As the winter skies become gray and cloud-covered, the winds blow, snow grows by the foot, and the temperatures dip in this two-peninsula state, a portion of Michigan’s 10 million residents face seasonal affective disorder, or SAD. According to Michigan State University research, the state’s affected audience ranges from 20% to 40%.

Simply stated, as sunlight and the day’s length decrease, SAD sets in for some individuals.

A recent study by Forbes magazine and research revealed that out of the nation’s 50 states, Michigan residents rank number eight in experiencing SAD. In their research methodology, Forbes used metrics like percentage of sunshine, average number of daylight hours, and annual rates of depression and anxiety to determine the states most and least affected by wintry sadness.

On Forbes’ list, Alaska ranked number one as the most challenging and Hawaii was number 50 as the best environment against SAD.

According to the American Psychiatric Association, SAD typically affects individuals between the ages of 18 and 30. In addition, research notes SAD tends to occur more in women.

The association’s data notes common SAD symptoms include fatigue, too much sleep, and weight gain associated with overeating and carbohydrate cravings.

SAD symptoms vary from mild to severe and can include many symptoms similar to major depression, such as:

∫ feeling sad or having a depressed mood,

∫ loss of interest or pleasure in activities previously enjoyed,

∫ changes in appetite; usually eating more and craving carbohydrates,

∫ change in sleep patterns; usually sleeping too much,

∫ loss of energy or increased fatigue despite increased sleep hours,

∫ increase in purposeless physical activity (e.g., inability to sit still, pacing) or slowed movements or speech (these actions must be severe enough to be observable to others),

∫ feeling worthless or guilty,

∫ difficulty thinking, concentrating, or making decisions,

∫ and thoughts of death or suicide.

The National Institute of Mental Health added there is also a summer-related SAD. Typical summer symptoms are:

∫ trouble sleeping (insomnia),

∫ poor appetite, leading to weight loss,

∫ restlessness and agitation,

∫ anxiety,

∫ and violent or aggressive behavior.

However, the institute’s research notes, “Winter-pattern SAD should not be confused with ‘holiday blues’ — feelings of sadness or anxiety brought on by stresses at certain times of the year. The depression associated with SAD is related to changes in daylight hours, not the calendar, so stresses associated with the holidays or predictable seasonal changes in work or school schedules, family visits, and so forth are not the same as SAD.”

HOW TO TREAT SAD: GENERAL OVERVIEW

According to the National Institute of Mental Health, the American Psychiatric Association, Mayo Clinic, and other clinical authorities, typical treatments involve the following:

Light therapy

Since the 1980s, light therapy has been a mainstay for treating winter-pattern SAD. It aims to expose people with SAD to a bright light to make up for the diminished natural sunlight in darker months.

For this treatment, the person sits in front of a very bright light box every day for about 30 to 45 minutes, usually first thing in the morning, from fall to spring. The light box, which is about 20 times brighter than ordinary indoor light, filters out the potentially damaging UV light, making this a safe treatment for most. However, people with certain eye diseases or people taking certain medications that increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision.

Psychotherapy

Psychotherapy, also called talk therapy or counseling, can help people with SAD by teaching them new ways of thinking, behaving, and changing habits that contribute to depression.

Cognitive behavioral therapy is a type of psychotherapy aimed at helping people learn to challenge and change unhelpful thoughts and behaviors to improve their depressive and anxious feelings.

Antidepressant

medication

Medications used to treat depression (antidepressants) can be effective for SAD when used alone or in combination with talk therapy. Antidepressants work by changing how the brain produces or uses certain chemicals involved in mood or stress.

Antidepressants take usually four to eight weeks to take effect. Problems with sleep, appetite, and concentration often improve before mood lifts. It is important to give a medication a chance to work before deciding whether it is right for you. You may need to try several medications to find the one that works best.

Vitamin D

Because many people with winter-pattern SAD have vitamin D deficiency, vitamin D supplements may help improve symptoms. However, studies testing vitamin D as a treatment for SAD have produced mixed results, with some studies indicating that it is as effective as light therapy and other studies finding no effect.

Personal

Approaches to SAD

The Washington, D.C.-based American Psychological Association offers the following guidelines for personal SAD management:

Take in as much daylight as possible

The lack of sun exposure is part of what causes SAD, so soaking it up could lessen symptoms. Sit by a window or go for a walk during daylight hours. You could even take up a winter sport to get you outside and keep you moving.

Eat healthily

Comfort foods don’t have to be loaded with extra calories and lots of sugar and fat. Get creative and look for hearty, low-calorie recipes that are easy to prepare. Instead of eating cake and cookies, try making a dessert from fruits like apples, berries, or pears.

Spend time with friends and family

Spending time with friends and family is a great way to lift your spirits and avoid social isolation. Snuggle with your kids or pets, visit with your friends while drinking a hot cup of tea, or play board games with your family. Talk to your loved ones about how the winter season is affecting you. Take the time to educate them about SAD so they can better understand your situation.

Stay active

Don’t stay cooped up in your house all winter. Get out and enjoy your community this season. Volunteer, join a local club, go for a walk, or other pleasurable activities with your loved ones to start. Also, if you know you experience SAD year after year, be proactive about planning out a schedule in advance of winter to keep active and engaged with others. Research shows exercise and scheduling pleasant activities can be effective ways to lessen the impact of SAD.

Seek professional help

If you continue to struggle with feelings of depression, you may want to seek help from a mental health professional, such as a psychologist. A psychologist can help determine if you have SAD and how best to treat it. Research shows that psychotherapy, such as cognitive behavioral therapy, is an effective SAD treatment and may have more long-term benefits than daily light therapy or antidepressant medication.

ADDITIONAL

INFORMATION

Additional information on SAD can be found at the following websites:

∫ nimh.nih.gov – National Institute of Mental Health

∫ psychiatry.org – American Psychiatric Association

∫ mayoclinic.org – The Mayo Clinic

∫ psychologytoday.com – Psychology Today

∫ apa.org – American Psychological Association

Jeffrey D. Brasie is a retired health care CEO. He frequently writes historic feature stories and op-eds for various Michigan newspapers. As a Vietnam-era veteran, he served in the U.S. Navy and U.S. Naval Reserve. He served on the public affairs staff of the Secretary of the Navy. He grew up in Alpena and resides in suburban Detroit.