Shorter, colder days can present mental health challenges.
By Lauren Drapeau.JPG) |
| Tough on wildlife, too (Photo by Will Collette) |
As every geographic location experiences
seasons differently, New England’s transition into the colder months poses a
particular threat to the mental health of residents in the area.
The Diagnostic and Statistical Manual of Mental Disorders,
Fifth Edition, DSM-5, defines Seasonal
Affective Disorder, more commonly referred to as seasonal depression, as a
major depressive disorder with a seasonal pattern.
While the symptoms are similar to depression, they will
occur most commonly in the fall and winter months, and begin to subside with
the arrival of spring. Less sunlight, in other words, can allow individuals to
struggle with daily functioning or become overwhelmed and distressed.
SAD can occur during warmer months as well, but this is much
less common. In these cases, individuals would experience the onset of symptoms
during springtime.
The disorder can affect individuals of any age range, but
the symptoms typically begin to present themselves between the ages of 18-30,
according to the DSM-5.
“The symptoms tend to be more severe, more present in younger people,” said Michela A. Muggeo, clinical psychologist with Brown Health Medical Group Primary Care. “Then in older people, they are still present but not severe.”
Early onset symptoms may be overlooked at first, according
to Muggeo, but some depressive symptoms are more common with SAD than others.
“With the seasonal [depression], sleep issues are more
prevalent, and there are changes in appetite,” Muggeo said. “These are two
symptoms that are a bit more severe in Seasonal Affective Disorder.”
Alongside fatigue, lower moods, and loss of interest in
activities that an individual would typically enjoy, there are increased
cravings for sugar and carbohydrates. As the seasonal cycle continues, these
would start sometime in the fall and increase in severity through the winter,
according to Muggeo. Along with the seasonal cycle, the symptomatic cycle
persists.
For younger age groups, a concern lies in the fact that
these symptoms may begin to present themselves at the start of their school
years.
It may be difficult to differentiate between Seasonal
Affective Disorder symptoms and depressive symptoms triggered by a
change in environment when moving into school and adjusting to new
surroundings, according to Christopher Furey, family medicine physician with
Care New England Medical Group Primary Care.
“I feel like people get caught off guard when it happens in
the fall,” said Nompelelo Boucher, the founder and owner of Cumberland
Counseling. “I think that it’s the lack of preparedness for people to
understand that things are going to slow down in the brain.”
At Cumberland Counseling, clinicians tend to see more people
attending, or returning to, therapy at the beginning of the colder seasons.
Boucher credits this phenomenon to the lack of sun, the days getting shorter.
“Ironically enough, the days feel longer, things feel
tougher, it feels tougher to concentrate,” said Steffen Gillom, clinical
director and an associate clinician at Cumberland Counseling.
People experiencing Seasonal Affective Disorder have reduced levels of serotonin in the brain, as shorter daylight hours may prevent molecules in the brain from being able to maintain normal serotonin levels, according to the National Institute of Mental Health.
“It just leads to a lot of maladaptive thinking patterns in the brain about
your own self-worth and who you are and where you’re going,” Gillom said. “It’s
actually just– you’re really far away from the equator and you need sun.”
This ultimately becomes a unique issue for locations at
greater distances from the equator.
Boucher was born in South Africa, and stated that she does
not remember anything about a seasonal depression phenomenon. Looking at
research in Alaska, according to her, the highest rates of this situation take
place there.
“It really is something that has to do with the sunlight,”
Boucher said. “It really is something that has to do with New England.”
Gillom expressed that many clients of color looking to treat
symptoms are coming from places where, in their country of origins or in more
southern states, they couldn’t draw a distinction between how they felt
throughout the months. This has become a dialogue in their Cumberland office.
According to studies, SAD varies based on geographical
latitude, age and sex. Younger people and women are at higher
risk, according to psychiatry.org.
Boucher and Gillom believe these numbers represent a lack of
proper research.
“Women are already in therapy for other reasons,” Boucher
said. “Men just come in with this low mood and lack of motivation, and they’re
so upset because they want to go forward. That’s what we see the most.”
Both professionals agreed that most of the individuals
expressing higher levels of depressive symptoms during this time are, indeed,
men. While this doesn’t necessarily mean more men experience SAD, it also
suggests that women might not be the largest group affected by the changing
seasons.
