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Simple steps to beat the winter blues; FROM TREATMENT OPTIONS TO DIET AND LIFESTYLE TWEAKS, ABI JACKSON TALKS TO LEADING EXPERTS ABOUT MANAGING SEASONAL AFFECTIVE DISORDER.

DOES the onset of winter fill you with dread - because it's not just the skies that'll be turning dark and gloomy, but your mood too? While a touch of winter blues is quite common, full-blown seasonal affective disorder (SAD - a recognised form of clinical depression that occurs as a response to less light exposure during wintertime) is relatively rare and can be majorly debilitating.

"We think about 3 to 8% of the UK population suffers with SAD," says Dr Balu Pitchiah, SAD specialist and consultant psychiatrist at The London Psychiatry Centre (psychiatrycentre.co.uk).

"But there is something called subthreshold SAD which affects about 20% of the population," he adds, referring to people who may experience symptoms but to a more minor extent.

The key factor in SAD is the clear seasonal pattern. "We usually find people get symptoms of depression throughout the winter months, but mostly from September to March or April," says Dr Pitchiah.

Generally, this means things like consistently low moods and sense of hopelessness, loss of interest and motivation - but often with the addition of sleeping much more than usual and increased appetite, particularly cravings for "sugary, fatty, carbohydrate-rich foods".

Stuart Haydock, a clinical psychologist at Bupa (bupa.co.uk), says people might also "have trouble staying connected to family and friends".

Dr Pitchiah adds that "research shows people with SAD have a slightly different sensitivity to light, (so) they're predisposed to developing it".

That said, whether you have full-blown SAD or merely a touch of winter blues, there are lots of things that can help - and there is no need to battle on alone.

DON'T SUFFER IN SILENCE STRUGGLING with any symptoms of depression, but not sure whether it's full SAD? Dr Pitchiah says: "It's always useful to have a conversation with your doctor."

Getting help earlier can prevent SAD getting worse. If you don't have SAD, there might be something else going on that needs to be looked at.

"There are many interventions that can help, so why wait until things get worse? There's no harm in having that conversation - and your doctor might say, 'Just take a few precautions, make some modifications and let's see how things go'. Not everyone will need anti-depressants," Dr Pitchiah adds.

"Getting professional help when you need it is really important," echoes Stuart. "A GP will be able to look at someone's situation and suggest treatment options that are right for them."

WHAT ARE THE TREATMENT OPTIONS? SAD treatment options can include anti-depressants and cognitive behavioural therapy (CBT).

"CBT is one of the most successful talking therapies for depression and may help someone manage their SAD symptoms," notes Stuart. "It may even stop the symptoms coming back each year."

Other drug-free depression treatments, such as rTMS (Repetitive Transcranial Magnetic Stimulation), may be an option for some people - and of course, light therapy can be hugely helpful.

"Light boxes can be a very powerful and easy intervention. About 30 minutes to an hour a day really helps," says Dr Pitchiah, who suggests using them earlier on in the day, as some people say they struggle to sleep after using them in the evening.

Some people see improvements within five days' use, with symptoms disappearing after one or two weeks, notes Stuart, "though it can take up to six weeks to work.

"A dawn-simulating alarm clock may also help," Stuart adds. "This is a timed bedside light that mimics sunrise and wakes people up gradually. This can help if someone struggles to wake up in the morning during winter."

SMALL STEPS CAN MAKE A BIG DIFFERENCE THE power of behavioural habits shouldn't be underestimated, however.

Dr Pitchiah says there are three main things they normally recommend - sticking to a good routine, diet and physical activity - and even as a SAD specialist, he stresses these things can have very positive results.

"When people with SAD get their symptoms, they tend to sleep more and can't stick to routine. But the first thing (we say is), it's really, really important to stick to your routine - try and stick to getting up at the same time each day and stick to your routine."

Keeping up social contact is also important.

"If someone's suffering with SAD, they may find it difficult to maintain contact with friends and family," adds Stuart. "Arranging regular catch-ups in advance might help to "Human contact is good for building emotional resilience and doesn't have to be anything too complicated - even just going for dinner one evening or a walk at the weekend can help."

EAT YOURSELF WELL FOODS rich in tryptophan, an amino acid associated with serotonin production, have been found to help relieve depression.

"So fish, bananas, nuts, avocados - these are some of the main examples we recommend," says Dr He urges people to be mindful of stodgy and sugary cravings too, which can do more harm than good.

Dr Sarah Brewer, GP and medical director for Healthspan (healthspan.co.uk), says don't forget about vitamin D - the "sunshine vitamin".

"Vitamin D is important for mood, and low levels during winter, when daylight hours are reduced, may contribute to SAD.

"While you can obtain vitamin D in your diet from foods such as oily fish, fortified margarine, eggs, butter and fortified milk, Public Health England advises everyone takes a vitamin D supplement during autumn and winter months.

"Their suggested dose to avoid deficiency is 10mcg, but if you have SAD, a higher dose may be needed, although this has not yet been confirmed in clinical trials," Dr Brewer explains.

"The upper safe level for longterm use from supplements is 100mcg per day. They can be taken at any time of day, ideally with food that contains a little oil/fat, as vitamin D is fat-soluble."

KEEP ACTIVE "IT CAN be very difficult for people to get out and go for walks when it's dark in the mornings and early in the evenings, but it's very important to keep on with the activity you usually do during summer months," says Dr Pitchiah. "Physical activity does really help."

If you can exercise outdoors - even if it's just a stroll - even better.

"Exercise can help to treat conditions associated with low mood and can take the mind off things, even for a short while," says Stuart.

"Being able to exercise outside can help increase sunlight exposure, but it has plenty of other benefits, so it's worth a try!" "If the decrease in daylight hours affects someone's mood, it's important to make the most of them and get outside as much as possible," he adds.

"Whether it's first thing in the morning or fitting it into a lunch break, wrap up warm and go for a walk."

We think about 3 to 8% of the UK population suffers with SAD... but subthreshold SAD affects about 20% of the population Dr Balu Pitchiah

CAPTION(S):

It's important to keep up the same activity you do in the summer - just be sure to wrap up warm

Light boxes are one way to tackle SAD

Something as simple as going for a walk at the weekend could lift your spirits

It's important to eat right during the winter months
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Publication:Huddersfield Daily Examiner (Huddersfield, England)
Date:Oct 31, 2017
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