The cold temperatures of winter tend to keep us indoors, but this year, so is the added threat of COVID-19. Outbreaks are likely to get worse as the virus is more easily spread indoors. In the meantime, you may feel pandemic fatigue External Site after months of social distancing, mask wearing and limited activities. This may leave you feeling isolated, unmotivated and burnt out.
The good news is a vaccine is on the way. In the meantime, however, experts have warned us to be prepared for a difficult winter. Health professionals are also concerned about the mental health consequences. At the height of the COVID-19 pandemic, U.S. adults reported depressive symptoms External Site three times higher in April 2020 than what was recorded pre-pandemic. Plus, the lack of connection with the outside world may feel especially difficult if you are working from home. You may also suffer from seasonal depression, also known as Seasonal Affective Disorder (SAD) External Site, during the cold, short days of the winter months.
What is seasonal depression, or SAD?
People with Seasonal Affective Disorder (SAD) report feelings of depression only during the winter months. This could include loss of interest in activities you once enjoyed, difficulty concentrating, fatigue, sluggishness, and in extreme cases, thoughts of suicide or death. With SAD, the short days and long nights of winter may also bring cravings for certain foods, headaches and sleep problems.
Experts estimate six percent of Americans External Site, primarily in northern climates, suffer from Seasonal Affective Disorder, and another 10–20 percent may experience more mild cases.
Researchers aren’t clear exactly what causes SAD, but many factors may play a role, including genes and stress. What makes SAD unique is the link to sunlight. Researchers believe the reduced number of daylight hours during the winter months interrupts the body’s circadian rhythms External Site, which help regulate the body’s internal clock, and let us know when it’s time to sleep and time to wake.
Yet other research has shown that people who are depressed have decreased levels of serotonin, a brain chemical that seems to be triggered by sunlight. The lack of serotonin may cause winter depression. The change in season can also disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood.
The most difficult months for SAD External Site sufferers are January and February, and younger people and women are at higher risk. This year, feelings of SAD may be intensified by surges in the pandemic.
According to Tim Gutshall, vice president and chief medical officer at Wellmark Blue Cross and Blue Shield, "SAD is a recurrent seasonal issue. So, if you're feeling depressed in the winter during a pandemic, it doesn't necessarily mean you have SAD. The first step is to talk with your doctor, whether that be through a primary care appointment, virtual visit, or an appointment with a behavioral health professional."
How to ease symptoms
In addition to speaking with a health care provider, try these simple tips at home to ease mild SAD symptoms:
- Increase the amount of light in the home. Pull back the curtains, open the blinds, remove the screens and wash the windows.
- Get outdoors. Sure, it’s cold, but bundling up and walking outdoors on sunny winter days can do wonders for the mood.
- Wake up to a dawn stimulator. Instead of an alarm clock, a dawn stimulator uses lights that gradually brighten like the sun.
- Do some self-care. Exercise regularly, eat healthy and maintain a regular sleep schedule.
- Stay connected to loved ones. Stay socially active via phone calls, Zoom calls, and other remote ways to connect.
A light on the horizon
For many people, SAD symptoms improve with the use of light therapy External Site. With this treatment, a sun lamp mimics the light intensity from the outdoors. This simple, effective therapy helps the body regulate serotonin and melatonin levels External Site.
A prescription is not necessary for a sun lamp, and they are available at many retail stores and online, with a variety of price points. Health insurance plans do not cover the cost, and sun lamps are not approved or regulated by the Food and Drug Administration (FDA).
Choosing a sun lamp
There are several names for the devices that provide light therapy: light boxes, sun lamps, bright light therapy or phototherapy. Despite the various names for the devices, all SAD treatment is designed to do the same thing. However, one device may work better for you than another. To make sure you purchase the right lamp, here are a few things to consider:
- Talk to your doctor or therapist for a recommendation. There may be side effects to using light therapy if you have certain conditions, like bipolar disorder, glaucoma or cataracts. So be sure to talk to your doctor or therapist to be sure you are purchasing a lamp best suited to your needs.
- Follow manufacturer’s instructions. Most recommend sitting in front of the lamp when you wake up each day for about 20 to 30 minutes, with the light about 18 inches from your face. Eyes should be open, but you should not look directly at the light. Just be sure to follow the instructions that come with your device. If you have questions, call the manufacturer or talk to your doctor.
- Make a plan for using the box. Light therapy works best when you do it daily. Therefore, it’s important to consider where you will use it, what type of light will work best for you, and what you will do during that time. For example, will you spend that time reading or working? It's important you're able to easily incorporate light therapy into your routine.
- Get the right brightness. The brighter the box, the less time you will need to spend in front of the lamp. Look for a lamp with a minimum brightness of 2,500 lux (a unit that measures the intensity of light hitting a surface). Most experts recommend brighter boxes, with exposure of up to 10,000 lux of light.
- Avoid ultraviolet (UV) light. Some light therapy lamps treat skin disorders like psoriasis, eczema or acne. These types of lamps give off UV (ultraviolet) light, which can damage eyes. Be sure you purchase a lamp for SAD treatment, which should filter out most or all UV light.
If you use light therapy consistently, you may start to see improved symptoms within just a few days. In some cases, it will take as long as two weeks to notice a difference. Some people need light therapy twice a day to see results. In any case, if your symptoms continue, be sure to talk with your doctor.
Try a virtual visit for SAD
If you have a tight schedule, are juggling kids, or live in areas where care isn’t widely available, you may want to talk to a virtual doctor about your symptoms. A virtual doctor is just like any other board-certified physician — you just receive treatment via phone, tablet or computer. Virtual visits are more common than you might think. In fact, Wellmark Blue Cross and Blue Shield saw a 3,000 percent increase Opens New Window in virtual visits for behavioral health-related use during the start of the pandemic in March.
For more information about mental health, including how to start therapy and treatment options for anxiety and depression, check out all our mental health stories here on Blue.