Ask a Medcan psychologist | How do you beat the winter blahs?

Shining light on a condition linked to lack of sun

While Canada is known by the rest of the world as a winter-loving nation, the dark days and persistent time indoors can have a negative impact on some people’s health. For most, the key to combating the winter blahs is to embrace the frigid temperatures with your tribe through outdoor activities, sleeping enough, and eating well.  Or, take a cue from the Danish “hygge” way of life, and make cozy comforts like lounging in your knitwear by candlelight while sipping homemade soup a part of your routine.   These physical and social routines ensure regular exposure to sunlight and activity, which are essential year-round, but perhaps needed to be planned more deliberately in the winter.

For others, winter fatigue is more serious. Around 2 to 3% of Canadians experience a seasonal type of depression that can significantly impact their health and well-being. Another 15% will experience a milder form of the condition, which is also known as Seasonal Affective Disorder (S.A.D.). I sat down with two psychologists to understand more about this condition and when it’s wise to seek help.

Is S.A.D. a real condition or diagnosis?

“The general consensus is that it is indeed a real diagnosis,” says Dr. Ricardo Flamenbaum, a psychologist at Medcan. “Seasonal Affective Disorder, or seasonal depression, is listed in the DSM-5, the official mental health classification system  used by physicians, psychiatrists, and psychologists, as a sub-type of major depressive disorder; what we call depression.  What makes it different from depression is the seasonal qualifier or the seasonal pattern. That means it tends to come on during particular times of year, usually in the fall or winter, when there is a decrease of exposure to sunlight. It can also be associated to the changes our biological clocks undergo during time changes when the days get shorter.”

If someone suspects they have seasonal depression, when is it worth looking into with a professional?

Dr. Aline Rodrigues, also a psychologist at Medcan, says symptoms like low moods and low energy may be something to investigate if you find yourself  unable to function in your daily life.

Other symptoms include feeling down and/or tired most of the time; a general sense of malaise; and a need to sleep more than usual. Some people tend to overeat and have a higher craving of carbohydrates (like sugary treats). Seasonal depression may be the reason you are having difficulty going to work, or being at work and not working (i.e. presenteeism). You may be withdrawing from your circle of friends, or not performing at work or at school as well as usually do.

What are some recommended line of treatments?

Get outside and move more

Both psychologists recommended that we should all, regardless of where you fall on the spectrum, get outdoors as much as we can – which also forces us to be active. So layer up and lug on your boots, it’s time to go into the cold (and maybe even enjoy it). Some options to consider: walk over to the local seniors’ home and volunteer your skills or companionship; leave the car and walk to pick up some groceries; or take a spin on an ice rink you’ve never tried — for Torontonians, have you checked out the new outdoor rink under the Gardiner?

Try light therapy

For more mild levels of seasonal depression, increasing your exposure to sunlight may also be helpful.  Studies have shown an association with light exposure and mood; it’s been found to be just as beneficial as Cognitive Behavioural Therapy (CBT) and, when coupled with exercise, even more helpful.

Talk to an RD about vitamin D

Some practitioners recommend vitamin D to help stabilize mood in the winter months. Victoria Upshaw, a registered dietitian at Medcan, says although there is a strong correlation between vitamin D and S.A.D., there is no concrete cause and effect relationship.

“Researchers suspect that the many vitamin D receptors in the brain play a role in regulating serotonin.  At a minimum, vitamin D is also essential for bone density, immunity, and parathyroid hormone balance,” says Upshaw. “Health Canada recommends adults take 600-800 IU per day but most individuals need 1000 IU or more daily to help achieve healthy levels.  Do not exceed 4000 IU per day unless directed by a clinician as vitamin D is fat soluble and toxicity can lead to calcifications in the body.”

In order to make sure this is the right option for you, speak to a registered dietitian.

I think I may have S.A.D., what should I do?

Dr. Flamenbaum recommends getting a professional assessment before delving into the often risky world of self diagnosis.

“If someone came to me and told me they think they had seasonal depression, I would first do an assessment to determine the extent of their symptoms and the impact on their level of functioning. I would also get a detailed history to determine how recurrent it is; i.e. does it happen every winter?” says Dr. Flamenbaum.  “It’s also important to differentiate it from other forms of depression, including depressive reactions related to other factors (e.g., loss of job, relationship stress), as this would inform the focus of treatment and types of interventions that I would use. That’s why a full assessment would be important.”

When do you recommend booking a check-in with a physician or a psychologist?

“It’s always worth talking with a family doctor or psychologist, even if you are experiencing a milder version of seasonal depression,” says Dr. Rodrigues. “And it is definitely time to see someone if your symptoms or mindset are interfering with your daily life and affecting impact. A psychologist or other mental health professional will do a proper assessment and determine the best next steps for both immediate treatment and prevention in the future.”

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