When the days become shorter and darker, some people fall into seasonal depression: they are depressed and lack drive, have an extreme need for sleep, and a ravenous appetite for sweets. Winter depression is seasonal depression. Year after year, it begins in the autumn months and ends in spring.
Winter depression – Description
Winter depression is one of the seasonal affective disorders (SAD). It occurs every year in the dark season: Winter depressions begin in the autumn months and usually end in spring. During this time, those affected complain of lack of energy and excessive sadness. They have a pronounced need for sleep and usually have more appetite than usual, especially for sweets.
SAD occurs significantly less frequently at other times of the year – even in summer. Some patients with SAD are not depressed but manic, which means they are inappropriately euphoric, tend to keep their distance, and overestimate their own abilities.
Not every depression in winter is a seasonal depression
Of course, people also suffer from classical depression in the winter. Only about every tenth depression that occurs in winter is actually a real seasonal depression.
Seasonal depression is less frequent than other forms of depression. Estimates suggest that in Europe about one to three percent of adults suffer from SAD.
Since the depressive symptoms appear regularly during the winter season, winter depression is placed in the group of recurrent depressive disorders.
Women are more often affected by seasonal depression than men. Children and adolescents can also fall ill. In southern countries, winter depression is generally less common. In the more northern latitudes, it is more frequent.
A more harmless – because clearly weaker – form is the Winter Blues. The blues sufferers drag themselves through the dark days without motivation and in a bad mood, but they are not really depressed. Among experts, this milder form is also called subsyndromal SAD (s-SAD).
Seasonal depression: Symptoms
The symptoms of seasonal depression differ in some respects from those of classic depression. For example, people with seasonal depression are extremely tired and even sleepy (hypersomnia). Especially in the morning, they find it difficult to get out of bed.
Another typical symptom of seasonal depression is an increased appetite and a ravenous appetite for carbohydrates, especially for sweets. This is why people affected regularly put on weight in winter. A stronger need for sleep and a craving for sweets are not unusual in winter, however. Only when these needs degenerate and become a burden, treatment is necessary.
Further symptoms of seasonal depression are:
- Lack of energy
- General listlessness
- Depressed mood
- Neglect of social contacts
Seasonal depression: causes and risk factors
Genes, hormones, but also the stress load and stress processing play a role in the development of depression. Experts suspect the cause of SAD mainly in the changed light conditions in winter. Depression can be the result of altered hormone production during the dark season.
Little light, a lot of melatonin
When it gets dark in the evening and less light enters the eye, this is a signal for the pineal gland. It releases the hormone melatonin – the human body gets tired. In winter the light intensity is generally lower. Therefore, more melatonin is also released during the day.
In patients with seasonal depression, the information flow from the visual cells in the eye to the brain is disturbed. Their photoreceptors are less sensitive to light than in other people. If the light is scarce in winter, their brain is stimulated to produce more sleep hormone than is usual in winter anyway. This could be an explanation for their severe fatigue and depressive symptoms. Because melatonin also dampens drive the mood.
A lot of melatonin, little serotonin
It is very likely that the neurotransmitter serotonin is also involved in the development of seasonal depression. For the production of melatonin, the body converts serotonin – the serotonin level decreases. This has an influence on the mind: Serotonin is considered a happiness hormone – it lifts the mood, among other things. Antidepressant drugs that increase the level of serotonin in the brain (SSRI = serotonin reuptake inhibitor) can improve seasonal depression.
If the brain lacks serotonin, it tries to compensate for the deficiency: An irrepressible craving for sweets overcomes many people with seasonal depression. Sugar and some ingredients of chocolate help to make more serotonin available to the brain cells again.
Adjusted biological rhythm
The human body follows a biological rhythm. The sleep-wake rhythm in particular is regulated by the incidence of light in the eye. With humans with seasonal depressions, the rhythm is obviously adjusted: They pour out Melatonin only late, and the production continues also in the morning hours on a higher level.
Seasonal depression: Diagnosis
For the diagnosis of seasonal depression, the characteristic recurring symptoms during the dark season are decisive. The depressive symptoms appear within several winter seasons and subside completely within 90 days.
A stronger need for sleep and a desire for sweets is not unusual in winter. Only when these needs degenerate, treatment is necessary. Only a psychiatric specialist is able to distinguish between a light winter blues and real depression. Therefore you should not hesitate to consult your doctor if you are in a gloomy mood during the cold season. The doctor will first talk to you in detail in order to be able to estimate the extent and the accompanying symptoms of the low mood.
With this knowledge in mind, the doctor will examine you physically, from an internal and neurological point of view. Blood tests, ultrasound (sonography), and, in rare cases, a magnetic resonance tomography of the head help to exclude other causes. These could be, for example, a lack of vitamin B12, dementia, or hypothyroidism. Various drugs can also trigger or aggravate depression.
Questionnaires used in the outpatient departments of psychiatric hospitals, by psychiatrists and neurologists help to classify the depressive symptoms.
Seasonal depression: treatment
The most important therapeutic option for patients with seasonal depression (SAD) is light therapy. For two weeks, the patient sits in front of a light device with about 2,500 lux every day before sunrise and after sunset for a maximum of one hour at a time. This artificially extends the day.
With a stronger light source of 10,000 lux, 30 minutes of light therapy per day is sufficient. With their help, the mood can brighten up after just a few days. For comparison: a bright sunny day can shine with up to 100,000 lux.
Especially in cases of severe seasonal depression, additional drug treatment is necessary. This involves the use of drugs that are also used for other forms of depression, especially selective serotonin reuptake inhibitors (SSRIs).
In addition to light and tablets, psychotherapy also helps. Cognitive-behavioral therapy, for example, has proven to be effective in treating seasonal depression.
What you can do yourself
During the dull months, the body needs as much natural daylight as it can get. This is not only true for people with seasonal depression. Move around a lot outdoors, for example, through:
- Cross-country skiing or skiing
- Nordic Walking
- Long walks, especially in the morning
All lazybones should remember that even an overcast sky is significantly brighter than any ordinary artificial light source. Exercise in the fresh air should activate the circulation as early as possible in the first morning hours. Even a well-structured daily program can have a positive effect on seasonal depression.