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For many people, gazing out of a window is a pleasant thing. The birds, trees, and sky can all bring a smile. But for Melissa Lewis, 47, of Prescott, AZ, it had a different effect.
“When I lived in Minnesota, I remember looking outside and saying to myself, ‘Oh no. No sun today? No sun tomorrow?’ ” Each year, around the beginning of fall and through early March, she dealt with severe fatigue. All she wanted to do was sleep until spring rolled around. “I felt trapped,” she says.
Lewis was later diagnosed with seasonal affective disorder (SAD), a type of depression that affects 10 million people in the U.S. It’s most common in the fall and winter months when the days are shorter and there’s less sun on our skin. It can be mistaken for other issues. You can have it in the spring or summer, too. “In a paradoxical way, people with spring and summer seasonal affective disorder may get too much light,” says Rebecca Brendel, MD, JD, president of the American Psychiatric Association.
Not the Same as the ‘Winter Blues’
You can feel down in the winter and not have SAD. But if heavy fatigue lasts for days and comes with other symptoms, you may want to check with your doctor to see what the cause is, whether it’s SAD or something else.
Lewis knows this well. Each year, when the days got shorter, she would notice that she didn’t want to do her normal activities. She also felt sluggish and had strong food cravings. “I couldn’t get enough starchy carbs,” she says. These symptoms would last for days to months and only ease up when the sun began to hang around longer.
Many years and several doctors later, a naturopath doctor suggested Lewis get checked for seasonal affective disorder. Before that, she had gone to doctor after doctor, trying treatments that didn’t work. She tried to do her own research but kept coming up short. “I only remember reading one book about seasonal affective disorder,” she says. “I knew this wasn’t normal. But I was a busy mom, recent divorcee, and like a lot of moms… my kids and others came first.”
Lewis says her general practitioner did tests to rule out other conditions, and the process led to her SAD diagnosis. “I got lots of testing. I was low in vitamin D,” she says. “I’ve had an autoimmune disease since I was younger and learned later that I had ADHD, but nothing explained my seasonal depression.”
Even if you don’t have SAD, it’s best to get help for winter symptoms, Brendel says. If you’re a caregiver, family, or friend, be watchful of loved ones. “If someone skips holiday gatherings or just isn’t themselves, it’s best to ask how they’re doing,” she says. “If symptoms are causing issues day after day, contact your doctor. Reaching out for help doesn’t mean it’s going to be a diagnosis of seasonal affective disorder, but having consistent issues with sleep or depression should still be addressed.”
Ruling Out Other Causes
SAD’s symptoms can vary from person to person. They also show up with other conditions. So doctors will rule out other issues before landing on a SAD diagnosis, as Lewis’s general practitioner did.
“The first thing we want to do is make sure there’s not an underlying medical condition,” Brendel says. “We do a [thyroid] function test or look for things like anemia, which can make you really tired. We suggest a basic medical workup and check to see if there are other mood disorders such as bipolar depression. Whatever we find, we take it seriously.”
Treatments are fairly standard for those with seasonal affective disorder. “I recommend people with SAD spend more time outside and in the sun when they can,” says Atlanta psychiatrist Valdesha DeJean, MD. “Phototherapy lights can help by re-creating a sunlight environment, but it should be used at the right dosage and time frame. We will also prescribe antidepressants in some cases.”
Lewis found the biggest relief in several alternative therapies. “I’ve had success with acupuncture, supplements (5-HTP), and red-light therapy.” Although research is needed to see if it works for SAD, Lewis says red-light therapy helped her pretty quickly. She’s also found, like many others, that getting out in the sun is still some of the best medicine – and it was one of the things her general practitioner and many doctors highly recommend for people with SAD.
“I make sure I get outdoor time,” Lewis says. “I take a walk or just sit outside. It really helps.” It’s become a family affair. “My kids know I have seasonal affective disorder and that sleep and physical activity are family priorities. They’ve also learned a greater level of empathy and compassion.”
If you’re in a climate where there’s not a lot of sun? “I encourage people to travel to warmer climates during the winter months if they can,” DeJean says. “It’s a good time to use those vacation days.”
Lewis says she’s seen a huge improvement after moving from Minnesota to Arizona, where there’s a lot more sunshine. But no matter where you live, she says that paying attention to her health is how she’s gotten through some of her toughest days. “The biggest thing is looking at your life in a different way,” she says. “Your body speaks to you. It’s talking to you all of the time.”
Sunnier Days Ahead
Lewis also made some other changes that helped her.
Nutrition was at the top of her list. “I started eating gluten-free, I cut out processed foods, alcohol, and most added sugars,” she says. “I wouldn’t suggest trying those changes in the middle of the season or adding all that you cut out when the sun rolls around.” Although Lewis found those changes helpful for herself, gluten-free diets or any other nutritional interventions have so far not been shown to be effective treatments for SAD.
Another help for Lewis? Yoga. She practices it regularly, teaches classes, and wrote a book called The Angel Wears Prana. (Prana is a term used in yoga to describe breath and life.)She also practices a movement called grounding that involves some time outside and meditation, and she works as a massage therapist and holistic adviser after having worked for years as a corporate wellness adviser.
Looking back, Lewis found that having put herself last was partly why it took so long to get diagnosed with seasonal affective disorder. “We all give so much to our kids, our partners, that sometimes we forget to make sure we’re OK,” she says. Taking a firm interest in her own health and learning the art of saying no freed her up to address SAD and feel better.
“Just because something might be common, doesn’t mean we have to live that way,” as Brendel says.