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Don't Let the "Winter Blues" Take Hold: There are things you can do to prevent seasonal affective disorder from affecting your mood.

If you feel sluggish and "down" when it's cold and damp outside, your symptoms may signal seasonal affective disorder (SAD), a type of depression that is triggered by the seasons, and manifests at about the same time every year. "After the switch to daylight savings time, as darkness falls earlier, people with this type of depression start to feel moody, anxious and lethargic," explains Dan Iosifescu, MD, director of Mount Sinai's Mood and Anxiety Disorders Program. Usually SAD improves by spring, but until the days get brighter there are self-help measures that can boost your mood.

What Makes You SAD? SAD is thought to be related to the pineal gland, which is located deep in the center of the brain and acts like a light meter, receiving ambient light via the eyes. Depending on the amount of light received, the gland releases melatonin: a hormone that helps regulate the body's day/night cycle by helping you go to sleep. "During the darker evenings of wintertime, more melato nin is released, and this disrupts the day/night cycle," Dr. Iosifescu observes. "This may result in a noticeable change in your mood, a greater need for sleep, and food cravings as you essentially go into hibernation phase."

Who is at Risk? Women are at more risk of SAD, possibly because their pineal gland is more sensitive to changes in daylight hours. You're also more likely to develop SAD if you live above the 37th parallel, which cuts roughly midway though the contiguous United States from west to east. People who live above the 37th parallel also are more likely to have lower vitamin D levels, since vitamin D production in the skin is related to sunlight exposure--and vitamin D deficiency may contribute to the risk for depressive symptoms.

Elevating Your Mood If you suffer from SAD, get as much natural light as possible. "If you can, get outside and take a walk during the day, especially in the morning," says Dr. Iosifescu. "Several studies suggest that exposure to bright light in the morning helps the brain and body get ready for the new day." Indoors, position your favorite seat near a south-facing window if possible, and consider replacing the light bulbs in the rooms where you spend most time with brighter "full-spectrum" light bulbs. These are more expensive than regular light bulbs, but they provide a light similar to natural sunlight.

Light therapy is an effective treatment for SAD, so you also may want to consider purchasing a light box. Available over-the-counter at many drugstores, and also online, these emit a glow that mimics outdoor light and is believed to cause chemical changes in the brain that lift mood. "Select a model that is designed specifically for treating SAD, since these filter out most UV light, which can cause eye and skin damage," Dr. Iosifescu says. "The intensity of the light should be at least 10,000 lux." A light box is typically used for about 30 minutes first thing in the morning after you wake. If you can't commit to that kind of routine, a light visor may be the best solution. These resemble baseball caps or visors, and are comfortable to wear.

Another kind of light therapy is called a "dawn simulator," and is activated by a timer. It is set up in your bedroom to mimic a natural sunrise, turning on early in the morning and gradually increasing in brightness so that you wake up naturally, without using an alarm.

Stay on Schedule Although it may be difficult to do during the winter months, maintaining your schedule and lifestyle will help to keep depression at bay. Dr. Iosifescu notes that SAD is often associated with excessive sleeping, so try to stick to a regular pattern of sleep. "If you don't have a dawn simulator, it may be helpful to have your bedroom lights on a timer to turn on a half-hour before you get up," he advises. "This may help when it comes to waking at a regular time every morning, when it is still dark outside in the winter months. Once you rise, immediately open the curtains in your bedroom to benefit from what light there is."

If these measures don't relieve your depression, talk to your doctor. Several antidepressants, including a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs, such as fluoxetine or sertraline) as well as bupropion, have been shown to be effective in SAD, and some people need a combination of light therapy, medication, and psychotherapy to treat their winter blues.

Caption: People living in areas above IP the 37th parallel are more likely to suffer from seasonal affective disorder.
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Publication:Focus on Healthy Aging
Date:Dec 1, 2017
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