Life Kit - How to cope with seasonal affective disorder (SAD)

Episode Date: December 21, 2023

It's getting darker and colder, and there's still a pandemic. Oh, and then there's seasonal affective disorder. Here's how to spot it and what you can do. (This episode originally aired in October 2020.)Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Hey everybody, it's Marielle. Seasonal affective disorder may not be your typical inspiration for a song, but when Maya was a teenager, she was trying to understand her feelings. Seasonal depression's got me sleeping off the days And we've wasted all our time feeling great That's Maya, who also goes by the name MXM Tune. She's a singer-songwriter from California. She doesn't use her last name publicly to protect the privacy of her family.

And I was feeling sad, looking outside, seeing that the weather was really bad and that it was dark outside, like just lying there for hours and hours, not knowing how to get out of bed and move or do anything. And it just makes it really difficult to do basic normal things, like getting up and going to eat a meal or going to drink water or even using the bathroom. And she wrote that song when she was a teenager, trying to understand her dark feelings during the winter. Being 16 at the time, Maya turned to social media. I went on Twitter and I was like, am I crazy?

Because I feel really sad right now and the weather went on Twitter and I was like, am I crazy? Because I feel really sad right now. And the weather is really horrible and I don't like it. And people are like, that sounds like you have seasonal affective disorder. It's like sad and you should look into it. So I talked to my parents. They're like, yeah, that's also something that I experience and go through and talk to my friends and like, yeah, it's also something that I go through. And I just realized that everybody feels horrible weather outside also makes you feel horrible inside. And so that's how I kind of discovered it. On this episode of Life Kit,

we are talking about seasonal affective disorder or SAD. It's a type of depression that's related to the change in seasons. Maybe you've never put a name to why come winter, you just wanted to stay under the covers all day, or you didn't want to meet friends, or just felt like you were in a fog, reporter Kavitha Cardoza is going to explain why you might feel this way and share some simple ways to feel better and more like yourself.

Before we get back to the show, the end of the year is coming up, and we're reflecting a little bit here at LifeKit. We have loved bringing you episodes throughout 2023 about things like how to save money on groceries and how to start running. And we're excited about everything we're going to our LifeKit Plus supporters and anyone listening who already donates to public media. Your support makes independent and accurate journalism possible. We prioritize facts, context, and different perspectives, and we're beholden to no one except you, the public. Your support ensures that everyone has free access to reliable news and podcasts, including people who can't afford to give this season. And to anyone out there who isn't a supporter yet, right now is the time to get behind the NPR network, especially with newsrooms gearing up for an important election

year. Supporting public media now takes just a few minutes and makes a real difference in what's possible moving forward. So join NPR Plus or make a tax-deductible donation now at donate.npr.org slash life kit. And thank you. Dr. Norman Rosenthal is a clinical professor of psychiatry at Georgetown University School of Medicine. Years ago, he noticed feeling less energetic during the winter and began studying the problem in others who said they felt the same way. Just like the autumn leaves, they became depressed on schedule, people getting less energetic and feeling worse as the days got shorter. And then in the spring, all of that being reversed. So it seemed like quite a distinct syndrome. And that was our first study of seasonal affective disorder, which is what it became known as.

He found about one in 20 people in the U.S. has seasonal affective disorder or full-blown winter depression. Feeling sluggish, depressed, oversleeping, overeating, you may gain weight and be disinterested in doing things you previously enjoyed. Many more have the winter blues, a milder version where you feel like basically a sadder, sleepier or slower version of yourself. One of Rosenthal's patients described themselves as feeling like a bear in the winter and wanting to hibernate. So if you feel any identification with a hibernating bear, think you might well have SAD. But in spring, those symptoms go away and you start feeling like yourself again. Women are about three times more vulnerable than men, and the condition seems to be more common in the northern hemisphere. Rosenthal says mood disorders were called affective disorders.

Affect is just another word for mood. And I thought, well, this is seasonal. And if we have seasonal affective disorder, it would be a snappy acronym, SAD. And that's what it's become known as ever since. So now we know what we're dealing with, let's talk about a game plan. Tickaway one is recognize your symptoms and their seasonal pattern. A funny, well, not so funny story. A few years ago, I called a friend in January. I was in tears and she said, I was expecting this. And I said, what do you mean? And she said, Kavita, you always call me crying in January. It shouldn't have taken me years to connect my sadness with the seasons.

