WHYSO SAD?

As the days get shorter and the temperature starts to drop, those suffering from Seasonal Affective Disorder (SAD) will not be looking forward to the winter ahead.

The end of October is when, across Europe, the clocks move back an hour. Most relish the extra hour in bed, and enjoy the increased light in the morning, however it soon feels like the night is closing in when we start going to work and coming home in the dark.

This may be an inconvenience for most people, but it has a serious impact on a minority that suffer from SAD. The symptoms of sufferers can range in severity, to being grumpy and gaining weight, to barely being able to get out of bed, having to take time off work, and having to limit activities.

There are a few theories as to why people should be so affected, one idea Increased desire for sleep and calorific foods, as well as depression, anxiety, loss of libido and moodiness are common symptoms of SAD, and it seems that sufferers want to ‘hibernate’ for the winter. As the name suggests these symptoms are related to the changing seasons, and usually start to kick in around October/ November and start to lift in March/April. It is this that makes it different from depression.

There are a few theories as to why people should be so affected, one idea is that people struggle to sync their internal clock once the light gets too low, so they are in a kind of perpetual jetlag. Another is that some people produce more melatonin during the winter, which affects their sleep cycles. Melatonin usually increases at night helping people feel sleepy and decreases in the morning sunlight, something vanishingly rare from November onwards. Scientists are also seeing results that suggest these factors suppress the formation of serotonin, which would exacerbate the condition.

Adding to this, there is growing evidence that the lack of vitamin D, caused by the lack of sun, could be feeding into these mechanisms. It seems that there is probably no one answer, and SAD is caused by more than one factor working together.

Many people are affected to some degree, and while it’s not realistic for most to move away from the Northern hemisphere for winter and escape, there are some ways of alleviating or managing the symptoms.

Light, or lack of it, seems to be the main cause of SAD. There are different ways of combatting this; light boxes can simulate real sunlight, and don’t require any effort. Just sitting in front of one for an hour a day while reading or working for two weeks, sees symptoms alleviated in around 85% ii of cases. Many people swear by a dawn-simulating alarm clock as well; these slowly brighten simulating a natural dawn to wake people naturally, and many will also offer a dawn chorus to really speed people on their way to a bright morning.

Many people with SAD take vitamin D supplements; people get vitamin D from their diets as well as sunlight, and it is thought that supplements may help, although science is divided on their effectiveness.

It’s also recommended that people who suffer from SAD try different forms of therapy to help them cope with the symptoms. Cognitive Behavioural Therapy (CBT) has seen promising results, and is a treatment used for depression and anxiety in general.

Chasing the sun

Lack of natural light has a massive impact on humans. Countries that have more dark hours have more sufferers of SAD; Scandinavians have sources mentioning the symptoms as far back as the sixth century.

Rjukan is a town in Norway that sits nestled in a deep valley 176 km west of Oslo, and during the day from September to March, the town gets no direct sunlight. Residents can see the light on the mountains surrounding them, but it never hits them, and they spend Autumn and Winter in a perpetual crepuscular light.

In 1928 a cable car was erected to allow townspeople to get high enough to experience the sunlight, but it wasn’t an ideal measure. In 2013, Martin Andersen, a local artist, developed ideas first proposed in 1913 and built a mirror, dubbed the Solspeil, on the top of a mountain with the intention to bring the sun to the inhabitants. During the no-light months it reflects the sunlight down into the valley for the residents to enjoy. During December and January that only amounts to two hours, but it has made a massive difference in peoples’ lives and is drawing attention from other light deprived places. Despite the £500,000 price tag, residents seem entranced with their new sunlight, and the project highlights how important sunlight is to people.

What impact does Daylight Savings Time (DST) have? It increases light in the evenings so it would be expected to help. DST has been used since the early 1900’s, starting in a small area in Canada and widely used in Germany from 1916 to save money on lighting. It is now used in 70 nations across the globe to allow more light in the evenings. So, does DST help SAD?

The evidence would suggest not. The American Medical Association recently published a study that listed the health costs of DST iii . It’s been long-noted that the time of year around the change sees increased incidences of strokes and heart attacks. The vulnerable – people suffering from illnesses, the elderly and children are particularly susceptible to interruptions in sleep patterns and impact on cognition caused by DST. There also seems to be a correlation with instances of traffic accidents. It would seem that the negatives outweigh the potential positive economic impacts, and in some cases the use of DST can make symptoms of SAD even worse.

The impact is so deleterious that the EU has passed legislation for all member states to stop use of DST by 2021. Nations will need to decide if they want to be on permeant ‘summer’ or ‘winter’ (standard) time in 2020.

The most important thing to remember is that around 20% of people in the UK and Ireland suffer to some extent, which at around 13 million people is no small number. Also, there are lots of options available that may work to help mitigate or banish symptoms. Most of us are affected to some extent by the long winter months, and it seems that the absence of light impacts our physical as well as mental health. Realising the issue and taking steps to counter it may mean you don’t need to wait till spring to feel better.