As fall and winter bear down on us, many people begin to dread the disappearance of daylight and the five months of cold, dark days that follow. At northern latitudes, many people experience a lower mood, irritability, decreased energy, and changes in appetite, starting around now and lasting until spring. About 10 percent of people in northern states experience full-blown Seasonal Affective Disorder (SAD), with depressed mood, anxiety, irritability, fatigue, carbohydrate-craving, and weight gain or loss. Another 30 percent experience sub-syndromal SAD, a low-grade version of seasonal depression. Last month we reported on the benefits of using light therapy to help to boost mood in the fall and winter. I have recommended light therapy for many of my clients, with good results. However, I find it works best when combined with other approaches.
THE DETAILS: Some recent research supports a combination approach to managing seasonal depression. A study published last month in the journal Behavior Therapyby University of Vermont psychologist Kelly Rohan, PhD, found that combining light therapy with cognitive-behavioral therapy (CBT, which focuses on observing and changing your own thought patterns) worked better than using either therapy alone. She found an 80 percent remission rate for patients treated with combination therapy, compared with 50 percent when a single therapy was used. (Only 20 percent of patients who weren't treated at all saw their symptoms abate.) In a second study, she found that one year later, 36.7 percent of the SAD patients treated with light alone suffered a recurrence, compared with only 5 percent treated with both light and cognitive-behavioral therapy. Interestingly, only 7 percent of patients treated with cognitive-behavioral therapy alone experienced a recurrence.
WHAT IT MEANS: Light therapy is effective for many people who experience winter depression. However, it is not the only effective approach, and by itself it may not produce the longest-lasting results. Whether you experience serious depression or a bit of the blues when the days become shorter, learning to observe and change your thinking and behavior can be invaluable in lifting your mood. And using other tools to help will likely improve your odds of feeling brighter.
Here are some ways to keep the dark days of winter from dragging down your disposition:
Make your seasonal mood-boosting plan now, before the shortest, darkest days of the year are upon you. Your plan should include multiple mood boosters, including exposure to sunlight, exercise, social contact, and constructive attitude adjustment. As you find which strategies work best for you, build those into your life. For instance, some people find a midwinter trip to a sunny climate helps them make it through the season. Others find their salvation on the ski slopes or at the gym, or in coming together with friends and family.
• Let there be light! Getting exposure to sunlight can be a powerful way to boost your mood. In fact, on a sunny day, the brightness outdoors is many times greater than the light emitted from a high-intensity light fixture. If you can go out for a walk when the sun is out, put on your overcoat and get outside. Don’t be daunted by the cold, but do bundle up so you'll be safe and comfortable. Treat yourself to the things that help you get out-of-doors on a cold but sunny day: a new, warm coat; snow boots; thermal underwear—whatever it takes.
• Buy some bulbs. When you can't get any outdoor light, a high-intensity indoor light fixture can help. You don't need to buy a full-spectrum bulb; just use standard CFL bulbs with a color temperature of 4100 Kelvin. If you have the budget, you can try using a light box, which is designed to provide therapeutic doses of light to SAD sufferers.
• Get moving! Boosting your exercise in the winter can provide a powerful lift to your mood and your energy. If your climate or job makes it difficult to be active outside during the day, find ways to work out at home or in the gym.
• Eat for energy throughout the fall and winter, combining lean protein and complex carbohydrates in your meals. Limit your consumption of alcohol, sugar, and high-fat foods, all of which may temporarily lift your mood but then leave you feeling tired soon after.
• Change your thoughts. Learning to think less negatively will help improve your mood. If you notice yourself feeling less peppy or enthusiastic during the winter, you can accept that feeling as a normal response to the dark and cold of winter without getting down on yourself about it. You can also respond to negative thoughts like "I hate winter," and "I can’t deal with this," or "Winter is never going to end" with "I know what to do to feel better" and "Winter is a challenge, and I become stronger by meeting the challenge."
• Reach out. When the world seems colder and darker, your connections with friends and family can supply the love, warmth, and stimulation to help sustain you.
• Reach in. Your inner life can be a source of vitality and inspiration when the natural world is gray and seems dormant. Prayer, meditation, inspirational reading, and religious observation provide inner light that can illuminate your journey through the darker days of fall and winter.
• Get help. If you are experiencing significant seasonal depression or have a recurrent pattern of seasonal depression, you may benefit from consulting with a psychiatrist, psychologist, clinical social worker, or mental health counselor who specializes in treating mood disorders. You can find a qualified practitioner by contacting your local mental health association, or the behavioral health department at a medical center in your area. You can find more information about SAD and light therapy from the Center for Environmental Therapeutics.
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