Winter blues or is it depression pulling our lives down? (representational image - Unsplash) 
Medicine

Winter blues or is it depression pulling our lives down?

Depression is a common disorder that many of us face at some point in our lives. It is a melancholy of unhappiness and grief.

Dr Indusree Venkatesh

Depression is a common disorder that many of us face at some point in our lives. It is a melancholy of unhappiness and grief characterised by sadness, despair, loss of energy, and difficulty in dealing with normal daily life. There are different types of depression, and one such is a seasonal affective disorder/severe recurrent seasonal major disorder.

Seasonal affective disorder (SAD) is a type of depression that's related to changes in seasons. It can sap your energy, dull your mood, and can make you inactive. It begins and ends at about the same time every year usually in the winter season, and resolves with the onset of spring or summer. However, rarely it can start during the summer, and resolve with the onset of spring or winter.

It is common to feel low or inactive during the monsoon or rainy season known as winter blues, but if it is recurring and interfering with your daily activities, decreasing your sleep quality or appetite then you must seek help as soon as possible because you may be dealing with SAD.

It is common to feel low or inactive during the monsoon or rainy season known as winter blues, but if it is recurring and interfering with your daily activities, decreasing your sleep quality or appetite then you must seek help as soon as possible because you may be dealing with SAD (representational image - Unsplash)

HOW DO YOU KNOW IF YOU HAVE SAD (Seasonal Affective Disorder)?

If you experience the following symptoms you should seek help:

●Feeling sad or down almost every day during the winter or summer season at about the same time every year.

●Changes in your sleep quality and quantity: Difficulty in sleeping or oversleeping

●Losing interest in activities which you once enjoyed.

●Having low energy to do regular activities

●Overeating and weight gain

Suicidal thoughts.

●Difficulty in carrying out regular activities

●Decreased concentration.

WHO ARE AT RISK?

Some of the risk factors of SAD are

●Women are more commonly affected than men

●Younger adults are more at risk than the elderly.

●Family history of depression or SAD in blood relatives(siblings, parents, maternal or paternal aunt).

●Previous history of depression or bipolar disorder.

●Low vitamin-d levels- the primary source of vitamin d is sunlight. During the winter season, due to decreased exposure to the sun, there is a high chance of Vitamin-D deficiency. It boosts serotonin levels which are often known as the “mood enhancer”. In vitamin -D deficiency its levels are low and can result in a dull, gloomy mood.

During the winter season, due to decreased exposure to the sun, there is a high chance of Vitamin-D deficiency. It boosts serotonin levels which are often known as the “mood enhancer”.

●SAD is also commonly seen in those who live away from the equator as there is no adequate sunlight exposure resulting in Vitamin -D deficiency.

WHEN TO SEEK HELP?

●Social withdrawal

●School or work problems

●Substance abuse(tobacco, alcohol or any illicit drugs).

●Other mental health disorders such as anxiety or eating disorders

●Suicidal thoughts or behaviour

Treatment for the seasonal affective disorder may include light therapy, psychotherapy and medications

WHAT IS OFFERED AS A PART OF THE TREATMENT OF SAD?

Treatment for the seasonal affective disorder may include light therapy, psychotherapy and medications.

Light therapy

It is one of the first-line treatments used. Getting good exposure to sunlight can increase your serotonin levels, can make you active and enhance your mood. Natural light is the best way but during rainy or winter seasons, artificial light can be used from a special light box which will be prescribed by your doctor or other sources of light except for computer screens or mobile phones which emit blue light that can further interfere with your sleep and worsen SAD.

Read more about the influence of light on sleep in this article:

Light therapy mimics natural outdoor light and is useful in improving symptoms of SAD to a large extent.

Psychotherapy

Cognitive behavioural therapy is a type of psychotherapy/talk therapy that is also found to be useful in the treatment of SAD. It can be done online or in person.

●Inculcate healthy ways with reducing avoidance behaviour, and schedule meaningful activities

●Develop a hobby that you enjoy. Try different hobbies and work on the one that you enjoy the most and suits you well.

●Managing your stress is important. Take regular breaks to re-energize and calm down.

●Schedule your sleep timings. Stick to one particular time and get at least 7-8 hours of sleep.

●Exercise regularly. It doesn't necessarily have to include, going to the gym, you can go on a walk in the morning every day, or do aerobics or exercise at home.

●Keep your surroundings bright. Allow as much as natural light to enter your house or room.

●Take a trip, meet new people, learn and explore different cultures.

●Meet up with your friends, relatives, and siblings.

Medications

If symptoms are severe you will be put on antidepressants. Usually, extended-release bupropion is used however other antidepressants are also used based on the profile of each individual and are best decided by your doctor.

Keep in mind that it may take several weeks to notice the full benefits of an antidepressant. In addition, you may have to try different medications before you find one that works well for you and has the fewest side effects

If symptoms are severe you will be put on antidepressants. Usually, extended-release bupropion is used however other antidepressants are also used based on the profile of each individual and are best decided by your doctor

WHAT YOU CAN DO BEFORE VISITING YOUR DOCTOR?

●Make a list of your symptoms,

●Identify the pattern of your symptoms, whether you feel low during a particular time or always. This can help to rule out other forms of depression

●Any other associated conditions

●Any recent trauma such as the loss of a loved one or job or major changes in your life

●Any major stressors

These can help the doctor to diagnose better and fit into a category

It's normal to have some days when you feel down. But if you feel down for days at a time and you can't get motivated to do activities you normally enjoy, see your healthcare provider. This is especially important if your sleep patterns and appetite have changed, you turn to alcohol for comfort or relaxation, or you feel hopeless or think about suicide. Help is always available. Talk to your parents, siblings or friends. There’s always someone who is ready to listen to you and is willing to help you out.

Remember, no one’s alone!

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