A Change in Weather and Mental Health
by Christine Whyde, staff writer
FEBRUARY 2021- As we endure the winter months, many Northeast Ohioans will find themselves experiencing seasonal affective disorder (SAD), also referred to as seasonal depression. But we are not alone. Boston University estimates that roughly 10 million Americans are impacted by SAD. Although the condition is prevalent, it is not widely discussed or understood by the general public.
When asked to define SAD, Nichole Ammon stated, “Seasonal affective disorder isn’t really its own disorder. When you classify it, it would be considered depression with a recurrent seasonal pattern.”
Ammon has been with the Northeast Ohio Medical University (NEOMED) for around eight years now. Her background in community mental health counseling has helped in her position with the university. Her work primarily focuses on bridging the gap between primary care and mental health care, helping to treat patients more holistically. Given her experience within the mental health field, Ammon is very familiar with SAD.
Although those who suffer from SAD might experience typical depression symptoms, Ammon noted that there are some symptoms specific to the condition that will also vary depending on the time of year that a person is affected. With winter SAD, the most common type of the condition, it is typical to see oversleeping, changes in appetite, potentially leading to weight gain, and overall tiredness.
During this time of the year, most people will find themselves experiencing SAD symptoms and some may even come to the conclusion that they are suffering from seasonal depression. To some degree this is warranted. Ammon believes that, “To some degree, lots of people experience a low-grade seasonal affective disorder. We tend to be a little bit more blue [in the winter].” However, she also asserts that the number of people who reach a diagnosable level of the disorder is considerably lower than those who say that they have SAD.
Although the exact cause of SAD is currently unknown, there are a few possibilities. Like Vitamin D, sunlight is actually responsible for regulating some of the molecules necessary for serotonin production. As we lose what little sunlight we have as Ohioans, some will be affected by this change in serotonin levels. Additionally, during this time we often see an overproduction of melatonin. Because melatonin helps to regulate our sleep, an increased amount has the potential to disrupt an individual’s daily rhythm and can lead to SAD symptoms. In some cases, simply taking a supplement can lessen symptoms greatly.
The likely role of sunlight exposure, on its own, is what makes the condition so unique. Dr. Randon Welton of NEOMED has had personal experience with this element of SAD.
In August 2020, Dr. Welton joined NEOMED as the Margaret Clark Morgan Endowed Chair of Psychiatry. With this position, he oversees the department of psychiatry and their contribution to the college of medicine and residency training. Dr. Welton has been involved in training residences and medical students for around 20 years and served as a U.S. Air Force psychiatrist for 24 years.
During his time in the military, Dr. Welton witnessed the impacts of SAD, while stationed in England. He recalled his time there: “It would be completely dark by four and not light until 10 [in the morning]. There were a lot of people, especially from southern places in the United States, that really struggled with how dark and dreary the winter was.” To combat this, a mental health clinic lent out light boxes for the service members to use.
Light boxes are a common treatment for SAD. When describing the devices, Ammon explained, “Light boxes filter out UV light but offer anywhere from 2,500 to 10,000 lux. Sitting in front of the light for 10 to 15 [minutes] a day seems to help a lot of people.”
Dr. Welton touched on the efficiency of this treatment, stating, “Folks who find this effective will generally need to use the box daily from late October through March.” He also added that he regularly uses a light box himself and people can benefit from the treatment regardless of whether they have SAD.
While it may seem that the solution for SAD is as simple as using a device, this is unfortunately not always the case. Although sunlight may have an impact on those with the disorder, some find themselves derailed by the social aspects of winter time.
Dr. Welton explained, “While we usually think of the holidays as a fun time to get together, which really won’t be happening this year like it used to, for some they are full of sadness and depression. The holidays often remind people of those that they have lost. You see an increase in depressive symptoms and suicides around the holidays because of that. We are not really blaming the winter for that; it is really just the family connections. Lots of people may have terrible families. I’ve had patients who have told me that they hate this time of year because when they turn on the television all they see are happy families and people getting together and having a great time, when they didn’t experience anything close to that.”
These patterns of negative thinking, sometimes leading to depressive symptoms, can be addressed through talking therapy and even through a low-dose antidepressant. Ammon clarified, “If it is seasonal, it obviously would not need to be taken all year, but if a person knows that every year they are going to hit a pattern of depression then their primary care physician or psychiatrist could prescribe a low dose antidepressant and remove that in the spring.” This also would apply for the less-common spring-summer pattern of SAD.
Even if someone does not believe they are suffering from SAD, or any other mental illness for that matter, talking therapy can still be beneficial. The United Kingdom’s National Health Service states that, “Talking therapy is for anyone who’s going through a bad time or has emotional problems they need help with.” In this way, therapy can be considered a form of support and self care. Ammon stressed that regular routines and preventative self care, such as exercise and a healthy diet can make all the difference on our mental health. She pointed out, “Exercise has been proven to be very helpful for depression.”
Although the Centers for Disease Control and Prevention reports that 50% of people will be formally diagnosed with some type of mental illness during their lifetime, a social stigma remains about the topic. This discourages people from reaching out to others for the help that they need.
Nichole Ammon stressed the importance of talking about mental health: “Seasonal affective disorder, whether it has reached a diagnosable level of depression…or if you have something that you know doesn’t quite meet that level but you know that you experience some of these symptoms, is extremely common, particularly in this region of Ohio and of the country. One of the reasons that the military base was built in Ravenna was very specifically because of the number of cloudy days and trying to prevent satellites from observing what was going on there. That by itself is going to lead many people in Ohio to experience [SAD]. It is important to reduce the stigma around it, so that people can talk about it and actively seek treatment without feeling like an ‘other’ or as if something is wrong with them. That I think is the most important thing.”
If someone finds themself or someone they know experiencing symptoms, it is important to take action. There is nothing wrong with reaching out for help, as it could save a life.