Looking out the window is a pleasant thing for many people. The birds, trees and sky can all bring a smile. But for Melissa Lewis, 47, of Prescott, AZ, it had a different impact.
“Living in Minnesota, I remember looking outside and going, ‘Oh no. No sun today? No sun tomorrow?’ “Every year, around the beginning of autumn and up until the beginning of March, she would struggle with severe fatigue. She just wanted to sleep until spring came. “I felt trapped,” she says.
Lewis was later diagnosed seasonal affective disorder (SAD), a type of depression that affects 10 million people in the United States. It is most common in the fall and winter months when the days are shorter and less sun shines on our skin. It can be confused with other problems. You can also have it in spring or summer. “Paradoxically, people with seasonal affective disorder may get too much light during spring and summer,” says Rebecca Brendel, MD, JD, president of the American Psychiatric Association.
You can feel down in the winter and you don’t have SAD. But if the severe fatigue lasts for days and is accompanied by other symptoms, you might want to ask your doctor what’s causing it, whether it’s SAD or something else.
Lewis knows that well. Every year, as the days got shorter, she found she didn’t want to go about her normal activities. She also felt sluggish and had severe food cravings. “I couldn’t get enough starchy carbs,” she says. These symptoms lasted for days to months and only subsided when the sun was longer.
Many years and several doctors later, a naturopath suggested Lewis get screened for seasonal affective disorder. Before that, she had gone to one doctor after another and tried treatments that didn’t work. She tried to do her own research but kept coming up short. “I just remember reading a book about seasonal depression,” she says. “I knew it wasn’t normal. But I was a busy mom, newly divorced, and like many moms…putting my kids and others first.”
Lewis says her GP ran tests to rule out other medical conditions and the process led to her SAD diagnosis. “I got a lot of tests. I was low on vitamin D,” she says. “I’ve had an autoimmune disease since I was younger and later found out 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 are a caregiver, family or friend, pay attention to your loved ones. “If someone is skipping holiday meetings or just not being themselves, the best thing to do is ask how they’re doing,” she says. “If the symptoms are causing you problems on a day-to-day basis, see your doctor. Getting help doesn’t mean you have seasonal affective disorder, but persistent problems with sleep or depression should still be addressed.”
The symptoms of SAD can vary from person to person. They also show up with other conditions. So doctors will rule out other problems before landing on a SAD diagnosis, as Lewis’ family doctor did.
“The first thing we want to do is make sure there’s no underlying disease,” says Brendel. “We are doing a [thyroid] Functional test or look for things like anemia that can make you really tired. We suggest a basic medical evaluation and check whether other mood disorders such as B. a bipolar depression. Whatever we find, we take it seriously.”
Treatments are pretty standard for people with seasonal depression. “I recommend that people with SAD spend more time outside and in the sun if they can,” says Valdesha DeJean, MD, an Atlanta-based psychiatrist. “Phototherapy lights can help by restoring a sunlight environment, but they should be used at the right dosage and time frame. In some cases we will also prescribe antidepressants.”
Lewis found greatest relief in several alternative therapies. “I’ve had success with acupuncture, nutritional supplements (5-HTP), and red light therapy.” Although research is needed to see if it works for SAD, Lewis says that red light therapy helped her fairly quickly. She has also, like many others, found that getting out in the sun is still one of the best medicines – and it was one of the things that her GP and many doctors highly recommend for people with SAD.
“I make sure I have time outside,” says Lewis. “I go for a walk or just sit outside. It really helps.” It’s become a family affair. “My children know that I suffer from seasonal depression and that sleep and physical activity are family priorities. They have also learned a higher level of empathy and compassion.”
If you are in a climate where there is not much sun? “I encourage people to travel to warmer climates during the winter months if they can,” says DeJean. “It’s a good time to use these 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 she’s gotten through some of her toughest days by taking care of her health. “The biggest thing is seeing your life from a different perspective,” she says. “Your body speaks to you. It talks to you all the time.”
Lewis also made some other changes that helped her.
Diet was high on her list. “I’ve started on a gluten-free diet, cutting out processed foods, alcohol and most added sugars,” she says. “I wouldn’t suggest trying these mid-season changes or adding whatever you cut out when the sun rolls around.” Although Lewis has found these changes helpful for himself, gluten-free diets or other nutritional interventions have not proven to be effective treatments for SAD proven.
Another help for Lewis? Yoga. She practices it regularly, teaches classes and has written a book entitled The angel carries prana. (Prana is a term used in yoga to describe breath and life.) She also practices a movement called grounding, which involves some time outdoors and meditation, and she works as a masseuse and holistic consultant after years of working as a wellness consultant has worked for companies.
Looking back, Lewis realized that part of the reason it had taken so long to diagnose seasonal affective disorder was that she had put herself last. “We all give so much to our children, to our partners, that sometimes we forget to make sure we’re okay,” she says. A strong interest in her own health and learning the art of saying no freed her to address SAD and feel better.
“Just because something could be commonplace doesn’t mean that we have to live that way,” says Brendel.