Let the sun shine: Mind your mental health this winter

Although the winter season begins with a bit of holiday cheer, many people feel a little “off” as the cold weather drags on. I’ve already seen a few patients who are puzzled by how easily they become irritated. “Is there something wrong with me?” “Why am I so unhappy?”  Often, their bodies are just responding to the darker and colder days.

We are governed by circadian rhythms, our body’s natural clock that helps regulate important functions including sleep/wake cycles and mood. These rhythms can be thrown off by the winter season.¹ The sky gets bright later in the morning, and dark earlier in the evening; yet, our hectic schedules require us to keep going as if nothing has changed. This shift, along with other factors – including genetics and body chemistry – may affect your mental health.

Maintaining wellness

Exercising, eating nutritious foods, practicing mindfulness, and maintaining social support systems are core components of maintaining a healthy lifestyle. Not only is physical activity a fantastic outlet for stress, exercising 30 minutes daily may help your body release endorphins, your natural “happy hormones.” It may be challenging during the holidays to eat healthy, but try to fill up first on healthy fruits and vegetables to maintain a balanced diet then have the occasional indulgence.

Meditation has been shown to improve symptoms in people suffering from depression and anxiety, and may also help you to stay well. Meditation can be as short as a 10-minute session every other day when you take the time to be mindful and check in with your body. Some people, especially those who find it difficult to quiet their minds, may find guided meditation helpful. There are plenty of apps such as Headspace and podcasts available to help you. Other meditative practices such as yoga, taking a quiet stroll in a park, or even closing your eyes to focus on listening to your favorite song can also be helpful.

Keeping in touch with your family, friends, and other caring people in your life strengthens your sense of community, and provides you with a strong support system to call on when you feel down.

Light therapy

Some studies² have shown that light therapy may benefit those with depression, especially if it is related to the season. A review article³ showed that light boxes that produce light intensities of more than 2,500 lux are beneficial (to compare, a cloudy winter day provides around 4,000 lux whereas a sunny day provides 50,000– 100,000 lux!). We usually recommend that light therapy be used early morning when you wake up, using a fluorescent white light box of 10,000 lux without ultraviolet wavelengths⁴ (these are sold specifically for seasonal mood problems). You should position the light 12-18 inches from yourself for approximately 30 minutes, keep your eyes open but do not look directly into the light. Many people will place it nearby as they eat breakfast or begin their daytime chores. Although light therapy is generally well tolerated, you should consult your doctor before starting the therapy, especially if you have preexisting conditions such as eye disease. Possible side effects include headache, eye strain, nausea, and even agitation or sleep disturbance, although this is usually related to using the light later in the day.

When to seek medical attention

Depression can come on during any season, and although some people might think they feel just a little “off,” it is important to call your doctor when you have these concerning signs of depression:

• depressed mood most of the day
• decreased interest or pleasure in activities that you used to enjoy
• difficulty sleeping or sleeping more than usual
• moving slower or feeling more hyperactive during the day
• feeling tired and less energetic
• feeling worthless or excessively guilty
• difficulty concentrating more than usual
• thoughts of death, suicide, or harming others

If you notice these symptoms almost every day during the week, or have thoughts of harming yourself or others, seek medical attention right away. It is also important to reach out to the supportive people in your life. If you notice these symptoms tend to occur in the winter months, you may suffer from seasonal affective disorder (SAD), which could benefit from medical treatment.

References

1. Duffy JF, Czeisler CA. Effect of Light on Human Circadian Physiology. Sleep Med Clin., 2009.
2. Golden RN, Gaynes BN, Ekstrom RD, et al. The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. Am J Psychiatry, 2005.
3. Westrin A, Lam RW. Seasonal Affective Disorder: A Clinical Update. Annals of Clin Psychiatry, 2007.
4. Kurlansik SL, Ibay AD. Seasonal Affective Disorder. Am Fam Physician, Dec. 2012.