Dr. Rosenthal says if every fall, when it gets darker earlier, you feel like things are getting more difficult. Ask yourself, does it get better in the bright days of spring and summer? And if the answer is yes, it's almost a diagnosis one can make on one's own. You probably have SAD. But a reminder, if you have any concerns, always consult a professional. Rosenthal says the change in seasons affect people along a spectrum, meaning some people don't feel different at all,

and some people are quite disabled by it. We've defined SAD as being people who would go to a doctor because the problem was bad enough. There's been a lot of scepticism over the years about whether SAD is a real disorder. Rosenthal says that's because it creeps up on you. For example, it might be a little bit serious in September and a little worse in October and a little worse in November. It's a little bit like the story of the frog in the bowl that keeps getting warmed up and he doesn't really realize that he's going to die of overheating because it happens so incrementally. That's how it is with SAD and the winter blues. But he says recognizing your

symptoms and taking them seriously is critical because SAD can be debilitating or worse. Takeaway two is let there be light because light and not getting enough of it is at the heart of this disorder. Light is the main cue for when to wake up and when to sleep. It kind of acts as a universal synchronizer between all life. We'll talk more about that in a second. It turns out that a fundamental part of the physiology of this condition is that some people just need more light. They don't seem as sensitive to light as other people. One often recommended fix for this is a sad lamp. Rosenthal says these lamps generate light that's far more intense than indoor lighting, about 10,000 lux, a measurement of light. I like fixtures that

are a little larger. For example, maybe one foot by one and a half feet. One foot up and down, one and a half foot across. He says this light is absorbed through the eyes, not the skin. And I never stare at the light. It's always coming down a little bit from an upper angle. I like the boxes that transmit the light downwards because that's how we evolved to see light, with the heavens above and the sun shining down so that it comes and hits the bottom part of our retina. The morning is often the best time and the earlier the better. He says if you use the lamp for about 20 to 30 minutes a day, you should feel a difference within

two weeks. If you don't, return it. Recent studies suggest that the value of preventative light therapy is inconclusive. It's really a patient's preference whether to use it or not. But Rosenthal says it's still a common treatment for those with SAD, because for some, SAD lamps can make a big difference. Like Isabella Harris, who's known as is in the vlogging world and lives in Virginia. She experiences SAD as general like fogginess and sleepiness. Most people go about their day normally with indoor lighting, but for people with SAD, that indoor lighting is the equivalent of darkness.

Is bought a SAD lamp, as they're known, and the result was night and day. It's like what someone feels like when they jump into cold water. And it brings you to like a sharper alertness. If I come in like feeling a bit foggy headed, I'll turn it on. And it functions a lot like taking a walk outside. It's like allowing my brain to wake up a little bit. And that's probably not the clinical term, but it feels like it's like waking up. She's used this special sad lamp for eight years. And on the days that I don't, I notice a significant difference in, you know, irritability, in kind of just general hopelessness,

and definitely energy levels. And even if you do use a sad lamp, make sure you're still trying to get as much natural light as possible. Go outside even if you don't feel like it. Even when it seems overcast, you're still getting light from the sun. And remember, small things can make a difference. So trim any overgrowth around your windows and clean the panes. Tickaway 3 is being thoughtful and consistent about what you eat. Dr. Rosenthal says people with SAD have a tremendous craving for carbohydrates. They crave sweets and starches. And needless to say, that puts on weight.

And they can't always take it off in the summer. So every year they're ratcheting up a little more, a little more, and it's a real problem. Emily Mnookian is a PhD and clinical researcher at the Salk Institute for Biological Studies. She says it's not just what you eat and how much, but when. To understand this, we need to talk about circadian rhythms. Circadian is just Latin for about a day. And so when we talk about circadian rhythms, it's referring to these 24-hour rhythms that we have within our body and kind of throughout biology. Think of every cell and system in your body as having a tiny clock. And each of these tiny clocks are on approximately 24-hour cycles.

So a master clock in your brain has to coordinate and make sure they all work together. This circadian system essentially signals your body what time of day it is, what time of year it is, and helps match your behavior with the environment. Manoukian says people with SAD usually have a sort of delay in their circadian rhythm, meaning something's a little off. It might really be getting at that they're having a harder time coordinating their internal rhythms with the environment. And so as you start to not be able to re-sync every day,

that can lead to kind of this misalignment of my body doesn't think it's time and now I'm forcing it to wake up. Manoukian says just like light, food is a strong environmental signal. If you're eating, your body thinks it should be awake. Eating is the biggest cue to your digestive system, to the rest of your body. So what does this have to do with SAD? She says when days get shorter, eating or not eating is a good way to signal all those tiny clocks. Being able to coordinate your internal clocks with your environment can kind of help ease any burden that changes and seasons might have. Make sure to stop eating three hours before you go to bed so your body knows it's time to rest.

