By Caitlin Cuggy
If you’re anything like me, you dread when the time changes in the fall. After a summer filled with sunshine and time outdoors, I find myself feeling angst about the impending dreary weather that accompanies the fall and the winter. I feel grey and blue, like the days are dragging and never-ending. The change of seasons can be particularly difficult for individuals who suffer from seasonal depression, which can be defined as a recurrent major depressive episode that occurs at a specific time of the year and fully remits otherwise. Although seasonal depression once stood on its own as a disorder in previous editions of the Diagnostic and Statistical Manual of Mental Disorders (i.e. Seasonal Affective Disorder), the current Manual defines this pattern of depression as a specifier for depressive episodes that occur at a specific time of year for individuals who have either Major Depressive Disorder or Bipolar Disorder. Importantly, this specifier does not apply to those situations in which the depressive pattern is better explained by seasonally-linked psychosocial stressors (i.e. seasonal unemployment or school schedules). The seasonal specifier simply provides clinicians with an idea about which type of treatment may be helpful to clients, which, in this case is most often light therapy. This form of depression occurs most frequently in the fall or the winter months, when days shorten and sunlight decreases. About 2-3% of Canadians will experience debilitating seasonal depression in their lifetimes and another 15% will experience a milder form, still being able to live their lives without any major disruptions.
Individuals who suffer from this form of depression are likely to feel sluggish and tired. For this reason, they tend to find it difficult to accomplish daily tasks because they would rather be in bed. These individuals typically experience diminished interest in activities that they once enjoyed. This form of depression is often accompanied by irritability and stress, cravings for sugar and starch, and a lowered sex drive. While the specific causes of seasonal depression remain unknown, there are several factors that appear to be linked to the disorder. It has been found that the decrease in sunlight in the fall and winter months may disrupt the body’s internal clock and lead to feelings of sadness and depression. In addition, many studies have demonstrated that serotonin (a neurotransmitter that affects mood) may be implicated in seasonal depression. Specifically, reduced sunlight can lower serotonin levels, which in turn can trigger depression. Furthermore, it has been found that melatonin, a sleep-related hormone, can be affected by the reduced sunlight in the fall and winter months. An increase in the body’s production of melatonin, which occurs during darkness, could affect sleep patterns and mood. The seasonal pattern of depression tends to be diagnosed more frequently in women, but men typically experience more severe symptoms. Children and adolescents are particularly susceptible to this form of depression, as are individuals with a family member with the illness. Finally, studies have found that those who live at a great distance from the equator are more at risk of developing seasonal-patterned depression. Light therapy has been found to be most effective in treating this seasonal pattern of depression. Treatment involves sitting near a special light for about 30 minutes/day. The artificial light causes chemical changes in the brain that improve mood and lessen the symptoms. 60-80% of affected individuals experience ameliorated symptoms as a result of light therapy. Cognitive Behavioural Therapy (CBT) has been proven to be a viable option for individuals suffering from seasonal depression. The negative thought patterns that are associated with depression are lessened through coaching and homework exercises.
Homework exercises may involve having clients keep a thought record wherein they challenge difficult and unpleasant thoughts with more helpful ones (for examples of Thought Records and other CBT exercises, please see Padesky & Greenberg, 2015). Mindfulness-based cognitive therapy (MBCT) has also been found to be effective in reducing depressive symptoms seen in this seasonal pattern of depression. MBCT teaches people to disengage from the deeply rooted dysfunctional thoughts that are commonly experienced in depression. Mindfulness exercises involve yoga, body awareness and homework exercises that attempt to teach the individual to be fully present in the moment (for more information on MBCT, please see Williams et al., 2012). Psychotherapy and light therapy are often used hand-in-hand when treating clients with this pattern of depression. Finally, self-care regimens that include regular exercise, a healthy diet, good sleep habits, and maintaining social networks have been found to minimize the symptoms associated with seasonal depression. Exercise in particular can be effective in reducing the depressive symptoms, with one study indicating that 47% of clinically depressed individuals saw relief in their symptoms by walking for only 30 minutes every day.
Références Diagnostic and statistical manual of mental disorders:
Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). (2013).
Washington, D.C.: American Psychiatric Association.
Evans, Mike. (2011). 23 and 1/2 hours: What is the single best thing we can do for our health?
Retrieved July 13, 2016, from https://www.youtube.com/watch?v=aUaInS6HIGo
Lu, Stacy. (2015). Mindfulness holds promise for treating depression.
Retrieved July 13, 2016, from http://www.apa.org/monitor/2015/03/covermindfulness.aspx
Padesky, C. A., & Greenberger, D. (2015). Clinician’s guide to Mind over mood (2nd ed.). New York: Guilford Press.
Seasonal Affective Disorder (SAD). (2013). Canadian Mental Health Association.
Retrieved July 11, 2016, from https://www.cmha.bc.ca/get-informed/mentalhealth-information/sad
Williams, J. M., Teasdale, J. D., Segal, Z. V., & Kabat-Zinn, J. (2012). The mindful way through depression: Freeing yourself from chronic unhappiness. New York, New York: Guilford Press. ABOUT THE AUTHOR:
This article was written by Caitlin Cuggy, who is completing her Master’s degree in Counselling Psychology (M. Ed.) at the University of Ottawa.