When I moved to Scotland, I realised I had a serious case of SAD
‘Tis the season, for at least 10 per cent of us, for annual Seasonal Affective Disorder (SAD). Triggered by lack of light, the condition is typified by a regular depression that drifts in around October, and only lifts in spring. This winter, with the continuing cost-of-living crisis and political turmoil may trigger more SAD than ever – and I should know.
Ever since I moved to the West Highlands of Scotland almost seven years ago, I have experienced SAD – or so I believe. Here, the shortest day – December 21 – runs from 8.45am to just 3.30pm. In deepest winter, the lack of light can be so spirit-lowering, it’s tempting to stay in bed all day, working from my boudoir like Barbara Cartland.
I’m normally an energetic person, filled with schemes – but not in winter, when a TV marathon under a furry blanket is all I can manage. Socialising takes a back seat, too; and I find myself craving vast bowls of white pasta. I can sleep for 10 hours if the alarm doesn’t go off, and waking up is like being pulled from a pitch black pothole.
Apparently, SAD can run in families, but I don’t know if anyone in mine suffers, as none of them has ever lived this far north. Last year, however, I’d had enough, and though I didn’t get a diagnosis (because getting a GP appointment seemed more trouble than flying to Barbados for the winter) I did take it upon myself to try and fix the problem – or at least alleviate some of the worst symptoms.
“SAD is a type of depression that affects people mainly during winter,” says Dr Qian Xu, A&E doctor and medical director at REDjuvenate Medical. “Around one in 20 people has been diagnosed, but it’s more likely about 10 per cent of people suffer from SAD.”
The trigger is the effect of less light on circadian rhythms. “Your circadian rhythm is a 24-hour body cycle – your internal clock,” says Dr Xu. “During these cycles, your body carries out essential functions; the most important is the sleep-wake cycle. A decrease in light can disrupt this internal clock and lead to feelings of depression.”
Brain chemicals also come into play, she explains. “Serotonin is a chemical messenger that works with your nerve cells. It is sometimes known as the ‘happy chemical’, but it also affects sleep health, bone health, digestion and wound healing. And reduced sunlight can cause a drop in serotonin.”
Melatonin, a hormone produced by the brain’s response to darkness, is also affected by changing light levels. “This, in turn, can negatively affect sleep and mood.”
A survey of 5,000 Europeans from Coffee and Health found that when days shorten, 21 per cent of us become more anxious, 24 per cent find it harder to concentrate and 25 per cent lose motivation to exercise.
If you haven’t been diagnosed with SAD you may not be aware of the symptoms, including appetite changes – “We all love carbs but an increase in cravings can be a sign,” says Xu. Then there’s loss of interest in activities, disrupted sleep and low energy – a classic sign of SAD. “You may also notice concentration problems.” And, of course, my own worst difficulty: oversleeping, yet still feeling tired.
The further north you go, the lower the light levels at this time of year, and SAD is more prevalent among people who live far north or south of the equator. It may also be affected by a lack of vitamin D, which helps to produce serotonin.
SAD sufferer Dr Michael Mosley investigated the condition and found evidence that people with SAD have higher than normal levels of SERT (a serotonin-transporting protein) during winter. “Higher levels of SERT mean lower levels of serotonin,” he says. “That could explain why SAD people feel so low.”
While some manage to live with the condition, others are rendered almost helpless by it. Women tend to suffer more than men. Robert Levitan, a professor of psychiatry at the University of Toronto, believes that’s a hangover from our long-ago past, saying, “Ten thousand years ago, this biological tendency to slow down during winter was useful, especially for women of reproductive age, because pregnancy is very energy-intensive.” Luckily, research since SAD was first identified in 1987 has provided several potential solutions, some of which I’ve tried and, I can report, do work (if you stick to them).
Maintaining a sleep schedule is essential, says Dr Xu. That means going to bed and waking at the same time every day, and opening the curtains to let light in as soon as you wake up. “Ideally, get outside early – morning light is the most effective at combating SAD.” I have started to do this, sleeping for eight hours, and forcing myself out of bed. If I take the dogs for a 10-minute walk, I feel far more awake by the time I drink my first cup of tea.
“Sticking to an eating schedule can also help stop the weight gain from carbohydrate cravings,” adds Dr Xu. I’m trying with this one, but when my brain wants toast, it doesn’t quit. Easier to manage is social activity. “Studies have shown there may be a causal link between social isolation and depression,” says Dr Xu.
Setting yourself goals for the day will also put you into a more motivated mindset, says Martin Preston, founder and chief executive at Delamere Rehabilitation Clinic. And don’t vegetate. “When you exercise, your body releases endorphins, which positively affect your mood. If intensive exercise doesn’t appeal, just have a target of a daily walk,” he suggests. “You may also benefit from mindful practices such as meditation.”
I now walk for at least 40 minutes every day – and it helps, without doubt. Preston adds: “If you work indoors, open any blinds to let in as much light as possible. It’s beneficial to work by a window to make you feel closer to nature.” However, when the daylight is more like grey water, light therapy can be an answer. “A SAD lamp can effectively give your body exposure to light that mimics the sun’s rays,” says Dr Xu. A meta-study from the University of North Carolina found that a significant reduction in depression symptom severity was associated with bright light treatment and dawn simulation in SAD.
Dr Xu also recommends a new version of the SAD lamp, Full Body Red Light Therapy (RLT) . “It’s key to giving your mitochondria – the body’s energy powerhouse – what they need to function correctly. That helps with melatonin production and circadian rhythm regulation.”
For those unable to afford red light therapy, however, there’s the SAD lightbox. Which type of lightbox to use depends on severity of symptoms and how they manifest – along with how much daylight you’re naturally exposed to. Experts recommend that SAD sufferers discuss their symptoms with their GP or pharmacist before buying a light box. The standard box emits 10,000 lux. This is around 20 times brighter than ordinary indoor light and UV light is filtered out – though they aren’t recommended for anyone with eye problems or photosensitivity. They are generally used every day for 30 to 45 minutes, usually first thing in the morning.
If that doesn’t alleviate the problem, psychologist Barbara Santini says: “A doctor may also prescribe antidepressants: these will take between four and six weeks to show positive changes.” Another approach is cognitive behavioural therapy (CBT), which uses mindfulness techniques that can be applied immediately to reduce anxiety and depression.
Further studies have shown the Mediterranean diet – oily fish, nuts, wholegrains, colourful vegetables, olive oil and a little red wine – is connected to lowered levels of depression. It’s also crucial to take a vitamin D supplement: oral spray is absorbed more effectively than pills
I’m already feeling more positive. I’ve added oily fish to my diet, and am sticking to my dog walks and yoga. I’m also making myself get up and outside to absorb the morning light, even if it’s obscured by curtains of rain. And if it gets really bad I’ll invest in a light box – because sadly, it seems stewing in front of the TV doesn’t count.
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