The idea that our mood can darken in the dark winter days has been around for millennia.
The coldest months of the year were a terrible time for the Greek Gods: Persephone was banished to the underworld every winter, while Boreas ushered in the cool winter winds and his nasty temper. Later, Shakespeare wrote, “a sad tale’s best for winter.”
Well, bring on the sad tales, because the darkest day of the year is here. On December 21, people in New York will get just over 9 hours 15 minutes of sun, while in Anchorage, Alaska there’ll be fewer than 5.5 hours.
Although there’s medical debate around Seasonal Affective Disorder (SAD), most people feel a little down in the winter months — it’s a time of year when depression rates spike (though suicides don’t).
So here’s what to know about the various types of winter blues, and how to counteract them.
A correlation between lower latitudes and less seasonal sadness
The idea that darker days could make a portion of the population susceptible to depression wasn’t picked up by modern clinicians until the 1980s, when South African psychiatrist Norman Rosenthal moved to the US and noticed a change in his mood during the New York winters.
He wondered whether darker days explained why he felt more glum and low-energy.
Rosenthal put the question to the masses in the Washington Post in 1981, saying he wanted to hear from anyone who felt sad in the wintertime and had “gone through enough cycles to know that this is going to happen again.”
The results of his subsequent telephone surveys showed a clear correlation between lower latitudes and sunnier dispositions. Only about 1% of people living in Florida reported experiencing winter sadness, Rosenthal found, while nearly 10% of those in places like Alaska and New Hampshire said they were feeling down.
Rosenthal also found that women between the ages of 20 and 40 were twice as likely to have seasonal blues compared to men. He hypothesized that may have to do with the hormones estrogen and progesterone.
Rosenthal’s new term for this seasonally-linked depression, Seasonal Affective Disorder (SAD), was first included in the DSM — the go-to-guide for psychologists and mental health experts — in 1987.
According to the DSM, people who have SAD are excessively fatigued, lose interest in their hobbies, tend to crave more starches and sweets, may gain seasonal weight, and have difficulty concentrating during darker months.
If you suspect you have this type of depression, it’s best to see a professional — don’t try to diagnose it on your own.
But is SAD a real thing?
Recently there’s been some debate about whether SAD deserves its place among other disorders. Psychologist Steven LoBello published a study of nearly 35,000 Americans in 2016 that found no variation in their depression that could be explained by latitudes or seasonal changes.
“The belief that winter is a cause of depression, sadness, ‘the blues’ is very widespread in western culture,” LoBello told Business Insider. But just because we believe we have SAD, he said, doesn’t mean we actually do.
LoBello’s study, however, didn’t rule out the possibility that major depression with seasonal variation exists for a very small portion of the population.
That’s an assessment other clinicians largely agree with. Kelly Rohan studies adult mood disorders and SAD therapies at the University of Vermont. She said estimates that suggest up to 10% of people in places like Alaska have SAD are likely due to overstated self-reports.
The real number of people with SAD is probably between 1-2%, she said.
“It’s going to be a pretty pervasive mood state that is going to affect the person for four to five months of the year,” Rohan told Business Insider. “It’s not going to wax and wane depending on what’s going on at work.”
What you can do about SAD
There are at least three ways that people who’ve been diagnosed with SAD can combat the problem.
Light therapy boxes
Artificially adding some bright light to the dark days via a light therapy box (some people call these “happy lamps” or phototherapy boxes) can help — when the tool is used regularly and as prescribed. The boxes are meant to mimic natural, outdoor light, and researchers believe they can cause some chemical shifts in a depressed brain. Most such devices emit more than 10,000 lux (for comparison, a typical house lamp emits around 50-80 lux, and office lights about 500 lux).
Good light therapy boxes are designed to filter out damaging UV light; however, these are not FDA-regulated so it can be tricky to find a reliable one.
The bulbs, which are usually white florescent and may carry the full spectrum of light, can also come with other side effects like mild sunburns, eye strain, and migraines. On the more serious side, some research has suggested the lights can increase thoughts of suicide or trigger mania.
The Mayo Clinic says the lights should be used in the morning, and patients should spend around half an hour in front of their lights after waking up. But again, it’s not a device that should be self-prescribed.
“Just because you can walk into Costco and buy one doesn’t mean that you should,” Rohan said.
Because SAD is a form of depression, antidepressants that increase serotonin in the brain and pharmaceuticals that treat major depressive disorders — particularly Bupropion, or Wellbutrin XL — have also been shown to work.
Cognitive Behavioral Therapy
CBT is a form of talk therapy that’s meant to change a person’s patterns of doing and thinking. Rohan said that with this approach,”we’re working with a person to identify negative thought patterns and habits” and then break them.
For example: “If the person is having the repetitive thought of ‘I hate winter,’ we might change that to ‘I prefer summer to winter,’ which is more of a neutral thought,” she said. Unlike light therapy, which is palliative (meaning you have to keep doing it to reap the benefits), CBT can have a lasting effect, so the treatment is a more long-term solution, Rohan said. Startups in Silicon Valley are even working to bring this kind of talk therapy to the masses with inexpensive texting apps and chatbots.
What to do about winter blues, even if you don’t have SAD
Some clinicians refer to the sub-syndromal type of winter blues as “S-SAD.”
Regardless of the official designation, there’s little doubt that seasonal changes impact our routines. A November 2017 study looked at the cell phone use data from 1 million people who lived in densely packed, artificially lit European cities. The researchers found that people were up and on the phone well past 11 or 11:30 p.m. in the summer months, while in the winter, they stopped gabbing by 10:30.
Here are some things that can help if the darkness makes you feel down.
Go for a walk first thing in the morning, just after the sunrise.
“Light therapy is based on the theory that the biological clock becomes sluggish in the wintertime due to later dawns,” Rohan said.
With a morning walk, you’re getting aerobic exercise (always helpful for mental health) while the natural light helps jump-start your circadian clock.
Don’t shift your routine to the couch.
The fact that it’s dark and cold at the end of a work day isn’t a good reason to ditch your gym routine. Keep staying active, and if you enjoy winter sports, bundle up and get out there.
Make an effort not to change your activity level too much.
During the darker months, continue seeing people, making dates with friends, and keeping appointments. You could even take a cue from the Swedes, who deal with their 24-hour dark days by celebrating ‘mys‘: an annual winter tradition of getting cozy, relaxing with friends, and eating delicious food.