The New Nation - Internet Edition

During the winter months in northeast Wisconsin, it is not uncommon for people to want to hunker down, eat comfort food and stay indoors.

When these desires begin to affect normal daily activities or coincide with feelings of sadness and depression, however, it may be more than just dealing with a cold time of year.

Jeff Stumbras, a licensed independent clinical social worker and marriage and family therapist, says an estimated 10 million Americans experience Seasonal Affective Disorder (SAD) each year.

"Seasonal changes have profound effects on our mind and body so when darker days of winter approach, people feel mood and behavioral changes," explains Stumbras, who practices with Prevea Health at the Prevea Ashwaubenon Health Center. "The symptoms include appetite changes, feelings of depression, the desire to sleep more and the inability to concentrate."

"People might also notice low energy levels, a loss of interest in things they usually enjoy doing, moodiness or the inability to stay asleep," adds Pam Clough, a therapist at Bellin Psychiatric Center, Green Bay. "These are all symptoms similar to clinical depression, but are not as severe."

Recognizing SAD

Many people who seek help for these symptoms know that they feel different but often don't recognize the seasonal pattern of their symptoms until they've talked to a medical professional.

"A lot of people come in and say that they just feel crummy," says Stumbras. "We then start taking a medical history and if the patient does have SAD we see a cyclical occurrence of the symptoms."

People in Wisconsin can start seeing SAD symptoms as early as October and many feel better by the end of March.

"We often say that to diagnose the feelings as SAD they need to have occurred in a seasonal pattern for two years and the patient should feel recognizably better in the summer," explains Sandy Stadler, an EAP counselor with Aurora Health Care.

Not the winter blues

Stumbras also points out that there is a difference between SAD and the winter blues.

"Winter blues are also very common. People with the winter blues, as opposed to SAD, are less cheerful and less energetic than normal but they don't have the profound sleep and appetite changes and concentration difficulties that go along with SAD," he says.

He also points out that people suffering from SAD also often gain weight because of low energy and the desire for high-carbohydrate "comfort foods."

Women at risk

While SAD can affect anyone, there are certain populations that are more at risk than others. Women, young adults and people who have family members who suffer from SAD are at the highest risk of experiencing it themselves. Geographically, the farther you live from the equator the more likely you'll see cases of SAD because of the long periods of dark hours during the winter months.

Treating SAD

Because the main cause of SAD is the change in exposure to sunlight, the primary treatment for SAD patients is light therapy.

It doesn't take long to find out if light makes a difference if it really is SAD. The patients sit in the light for 20 minutes each morning. Seventy-five to 80 percent of people get better with light therapy. If the light doesn't work, other options are talk therapy and medication. Patients who aren't seeing success with other options should look into medication. Through the care of a physician, SAD patients can begin anti-depressants before the symptoms get too bad each year and know when to start tapering them off at the end of the season based on their cycles of feeling bad.

Exercise, sleep and light

Additionally, Clough recommends certain lifestyle considerations to help control the symptoms of SAD.

You can replace your light bulbs with full spectrum bulbs, which give the brain what it's missing from the sun. Exercise is also important.

Since exercising outside isn't always possible in the winter, Clough recommends going to the mall to walk. Keeping yourself on a strict sleep schedule will help as well and looking for ways to get more light into your life. Go for a walk or drive your car for 15 to 20 minutes in the middle of the day to get some sunlight exposure.

Even simple things like keeping shades and shutters open and sitting in the lightest rooms of your home can help.

Asking for help

Above all, doctors encourage anyone who is feeling crummy to seek help.

We are always sensitive to it when we see people in the winter months and ask the questions to find out if it we can identify a pattern.

Sometimes people just need someone to help them figure out how to cope with their feelings. Others need more and we can help them in either situation.