Coping During Another Pandemic Winter

It’s that time of year again. You know, when the cold weather and shorter days start to get to you? When all you can think about is hibernating until spring? Don’t worry, you’re not alone.

As the season shifts, so can our mood. We typically call it the “winter blues.” We spoke to an expert about seasonal affective disorder, most commonly referred to as seasonal depression, and how to combat it Shedrick Martin, Pharm.D, BCPP, is a clinical pharmacist specialist in psychiatry and a board-certified psychiatric pharmacist who treats patients with psychiatric and neuropsychiatric disorders.

“Generally, people look at seasonal affective disorder as what we call winter blues,” Martin says. “During the wintertime when there’s less light available, people tend to have a lower mood, lower energy, and a worse diet. Most people look
at this as being down in the dumps, but it’s an actual mood disorder similar to depression.”

When Diagnosing Depression, Healthcare Professionals Use The Mnemonic SIGECAPS:

[ S ] Sleep. (Having insomnia)

[ I ] Interest. (Losing interest in normal routine activities)

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[ G ] Guilt. (Feeling guilty or a sense of worthlessness)

[ E ] Energy. (A decrease in energy)

[ C ] Concentration or Cognition. (Having trouble completing strenuous tasks)

[ A ] Appetite. (Having a decrease in appetite)

[ P ] Psychomotor Agitation. (Having slow, purposeless movements)

[ S ] Suicidality. (Having suicidal thoughts)

While depression and seasonal affective disorder share parallel symptoms, according to Martin, signs of SAD are usually out of the norm for an individual and harder to recognize since it’s often attributed to being tired and sleepy during winter months. Instead of insomnia, people with SAD generally exhibit hypersomnia – the tendency to sleep more. Instead of losing appetite, people tend to load up on carbs. Losing energy and interest in society is expected, which leads to people isolating themselves at home. But why do depression and seasonal affective disorder even occur? Because of the decrease of serotonin – a neurotransmitter that regulates mood.

“Studies in the United States show that in the winter months or darker months, people produce less serotonin,” Martin says. “The other thing that’s common in SAD that’s not as common in regular major depressive disorder is an increase in what we call melatonin.” 

To non-medical professionals, melatonin is a drug used to promote sleep. Martin says the body naturally makes more of this based on the decrease of light during winter. Even more, data shows that people who live closer to the equator have lower rates of SAD. States like Florida and Georgia, for example, have around a 1-2 percentage level of SAD, compared to Alaska, which is closer to 7-9 percent, Martin says.

“There’s more melatonin present in the darker months because the use of light cues our brains to either make more melatonin or stop making it altogether. In the darker months, especially in the northern states, melatonin obviously increases, causing people to sleep more, which contributes even more to SAD.”

Martin also says SAD doesn’t have to coincide with winter but can occur around dates that trigger trauma, like the death of a loved one, for example.

IS THERE A CONNECTION BETWEEN VITAMIN D AND DEPRESSION?

Winter is also when people are most at risk for vitamin D deficiency, a vitamin critical for physical health that the body makes following sun exposure. 

Years ago, the National Institute of Health recognized that patients with mental health disorders such as depression, anxiety, and schizophrenia generally have lower vitamin D levels than populations who didn’t have any mental health disorders. Martin says this observation prompted studies to see if vitamin D would help depression. Interestingly enough, it didn’t.

According to research, people with mental health disorders, especially depression, are more likely to be socially isolated, resulting in less sun. They typically have poor diets and more medical conditions such as obesity, diabetes, cardiovascular diseases, and immune-related disorders. These populations also have lower levels of vitamin D. While Martin doesn’t think there’s a specific connection to low vitamin D and depression, the lifestyle of people with depression worsens their health overall and can lead to vitamin D deficiency.  

Martin also notes that people in Black and minority communities often have low vitamin D, which he attributes to a lack of health education, exercise, and medical issues. People with darker skin are also at risk for vitamin D deficiency because darker skin blocks more of the sun’s rays needed for producing the vitamin. Just because people with depression have low Vitamin D, that doesn’t mean it causes depression or SAD,” Martin says, “But it is insight on health status.”

SAD, DEPRESSION, OR OTHER?

Data shows mental health has plummeted during the pandemic, including SAD. While lots of people have suffered a loss in some form or another, other determinants have been attributed to people having more sedentary lifestyles, yo-yo sleep schedules, followed by the lack of fresh air and sunlight.

However, considering the nuances of depression and SAD, how do you go about determining the difference? Martin’s first recommendation is to seek a professional to make sure you’re “getting it right.” Too often, 

SAD is confused with other undetected issues, and determining the root of any health issue leads to better care and understanding.

The best way to improve SAD naturally is with sunlight, which Martin suggests getting as much of as possible. “When you wake up in the morning, open your blinds, maybe go for a short walk, anything you can do to soak up some sun.” Martin proposes light therapy for grayer locations such as Detroit and the rest of the Midwest and northern states. Using lightboxes as a source of artificial sunlight for a brief period daily can improve the symptoms of SAD.

Another natural way to minimize SAD is good sleep hygiene, which Martin considers the “cornerstone of health.”

According to him, when your circadian rhythm is off, mental and physical health outcomes are worsened.
The last way is a good diet. So often, we look for ways to medically combat disorders and diagnoses. And while the medicine is recommended, we can expect certain tag- team occurrences through health education and proactive measures. The seasonal affective disorder is accurate, but we have to do our part to combat it. 

“Overall health is significant in preventing deficiencies and reducing mental health and other physical conditions,” Martin says. “That’s always important to remember.”

“The lifestyle of people with depression worsens their health overall and can lead to
vitamin D deficiency.”  

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