Winter’s long nights and short days can wreak havoc with our daily habits, our sleep and even our mental health, according to two Allina Health experts. But there are ways to combat seasonal malaise — and much that can be learned from cultures that make the most out of the darkest part of the year.
[image_caption]Sarah Paper[/image_caption]
“There are so many connections between the season and our mental health,” Paper said. For many of her patients, she continued, “the approach of the winter months will be hard on their general emotional state. One of the biggest contributing factors is the lack of sunlight, the shortness of the days. It has huge impacts on our mood and overall health.”
Though Paper said that diagnoses of seasonal affective disorder, or SAD, are actually relatively rare, many people report a slump in their mood as the days turn darker.
“Twenty percent of people report feeling more down during the winter months,” Paper said, adding that a smaller percentage — around 5% — actually have SAD. Among people with depression, however, SAD diagnoses are higher, she said, perhaps because of their general tendency to feel blue: “They might experience more depressive symptoms during the winter months.”
People diagnosed with SAD truly struggle during the weeks when the sun is under cover, Paper said. “It is a form of depression, a full-blown depressive experience that usually does resolve once spring comes around.”
There are effective treatments for SAD, Paper said, including, “cognitive behavioral therapy, antidepressants, light therapy and vitamin D supplements.” Vitamin D is produced naturally by sun exposure, she explained, and because people spend less time outdoors in the colder months, our D levels drop. Because vitamin D has been shown to be a mood booster, supplementation makes sense.
Though the Minnesota sun shines brightly for much of the coldest winter months, Paper said that below-zero temps can also contribute to seasonal depression. Time spent outside, no matter the weather, has been shown to boost our emotional mood. But it takes work to enjoy the Great (cold) Outdoors.
In the winter, Paper said, “We can feel really trapped inside. It can take a lot more effort to get out and do things. We are physically trapped in our homes and offices. In Minnesota particularly, there are times when it is dangerous to get outside.” Sometimes, those hurdles can feel like just too much, she added: “For someone who is struggling with seasonal depression, putting on snow boots, a jacket, a hat, mittens takes more effort than it does for other people.”
Even the most committed winter outdoor enthusiasts have to admit that the coldest months of the year can get lonely. The social isolation that often accompanies winter can send some people into a depressive spiral. Unlike spring and summer, where you can greet your neighbors while mowing the lawn or bump into friends on a walk around the lake, the winter months are quieter, with fewer people outside. Socializing below zero just takes more effort.
“There is less getting together, less just being outside and running into other people,” Paper said. “Those realities can affect our mental health.” Waning daylight hours only make the situation worse: “When the sunlight is limited, that tends to be a huge factor. We produce less of the natural mood stabilizer serotonin when we get less sunlight. Instead, we make more melatonin, which makes us sleepier. These factors all play into how winter impacts our mental health.”
Rooted in the past?
Some of the mental health impact of winter is likely based in the way our ancestors survived the cold, dark months, said Andrew Stiehm, MD, an Allina sleep medicine physician. The wintertime reality of long nights and short days has a negative impact on our mood and even our sleep habits. For many of his patients, he said, “There is this almost innate sense of, ‘When there is less light, there is less happiness.’”
This feeling may be based in our body’s inner sense of the slowing pace of life that comes naturally with turning further away from the sun. While people in the distant past may have taken this natural opportunity to create a season of rest and quiet, the demands of modern culture, with its insistence that life continue at the same pace no matter the season, works against our nature, he said. He believes that winter-based downturns in mood in the darkest months may be a reaction to that history: “There is some evidence that suggests that in the more northern latitudes there is more seasonal depression.”
[image_caption]Andrew Stiehm[/image_caption]
Instead of pushing through the darkness, Paper said our ancestors, “went to bed when it was dark. It would be dangerous to go out. There weren’t cars to protect them or light to keep them active.” Things are much different today, though our bodies may not always understand, Paper said, “Our lives don’t change much in the winter. We need to have the same energy we had in the spring and summer, to live our lives the same way — which can be frustrating and may lead to more feelings of depression.”
