Health and Wellness Mental Health When Winter Malaise Hits, Is More Light Enough? The days are short and everything feels ugh. The psychiatrist who coined the term “Seasonal Affective Disorder” unpacks what can actually help with winter woes. By Jessi Gold, M.D. Jessi Gold, M.D. Instagram Twitter Jessi Gold, M.D. writes about the intersection of mental health and popular culture for InStyle.com. She is an Assistant Professor and the Director of Wellness, Engagement, and Outreach in the Department of Psychiatry at Washington University in St. Louis. She graduated from the University of Pennsylvania (B.A. and M.S. in Anthropology), The Yale School of Medicine (M.D.), and Stanford University (Psychiatry Residency). She clinically sees college students and healthcare workers but spends her weekends watching Bravo. InStyle's editorial guidelines Published on December 14, 2022 @ 07:30AM Pin Share Tweet Email Photo: Stocksy Waking up in the winter goes something like this: The alarm starts beeping. It’s still dark outside, as you attempt to open your eyes. Even if you briefly consider getting out of bed, the warmth keeps pulling you in. Checking the weather, you realize it’s not only dark outside, it’s cold. You feel what can be best expressed as “ugh.” And, you are not alone. In one survey, winter only received 11% of the vote for America’s favorite season, losing overwhelmingly to fall. “There are many things about winter that can get us down, such as the cold, difficult travel conditions, and the flu, but one critical factor that has emerged in recent years is the shortening of the days and lack of light,” Norman Rosenthal, M.D., clinical professor of psychiatry at Georgetown University School of Medicine and the psychiatrist who first coined the term Seasonal Affective Disorder (SAD) told InStyle. “It’s important that people understand the nature of their illness” — because, yes, SAD is a real type of depression and more than just the ‘winter blues’ — “so that they can take all available measures to help themselves. They need to recognize that their symptoms are biological and not their fault.” Lack of light has real implications for our mental health, but is adding light back into our daily lives really all it takes to feel better? As a psychiatrist, I help people navigate this time of year, well, every year, and understanding SAD is crucial to getting through it. I'm a Psychiatrist, and Numb Is a Valid Feeling Right Now So, here goes: You don’t just have trouble getting up because it’s dark outside, you have trouble getting up because your brain tells you you should still be sleeping, because it’s overproducing melatonin, a hormone responsible for maintaining our internal clock. As a result, we develop a kind of winter jet lag, and the darker days make us sleepier, earlier. We also have decreases in our mood-regulating hormones, like serotonin, in the winter and have less exposure to vitamin D. It’s not surprising, then, that in the winter many of us feel low or even depressed. In fact, according to a new American Psychiatric Association poll of over 2,200 people, nearly a quarter of adults feel depressed in the winter, and two-thirds noted behavioral changes. These changes may include (but are not limited to): low energy, low interest, and social withdrawal. So, yeah, if you feel down in the winter, it’s not in your head — and it’s nothing to brush off. While a lot of people may diagnose themselves with SAD (based on the memes alone), technically speaking, these symptoms don’t warrant the label from a mental health professional like me until they are more severe, lasting the whole season, and interfering with functioning at work and home. Punching Things And Other Great Workouts for Menopause Brit Barkholtz, LICSW, a clinical therapist in Minnesota, has seen many of these changes in her clients lead to less motivation and energy in all aspects of their lives, particularly socially. “Because of the practical impacts of the dark and cold, we tend to see our friends and family less frequently — no patio happy hours or walks in the park or get-togethers at the lake or bike rides on the trails. We often end up siloed and isolated at home in the cold and dark months, which adds to the mood impacts,” she explains. Plus, as Barkholtz points out, the stress and potential trauma-triggering of the holidays compounds the existing challenges the weather creates. So, how do we fight the urge to sleep all day and isolate ourselves in a self-induced hibernation? Let! There! Be! Light! One option is to find any and every way to increase your exposure to light. Mary Moffit, Ph.D., medical psychologist and associate professor in the department of psychiatry, Oregon Health & Science University emphasizes the need for people to move outdoors, even on cloudy days, as the sun is much stronger than people realize. She suggests going for walks with a friend, or a dog — whatever gets you moving — while there is still light outside. Have some PTO saved up? You can also take a winter holiday at a lower latitude for temporary relief, adds Raymond Lam, M.D., professor in the department of psychiatry, University of BC. If natural light isn’t enough, you can invest in a light box, which may seem slightly woo-woo or the centerpiece of a comedy routine (see: Broad City), but actually works. In a meta-analysis, ‘SAD lamps’ as they’re commonly called, have been shown to reduce symptoms of depression, and, anecdotally, a lot of my patients really appreciate their benefits. Dr. Lam says to use a 10,000 lux white fluorescent light box with a UV filter for 30 minutes a day, usually in the early morning. Note: Just like skincare products, using these lights consistently and correctly (specified by your particular device) is key to seeing results. Adding lightness to your space can also help improve your mood. “Have at least one room that is your ‘bright room,’” suggests Dr. Rosenthal. “Paint the walls a light color, bring in lots of lights, and use colored throws and scatter cushions to brighten it up further.” But no matter how cheery your space may be, isolating yourself inside it all season won’t do. Dr. Rosenthal adds, “As the pandemic has shown us more than ever, people need social engagement and stimulation to live a full life — and that includes people with SAD.” Barkholtz agrees and recommends really proactively socializing during this time of year. She tells her patients to establish a winter plan with others to prevent their reflex to hide out. “The plan doesn't need to be anything formal or structured, it can just be as simple as, ‘Hey I want to make sure we still see each other this winter, can we make a mental plan to try to get together once a month for pasta night?’ or ‘If you haven't heard from me for x amount of time can you just shoot me a text to say hi?’” Staying connected, and warning your friends that you might try not to, can help prevent your mood from becoming low. Dr. Moffit suggests paying attention to your sleep and eating patterns, and your schedule overall. She emphasizes trying to keep a sleep/wake cycle that is close to the same time every day, not sleeping more than eight to nine hours, and trying to not rely on carbs exclusively as your winter comfort food, which can make you feel briefly energetic, but eventually even more sluggish. Additionally, knowing the holidays or winter might be a trigger, Barkholtz finds it helpful for people to consider scheduling therapy sessions in advance, particularly around hard times. Of course, medications might also be helpful if you have SAD, and seeking out help more preventatively might make all of the difference. Winter may not be everyone’s favorite, but we can do more than grin and bear it every year, like trying to prepare, physically and mentally, for the dark days ahead. Finding more light is only the beginning.