By just controlling the time that you eat and say keep it to a consistent 10 to 12 hours every day, you're now giving your body a really strong cue to tell at the time of day that it is, regardless of anything else that's going on. Takeaway four is get some exercise. Emily Mnookian says like light or food, it's another environmental cue that helps signal all those internal clocks what time it is. There's a lot more data coming out now on how physical activity actually affects your clocks and how that feedback feeds back on the master clock in the brain

to be able to kind of coordinate your system. She says physical activity is a cue that says, wake up. And so by doing things like exercising, you know, during the active time of your day can actually help your body again, know kind of what time of day it is, coordinate, you know, during the active time of your day can actually help your body again, know kind of what time of day it is, coordinate, you know, using all that energy and, you know, stimulating the brain to be awake to the right time of day, and then allowing your body to really rest in the evening. Really controlling those external cues allows your body to really respond to the environment much better. If you work out indoors,

Rosenthal says make sure you put on that sad lamp for a twofer. I never work out indoors during the winter without having my light box on. And I would encourage other people, especially those with this problem, to do the same. He says when it's cold and dark and you don't feel energetic and aren't active, it's a vicious cycle. You don't feel like getting up in the morning, so you pull the covers over your head, so you get less light, so you feel more depressed, so you feel even less like getting up. Whereas if you force yourself to get up, then push yourself to do all these things, then you can feel much, much better. And feeling much, much better is the goal.

Takeaway five is to reduce stress. You may want to decorate a room with bright colors and photographs that make you smile. You may want to see a therapist and talk through how you feel. You may want to try meditation. Rosenthal says the effects of practicing meditation and SAD haven't been fully studied yet, but he believes it can help. What meditation does is it de-stresses you. He says seasonal affective disorder has three main causes. There's a genetic component, a lack of light component, and there's stress. Stress is going to bring out the symptoms because if you didn't have anything you had to get up and do and you could lie around, it wouldn't emerge in such a symptomatic way. But it's when you've got things to do and you're feeling down and not thinking straight and not feeling effective, that's when you can really feel most depressed.

So anything that reduces stress, which meditation can do, can make a better adjustment to the winter. Another thing you can do is make pleasurable plans. It may need a little more creativity because of the coronavirus, maybe painting or dancing or meeting a friend. Because sometimes when you plan to do something enjoyable and you make yourself go through with it, in spite of everything, you find yourself having a wonderful time. Maya says she doesn't wait for occasions like a birthday or holidays to do something special. I think as people, I know for myself at least, I spend so much time waiting for other people to give me permission to be excited about things. And I think that the moment where we can kind of choose to make our own calendars and schedules something

that genuinely will bring us joy is a really big changing point. She celebrates the little things. And so I try and make myself have things to look forward to, whether it's like baking a pie on the weekend or drinking a cup of tea every single day. And that fuels me a little bit more and feeds me as a person when I'm not able to go outside and feel fed by the world. For Maya, an important form of self-care is songwriting. And a few years ago, she released Seasonal Depression as MXM tune. I just don't see a whole lot of sun. And lately I just can't seem to have any fun.

She also accepts that for her, winter will never feel like summer. I think that's been something that I've also reminded myself, is that it's just an indication that the year is passing by and that's okay. And reminding yourself that everything is cyclical and, you know, it's bad right now, but it will be good in the future. Seasonal depression's got me sleeping off the days And I've wasted all my time feeling gray We haven't talked about medications, mostly because, well, we're not doctors. But Dr. Rosenthal, who is, says a lot of people do really well following these simple measures.

But if you don't find yourself feeling better or sad as interfering with your personal relationships or work, he says medication can be very effective. Keep in mind, none of this will make the disorder go away. But as Rosenthal puts it, It's not a cure, but it's like if you do all the things I've said, then sometimes the SAD dies of neglect. All right, so let's recap tips for managing your sad symptoms and not being a bear this winter. Takeaway one, recognize your symptoms. I think that for me it always started with a decrease in energy and a general hopelessness. Takeaway two, get some light. A sad lamp can be very effective.

Some people just need more light. They don't seem as sensitive to light as other people. Takeaway three, be thoughtful and consistent around what and when you eat. Stop eating three hours before bedtime is a good rule of thumb. Okay, takeaway four, exercise even if you don't feel like it. Really controlling those external cues allows your body to really respond to the environment much better. And finally, takeaway five,

reduce stress. Make plans you can look forward to. And remember, they don't have to be grand plans. So I try and make myself have things to look forward to, whether it's like baking a pie on the weekend or drinking a cup of tea every single day. That was reporter Kavitha Cardoza. For more Life Kit, check out our other episodes.

We've got one on how to start therapy, another on how to give advice, and lots more. You can find them at npr.org slash life kit. And if you love life kit and you just cannot get enough, subscribe to our newsletter at npr.org slash life kit newsletter. Also, we love hearing from you. So if you have episode ideas or feedback you want to share, email us at life kit at npr.org. This episode of Life Kit was produced by Andy Tegel. Our visuals editor is Beck Harlan. And our digital editor is Malika Gharib. LifeKit at NPR.org. This episode of LifeKit was produced by Andy Tegel.

Our visuals editor is Beck Harlan, and our digital editor is Malika Gharib. Megan Cain is our supervising editor, and Beth Donovan is our executive producer. Our production team also includes Audrey Nguyen, Claire Marie Schneider, Margaret Serino, and Sylvie Douglas. Engineering support comes from Gilly Moon and Phil Edfors. I'm Mariel Seguera.

Thanks for listening, and I hope you're able to feel a little less sad this winter.