The vast majority of us often feel a bit blue in the winter, when the days are considerably shorter and the sky is usually gray and miserable. However, a minority of us suffer more than the occasional blue spell. When the months get colder and darker they sink into a state of despair, one that is characterized by extreme lethargy, fatigue and depression and often marked by over-eating and sleeping too much. Many people suffer from increased anxiety during the winter months

Many people suffer from Seasonal Affective Disorder during the winter months.

In days gone past, we told people with seasonal depression to simply snap out of their funk. Many of us feel a bit off-color during the colder seasons, we'd say, so stop moaning and deal with it like an adult. However, scientists have now recognized that people who suffer from a more severe form of the winter blues actually have a known medical condition - known as Seasonal Affective Disorder, or SAD. It's not that uncommon - and the good news is that it can almost always be very successfully treated.

What is Seasonal Affective Disorder, or SAD?

As mentioned, SAD is not about feeling a bit miserable when it's dark and cold out. It's a cyclical feeling of depression and despair, which in severe cases can threaten to take over an individual's life. It usually begins either in late fall or the beginning of winter and last until the weather changes, although in some cases it starts during the summer months. Interestingly, it mainly affects people under age 40, and the ratio of women affected as compared to men is 3:2.

Our age, lifestyle, genetic factors etc play a role in who gets affected by SAD. But the clever boffins who gave a name to this condition have also pinpointed several other factors. They include an increase of melatonin, which can affect both sleep and depression, and a decrease in the feel-good hormone serotonin. They concluded also that some people are more affected by cyclical changes than others, and that their circadian rhythms, or natural body clocks, are thus more affected as well.

In any case, symptoms usually worsen then get better when the weather changes - making those affected act much like a bear desperate to put on a layer of fat and hibernate the cold months away. In rare cases, however, people suffer from what is known as Reverse SAD, experiencing feelings of elation, euphoria and overpowering enthusiasm for no apparent reason until the weather lifts (sounds good!).

If you think you suffer from winter-onset SAD, here is a checklist of possible symptoms to look out for. Remember, they are season-dependent - if you have these symptoms all the time regardless of season, you may just be suffering from plain old depression, and should ask your doctor for help. Symptoms include:

• Tendency to oversleep
• Tendency to overeat, especially comfort food such as carbohydrates
• Anxiety and other forms of nervousness
• Depression
• A feeling of hopelessness and despair
• Lack of interest in things, which may include sex
• Weight gain
• Marked difficulty in being able to concentrate

If you suffer from summer-onset SAD, which is much less common, signs may include being irritable, becoming easily irritated, having a marked increase in sex, insomnia, weight loss, agitation and nervousness.

Treatment

As a lack of sunlight is seen as the main culprit in causing SAD, it makes sense that the main treatment for this disorder is to get more light (no surprise here). People with mild symptoms can try to be outside for longer when it's sunny, taking part in outdoor sports, exercising in the open air or taking walks in the middle of the day. Exposing themselves to as much natural sunlight is key.

For patients with a more severe form of the condition, the best treatment is usually phototherapy, or light therapy. Patients either sit or stand in front of a specially designed light box or wear a special light visor for up to 45 minutes a day. Often this is done first thing in the morning, when the effect can last longer. The light box should only be administered by a professional, as it is mandatory to get one that filters out all harmful UV rays.

If light therapy does not seem to help, then behavioral therapy or medication may be a next resort - or even a combination of treatments used at one time. Behavioral therapy is a form of counselling where patients will discuss why they have negative thoughts and how they affect them, and what they can do to reduce them. Medication may include antidepressants, so be careful as they can interact with other medication you may be taking.

Other therapies include taking regular exercise, eating healthily and dawn light simulation. This rather bizarre technique is very simple: a light comes on in your bedroom while you sleep, then slowly gets brighter and brighter as if mimicking a dawn sunrise, making you feel as if you were warmed by the sun. Please note that tanning beds are NOT cures for SAD, and will not help someone who has been accurately diagnosed with the condition.

In places like Siberia and Alaska, where there is often less than one hour of natural sunlight a day during the winter months, schoolchildren are often exposed to phototherapy every day while at school. It is seen as a natural way to make up for nature's lack of sunshine. In Norway, children are routinely given cod lover oil before the winter months to "prepare" them for the dark days ahead. Sometimes prevention is better than cure.

Looking Ahead

SAD is a type of depression, and like many forms of depression it is often not recognized and is easily overlooked. Even children can be affected by SAD, causing them to lose interest in school and their friends, and even normally fun after-school activities like parties and hobby clubs. Often, parents see their children as slacking off, and don't realize that they actually have a recognized mental health disorder.

Fatigue, lethargy and an overall feeling of malaise could be caused by a more serious condition, so if you are wondering whether you or someone in your family is suffering from SAD, it's important to see a medical professional to rule out anything more serious first. If SAD is the diagnosis, getting help and the proper treatment is easy.

Nobody should suffer from any mental health problem in silence. If you believe you suffer from SAD, see your doctor. And along with following his or her instructions, it's not a bad idea to prepare yourself for the advent of winter by eating healthily, exercising regularly, and making sure you have a support network of family and friends around you.

Light Therapy - Light therapy or phototherapy consists of exposure to specific wavelengths of light using LEDs & has been proved effective in the treatment of both seasonal depression and non-seasonal depression.