From a clinical standpoint, Boucher worries that SAD has not
been emphasized as pertinent enough to treat as its own condition. Due to the
nature of therapy, patients are encouraged to attend regularly.
“There might be a financial component to it, too,” Boucher
said. “Because it’s known to be a time-limited experience, we are almost
encouraged to [focus on] things like bipolar, mood disorder, things that are
going to be ongoing.”
There is no medication specifically designed to treat SAD,
although individuals can be prescribed umbrella medications that are meant to
treat larger disorders like depression and anxiety, such as Prozac or
Zoloft.
“It’s known to be something that is fleeting, so maybe the
research has lagged in that area,” Boucher said.
Commonly prescribed methods to treat the seasonal onset
of depression include light therapy, psychotherapy, antidepressants,
and vitamin D.
Many clinicians will recommend light therapy boxes, which
can be purchased on Amazon, to improve mood and energy. It is important that
these are made specifically for SAD when purchasing, according to Muggeo. With
routine exposure, these light boxes can help mimic early sunlight exposure that
one might experience during warmer months.
If these do not work, antidepressants can temporarily be
prescribed in order to help individuals through the season. Psychotherapy may
be encouraged for more severe symptoms.
“One of the day-to-day recommendations is to get out as much
as possible,” Muggeo said. “If you can’t because you’re working during the day
when it’s light out, sit next to a window or have lights or candles around your
space.”
Clinicians recommend that if this pattern persists annually,
people reach out earlier in the year for treatment options to get ahead of
symptoms before they become more severe.
Gillom expressed that the first step in looking at SAD for further research would be to analyze behavior patterns and how individuals cope. Looking at specific demographics may help to understand the issue on a broader scale, as well, according to Gillom. Individuals with lighter skin have less melanin, allowing them to absorb radiation more effectively and produce more vitamin D.
“I think that we could have these conversations across communities of color, as
well,” he said. “I know for my friends who are black and brown, they are
usually taking some sort of vitamin D supplement at this time of year. Our skin
is darker and so therefore it’s repelling the sunlight.”
Both clinicians teach other clinicians in the field, and
stated that SAD has not been added to their dialogue quite yet.
“This is something that is in the background, but it’s
something that is causing so much suffering,” Boucher said. “I don’t think
we’re talking about it.”
Additionally, Boucher and Gillom state that many of the
research’s numbers may not be completely accurate as many demographics are
unaware they may experience SAD. After discovering a behavior pattern with
seasonal depression, individuals still may need a mixture of multiple
treatments in order to balance their mood, according to Muggeo.
“At any time of the year, if you’re feeling depressed or
anxious, I think reaching out, if you’re in school, to your student health
services or to a medical professional is the first step for sure,” said Care
New England Medical Group Primary Care’s Furey.
If any New England residents, or other individuals farther
from the equator, experience depressive symptoms in the colder months, there
are options available.
Anyone in immediate danger should call 911.
Other resources:
— BHLink: For confidential support and to get connected
to care, call (401) 414-LINK (5465) or visit the BHLink 24-hour/7-day triage
center at 975 Waterman Ave., East Providence. Website: bhlink.org
— The Samaritans of Rhode Island: (401) 272-4044 or (800)
365-4044. Website: samaritansri.org
— The National Suicide Prevention Lifeline: (800)
273-TALK, or (800) 273-8255
— The Crisis Text Line: Text HOME to 741741 “from
anywhere in the USA, anytime, about any type of crisis.”
— Butler Hospital Behavioral Health Services Call Center:
Available 24/7 “to guide individuals seeking advice for themselves or others
regarding suicide prevention.” (844) 401-0111
— Thrive Behavioral Health’s Emergency Services: 24-hour
crisis hotline (401) 738-4300.
— Prevent Suicide in Rhode Island: a Rhode Island
Department of Health resource. If you are in crisis, call (800) 273-8255 or
text TALK to 741741. Website: preventsuicideri.org/
Lauren Drapeau is a senior journalism major at the
University of Rhode Island. She is the current editor-in-chief of the campus
newspaper, the Good 5 Cent Cigar, and has been on the editorial board for 3
semesters. She is also a consultant at URI’s Digital Writing and Research
Studio, and serves as a TA assistant for multiple journalism courses on campus.
In her free time, she enjoys spending time outside, seeing friends, and
reading.