The mornings are dark and cold, and evenings
seem to come ever earlier. It is no surprise that few relish the gloom of the
UK winter, when many of us will see no more than a few hours of natural light
So spare a thought for the four million Britons who have to contend
with the symptoms of seasonal affective disorder (SAD) including depression,
lethargy, concentration problems, insomnia and even aching joints as a result
of the change of seasons.
Once dismissed by medics, the condition is now recognised by
psychiatrists and GPs and there are many treatments available on the NHS.
But experts believe that because the symptoms are similar to other
illnesses, it is often undiagnosed leaving sufferers struggling to cope.
'Light has many physiological effects on the body,' says neuroscientist
Professor Russell Foster, of Oxford University.
'Cells in the eyes register light so the brain knows when it is day or night.
This triggers the release of certain hormones that regulate hunger and
digestion, growth, mood, and energy.'
Darkness causes an increase in the production of the hormone melatonin,
which helps us to sleep. There is also a reduction in serotonin, crucial for
keeping us alert, and often called the feel-good hormone, which also regulates
the digestive system. Light triggers the release of cortisol, which helps us
'If you drive to work in the dark, spend all day indoors in artificial
light, and return in the dark, your internal body clock has nothing to lock
onto and normal rhythms can be thrown,' says Prof Foster, who recommends you
should experience two hours of natural light a day, even if it's via a large
As the symptoms of SAD are similar to those of anaemia, underactive
thyroid and even heart failure, it is often hard to diagnose.
The only specific criterion is the seasonal nature of the
Dr Tom Henderson, a GP in Cambridgeshire, says: 'There is no specific
test for the condition. We diagnose it after ruling out any other underlying
conditions, and patients need to have suffered symptoms for three years, two
consecutively, and with remission in the summer.'
But is it over-diagnosed? Are there people feeling a bit low who may
erroneously believe they have SAD?
'Yes,' says Dr Henderson. 'I get patients who suggest they have it. In
fact, they're just a bit miserable. There is a difference between winter blues
- which most of us get to some extent - and full-blown SAD.
Likewise, I am sure there are many patients who have been wrongly
diagnosed with something else, when in fact they have SAD.' Dr Deenesh Khoosal,
of the Royal College for Psychiatrists, agrees: 'There will be some people who
say it's all in the mind and that sufferers should snap out of it, but it is
now accepted as a genuine condition.'
For James Langley, 37, a diagnosis of SAD from his GP last autumn
explained the curious, and sometimes crushing, mental and physical symptoms
that he had come to dread every winter over the past two decades.
When he left school at 17 he worked in a high-pressure sales job. 'That
autumn I began to feel sluggish and lethargic. I knew I wasn't
functioningproperly, but I didn't know why. I felt the clouds were closing in
In his early 20s he saw a GP who told him he was simply stressed. 'I
went on holiday and came back feeling much better. I now realise that it was
the sunshine that perked me up, rather than the time off work.'
Counselling was offered, but James dismissed this. 'I was convinced that
my problem was purely physical and not depression.'
But by his late 20s, James had accepted that winter was a difficult
time. 'I find it very hard to concentrate at work, despite loving my job,' he
says. 'By nature I'm social, but I yearn to stay in and eat junk food.'
Even his relationships are affected. 'I am usually single in the winter.
By Christmas I just want to be on my own and hibernate.'
Despite running a property and art-buying business, James, from West
London, admits winter is a struggle. Last autumn his GP ran tests to ensure
there was nothing more sinister occurring.
'He couldn't find anything wrong, and suggested it could be SAD. My
initial feeling was one of relief - partly that there was nothing physically
threatening - and also because I knew what I was dealing with.'
Government advisory body the National Institute for Clinical Excellence
now classifies SAD within its guidance on regular depression. They recommend
counselling and antidepressants.
At the suggestion of his GP, James bought a light box which he put in
his office and used daily.
'Light boxes are medical devices,' says Jill Laughlin, of light therapy
specialist Lumie. 'Natural light is made up of a spectrum of colours, from red
to blue, although this is perceived as white. Normal household bulbs emit a
narrow spectrum yellow light. Light boxes emit a broad spectrum similar to
daylight.' Depending on the size of the box and the distance you sit from it,
patients need to spend from 30 to 90 minutes a day in front of it. The theory
is that this is enough to 'trick' the hormonal system into thinking it's
James has also been undergoing treatment called Real Sunlight, which is
available at the Wholistic Medical Centre on Harley Street, London.
'It's a room containing five vast light boxes fixed to the ceiling. The
idea is that it's relaxing - like a holiday - so the room has two sun loungers.
It's decked out like a garden, with forest-patterned wallpaper and it has green
flooring. There's even a small fountain,' he says.
The bulbs used have been designed to be as close to real sunlight as
possible, and treatment costs £50 for one hour. You can even wear sunglasses
and choose your sunny location. The UVA and UVB emissions are filtered to safe
'My favourite is Miami, which is bright sunlight, but you can also have
the more relaxing sunset mode,' says James. 'I've been four times. It has
definitely perked me up.'
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