vitamin D and sunshine, allowing them to ward off any signs of winter blues. For those of us that are not snowbirds, it is not uncommon to feel as though everything in the winter requires a bit more effort, including things as simple as leaving the house. Braving icy winters also often involves more time spent indoors that can bring about feelings of isolation. In fact,

around 15% of Canadians experience a general unhappiness during the winter season.

More severely and formally, this winter time unhappiness is known as Winter Seasonal Affective Disorder (Winter SAD). Winter SAD involves a seasonal pattern of episodes that involve reoccurring depression symptoms that have a tendency to relieve themselves in the spring. Some of these symptoms may include but are not limited to; fatigue, sleeping problems, and irritability.  

Treating the Winter Blues:
The lack of energy that is symptomatic of winter SAD can impede severely on an individual’s livelihood and ability to function. Fortunately, there are research based means of managing symptoms each winter. One well studied option is light therapy, which involves daily light exposure using a powerful florescent, ultraviolet light. This is a viable treatment option for those of us that are not snowbirds and want an immediate treatment option for winter time SAD. However, light therapy requires a daily commitment, making it fairly time consuming.
A secondary option for treating SAD and winter time depressive symptoms has been examined recently by researchers. Cognitive Behavioural Therapy (CBT) is a talking based psychological intervention commonly used for a variety of psychological disorders. A recent study has compared CBT and light therapy for treating the symptoms of winter SAD, focusing on the long-term effectiveness of symptom relief. The study used two groups of participants all of which met the criteria for major depression with a seasonal pattern. One group was given the light needed to conduct light therapy within their home each morning for 30 minutes for their symptomatic period. The other group of participants took part in a 90 minute CBT session twice a week for 6 weeks and were then encouraged to use what they learned for the winter months following. The two groups were followed for two years after to the original treatment period and the amount of reoccurring symptoms as well as remission statuses were examined.  The study found that CBT for Winter SAD was more proficient at reducing reoccurrences of Winter SAD symptoms than light therapy two winters following the original treatment. CBT was also associated with more remission cases than just light therapy.

Now before we all go and sign up for CBT classes for ourselves to get through this winter, it is important to note that for some people CBT alone or light therapy alone are not enough to manage their depressive symptoms. Everyone has to find what works best for them to manage their case of winter blues, even if this means heading south until spring. This study highlights that for long term relief of SAD symptoms CBT seems to be a better option, it gives individuals tangible skills that they can utilize in seasons following the original CBT sessions. Examining this study as we embark on another winter emphasizes that winter is far less than a wonderland for many of us and to treat others with compassion and understanding this season.

- Katharine Constable

Rohan, K. J., Meyerhoff, J., Ho, S., Evans, M., Postolache, T. T., & Vacek, P. M. (2016). Outcomes one and two winters following cognitive-behavioral therapy or light therapy for seasonal affective disorder. American Journal of Psychiatry, 173(3), 244-251. 

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