Stiehm places a good portion of the blame for seasonal depression on the sudden shift inflicted by the end of daylight saving time in early November. “Absolutely the biggest issue with the winter is the amount of daylight changes,” he said.
For many of his patients, Stiehm said, time change created by daylight savings time, “creates problems.” Even having sleep thrown off by an hour can be hard for someone who struggles to get enough sleep in the first place. “For instance, I’m used to waking up at seven in the morning. Now, when daylight savings time ends, I’m waking up at six because my body is used to that. I used to go to bed at the right time on the clock, but now I’m waking up an hour earlier.”
He said that research has shown that the abrupt shift causes people to struggle with their mental health: “We see it when we spring forward and when we fall back. Rates of suicide and depression spike right around either change.”
Paper said that her patients tend to feel the season’s mental health impact most acutely when the end of daylight savings time accelerates the plunge into darkness. “It can take a few weeks or even a month to get used to the darkness,” she said, “until you start to realize that the fact it is dark doesn’t mean you have to run home. After a while, you get used to it — and then you start to feel like you can go to Target or meet with your friends. But until that happens, it can be hard.“
Stiehm believes that daylight savings time is so bad for our collective mental health that he’s been advocating for putting an end to the practice. While he says that the jury’s still out on whether we should select permanent daylight savings time or permanent standard time, he said, “I think there’s universal agreement that we should stop changing the clock.” It’s only a matter of time — pun intended — before we put an end to it.
If anyone asked, Stiehm said his vote would be for sticking with standard time.
“I’m a doctor,” he said. “I only have to care about saving lives. I believe we should be on standard time year ‘round. The American Academy of Sleep Medicine and the European Sleep Research Society agree. This is recommended broadly.”
Ways to combat seasonal depression
Paper, who came to Minnesota from warm, sunny Tucson, AZ, knows better than most that surviving a Minnesota winter requires a serious attitude adjustment. When she first arrived in the state, she recalled, “I was working at an elementary school. I had earmuffs on when it was 50 degrees outside. A kid said to me, ‘What are you wearing earmuffs for now? It is going to get 100 degrees colder.’”
While the idea of the temperature actually dropping that far felt shocking, to her, the student’s observation helped Paper realize she had to adjust her perspective. If it was going to get that much colder, she needed to start considering 50 degrees a comfortable temperature.
Research conducted at Stanford University and Norway’s University of Tromsø found that having a positive mindset about winter — even in parts of Norway that see only a few hours of sunlight a day in the winter months — can have a positive impact on our mental health.
“They looked at people in Norway and how they have been able to manage the lack of sunlight they experience in the winter through a positive mindset,” Paper said. For Norwegians, the researchers found, she said, “Seasonal celebrations and cultural habits seem to not only protect them from being down or experiencing seasonal depression, but rather help them to feel more joyous or excited.” She said that researchers found that, “The lack of sunlight doesn’t take a physical toll on them like it does in some other Scandinavian countries like Finland.”
We can use those lessons in our own approach to winter, Paper said. “If we can think about our own mindset, how can we get through these months, we might be able to make them more bearable. Many of us need to rethink the way we approach the dark winter months.”
When an attitude adjustment isn’t enough to get you through the winter, there is scientific evidence that light therapy helps treat seasonal depression. This can be achieved by spending a set amount of time each day in front of a light therapy lamp that emits UV light.
Paper also suggests trying a sunrise alarm, that, instead of startling you from your slumber with noise, “wakes you by progressively increasing the light in your room. It lets your brain know it is time to wake up by the feeling of the sun. It helps to reset your internal clock.”
Some people think that the only way to survive winter is to escape it. “People often recommend that you take a winter vacation,” Paper said, “But that’s not always feasible for everybody.”
For those who can afford to get away in the wintertime, it isn’t always the perfect fix, Paper added. “It depends on the person and their attitude. Some people experience a further drop in their mood when they come back from vacation.” While many people say time away helps keep them going through a long winter, she said, “I have also seen people come back and feel worse. They say, ‘Why do I live here?’ — and it all starts over again.”
