By SARA ARTHURS
It’s Ohio and it’s February. The majority of people may not be thrilled about that combination. But for many people, the short, cold, gray days lead not just to disappointment, but the illness of depression.
Seasonal affective disorder, or SAD, is a subtype of major depressive disorder, said Hannah Stokes, assistant professor of psychology at Ohio Northern University. Symptoms include loss of appetite, sleeping too much or not enough (or just feeling “consistently tired,” Stokes said), feelings of worthlessness or guilt and major thought changes. Sometimes there are recurring thoughts of suicide.
People may also experience irritability, difficulty concentrating, and constricted thinking akin to “tunnel vision,” said Nancy Stephani, an outpatient therapist at Firelands Counseling in Fostoria and Fremont and a social work instructor at Ohio State University, Lima.
Stokes said people often also describe the symptoms of SAD as that “their body physically slows down” and they are moving more slowly and have slower reaction times. Other times it’s the opposite, and their body is excessively restless and they may have racing thoughts.
Stephani said light affects brain chemistry, and those of us in the northern hemisphere get less light from October through March. And if people have other things going on in their life, like a breakup or a job change, this can also contribute to depression — or, a life stress like this in combination with SAD can lead to more serious major depression.
Stokes said many complex systems affect circadian rhythms, the process that regulates the sleep-wake cycle. Two chemicals in the brain involved with this are melatonin and serotonin. Serotonin is also one of the major neurotransmitters implicated in the diagnosis of depression, so a disregulation with the serotonin system can lead to things like depression.
She said it’s not quite as simple as “it’s dark outside and so that causes depression.” There are “all kinds of factors” that compound together to produce symptoms of depression. But the lack of light means changes in how the body regulates sleep. In addition, when it’s cold outside, people are less likely to go out and can become more isolated.
Stokes said it’s important to prioritize seeing family or friends. “That sounds really simple” to someone who is not depressed, but is harder for someone facing depression. But breaking that cycle of isolation is really important, she said.
If you’re having trouble sleeping, “just not hungry anymore” or notice you have stopped hanging out with your friends or lost interest in your hobbies, that can be a sign, Stokes said. Or maybe you’re getting into more fights with your significant other about things you don’t usually fight about.
Treatments can include cognitive behavioral therapy, medication and light therapy. Stokes said as a clinician, “I tend to refer people to therapy first” before trying an antidepressant, because of possible side effects with medications.
Cognitive behavioral therapy works around “retraining a person how to think,” she said. If someone becomes depressed, “their worldview gets more and more negative,” so therapy involves reframing their thoughts.
Stephani added cognitive behavioral therapy is about how you “think, feel, do,” and you learn to challenge your irrational beliefs.
She said if people seek to go off their medications after depression, they should have been symptom-free for six months first, and should not go off their medication between October and March.
Cardiovascular exercise produces endorphins, which can help. But depression is “like thinking through mud,” and it can be hard for people to get up and go exercise, Stephani said.
Spending time next to a broad-spectrum light can cause your body to react as if it is sunlight.
“Your brain gets the message that it’s light outside,” Stephani said.
Stokes said not everyone finds the light helpful, but the thought is that spending time around the light can reduce the symptoms of SAD. And, there may be a placebo effect in that people who are “taking active steps toward making themselves better” often do indeed feel better.
Stokes said one misconception people have is that when it becomes more light out, the symptoms of SAD will automatically go away. This assumption can make it difficult for people who have depression who do not find that it improves. Sometimes people are depressed in winter and still experience symptoms in spring, when they feel like they “should” be happy.
People also can assume if they go on vacation to somewhere sunnier, it will fix the problem. But sometimes going somewhere warmer helps and sometimes “they go on vacation and they’re still depressed,” she said. And some people even find themselves becoming more depressed in the summer.
If it’s not you but a loved one who is depressed, Stokes said “being patient and listening” makes a difference. At the same time, she tells families “it’s so important to set boundaries.” If someone is depressed, “that doesn’t give them license to be abusive,” and if someone is talking of suicide, it’s OK to say it requires more intensive help, as you yourself “don’t have the training” to deal with that.
Stokes teaches courses related to clinical counseling at ONU. After earning their undergraduate degree, many of the psychology students go on to graduate school to become a counselor. She tells her students who are learning to be counselors that they need to pay attention to their patient’s narrative and “they really, really need to listen.”
The Hancock County Crisis Hotline is 888-936-7116 and the National Suicide Prevention Lifeline is 1-800-273-8255. To reach Ohio’s Crisis Text Line, text “4hope” to 741 741.
Arthurs: 419-427-8494 Send an E-mail to Sara Arthurs