It starts in the early fall. Suddenly going out on the town with friends doesn't sound as good as sitting at home on the couch. You're tired, a little more irritable than usual and maybe even sad. Instead of hitting the gym, you're now a regular at the donut shop and the pounds are piling on.
You've got the winter blues — and spring feels like it's a long way off.
For sufferers, January and February tend to be the months when this form of depression, clinically known as Seasonal Affective Disorder (SAD), hits hardest. Those battling a severe case can have trouble getting any work done. They completely withdraw from social and professional connections and may even watch their libidos crash.
"It's real misery," says Michael Terman, director of the Center for Light Treatment and Biological Rhythms at New York-Presbyterian Hospital and professor in the department of psychiatry at Columbia University in the College of Physicians and Surgeons. "It can be as bad as any depression."
What's behind it
Although no one is sure exactly what causes the disorder, it appears to be related to a lack of exposure to sunlight and tends to occur more often to those who live at higher latitudes where there is less wintertime daylight. Our genes also play a role in determining whether we're susceptible to depression and seasonal changes and, according to the American Psychiatric Association. Younger adults and women are thought to be at higher risk.
Terman estimates that up to 5 percent of the U.S. experiences severe SAD, another 20 percent faces a milder version of the winter doldrums and another 25 percent has a symptom or two but remains totally functional.
How to treat it
But thanks to years of research and numerous studies, there are several methods considered effective in treating SAD. These include bright light therapy, negative air ionization and even prescription drugs.
Light therapy involves exposure to a fluorescent lamp for 30 to 90 minutes a day. New devices called ionizers can be used to fill the air with negative ions, which have been shown to have an antidepressant effect in some people.
Before choosing though, experts recommend seeing a doctor, who can help determine if you have SAD and which therapy might work best for you.
"People may feel that they can just go online, get a device of some kind, do it themselves — and that that should do the trick," says Janis L. Anderson, director of SAD clinical services at Brigham and Women's Hospital for more than 10 years. Not so.
The problem is that light therapy boxes, for instance, aren't regulated, so it isn't always easy to tell what's safe and effective. If you decide to do it on your own, you should look for light boxes that have been tested in peer-reviewed clinical trials and have smooth diffusing screens, which filter out harmful UV rays, according to the educational nonprofit Center for Environmental Therapeutics.
Because each of us also has an individual time clock, people will benefit from light therapy at different times of the day and at varying doses, Terman says. For a small minority, for example, 30 minutes of bright light therapy can cause agitation and queasiness. A doctor with expertise in the field will be able to figure out what's right for you.
Simpler techniques that may help people beat this seasonal lethargy include sticking to a structured schedule, which includes spending part of the day out of the house, says psychologist John Grohol, founder of PsychCentral.com, a mental health information source. Exercise also helps treat depression by getting the blood moving and releasing endorphins.
Dr. Norman Rosenthal, author of Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder, says keeping a positive attitude can make a difference too.
Doing things you enjoy, such as seeing a friend, getting tickets to concerts and sporting events or going for a facial can quickly lighten up your day. Managing your stress level also is essential. If you're already feeling down, extra stress will only make the situation worse.
"Don't take on deadline projects that are geared toward March,” says Rosenthal, “if you're a person with this problem.”
Though most people battling SAD will begin experiencing relief around early spring, experts say silently suffering until then is a bad idea.
"If you're depressed, see an appropriate clinician to evaluate how you're doing," says Dr. Doug Moul, assistant professor of psychiatry at the University of Pittsburgh Medical Center. "It's a question of finding the right medication for the right person."