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Mental Health
Difference between SAD and depressive disorder
Is the ‘winter blues’ a real thing? When to know if you need help
The ‘winter blues’ may not be a recognised clinical diagnosis, but it is a very real phenomenon that can be associated with serious mental health issues.
It’s common to feel a shift in mood during the colder, darker days of winter, and the “winter blues” is recognised as a phenomenon that affects some Australians.
It can be as simple as feeling tired and gloomy, but if the fatigue and pessimism occur over a significant period every winter and interfere with daily functioning it may develop into a clinical condition known as Seasonal Affective Disorder (SAD).
Beyond Blue Lead Clinical Adviser Dr Grant Blashki says SAD is a recurring condition associated with less natural sunlight and includes a range of symptoms.
“People may experience a lack of energy and find it tough to get up in the morning,” he says. “With SAD, people can feel very fatigued and often crave carbs and overeat. Often, they lose interest in normal activities.
"Some people are really affected by the seasonal change, and it’s important to say it’s not a trivial problem — in my clinic I see that people can feel quite knocked about by it.”
How lack of sunlight can affect us
Blashki says SAD is related to the shortening of daylight hours during winter.
“Research suggests SAD is precipitated by less light exposure, which affects the body clock and sleep-wake cycle, as well as key regulatory hormones, particularly serotonin and melatonin,” he says.
“Research shows it occurs more commonly the further away from the equator you live, which corresponds with getting less sunlight in winter.”
Difference between SAD and depressive disorder
Blashki says a diagnosis of Seasonal Affective Disorder can be tricky because people often have reasons other than seasonal changes affecting their mood, such as financial or relationship issues, a family history of mental illness, or a genetic predisposition to mood disorders.
“We all have ups and downs with our moods, and we don’t want to over medicalise everyday human emotions - sadness is not always depression, and poor motivation is not always the winter blues,” he says.
“One tell-tale feature of Seasonal Affective Disorder is that the symptoms tend to come back at the same time of year, so there’s a consistent seasonal pattern.
“Whilst depression can occur at any time of year, people with SAD often report feeling ‘here comes winter and here comes my low mood!’”
When managing Seasonal Affective Disorder, it’s important to do some exercise every day, even if it's just for 20 minutes. Image: Matt Harvey
When should you seek help?
As a GP, Blashki says it’s important to assess if the depressive symptoms are pervasive and affecting a person’s ability to work or perform their usual family duties.
“With SAD or depression, the low mood and poor motivation is usually across all aspects of life. If it’s only when you go to work, it just might be, for example, that you hate your job.”
If feelings of lethargy, apathy or pessimism persist, Blashki recommends seeing a doctor.
“As a GP the first thing I do is a blood test. Sometimes we find that the someone experiencing these symptoms actually has low iron levels, or their thyroid hormone is out of whack, or perhaps they have developed diabetes. So, it’s a good idea to start with a GP and a general check-up,” he says.
COVID-19 impact on mental health
In addition, the COVID pandemic, with restrictions of movement, social-distancing measures, physical isolation, and lockdowns, has amplified the mental health issues people may be experiencing.
“Many people are not fully back to their usual patterns or routines yet, and I think the stress and anxiety isn’t just at an individual level, I think the whole community is still feeling burnt out,” Blashki says.
“With mood disturbances there is a usually a mix of physiological and social stresses and the pandemic has created many stresses in people’s lives.”
Research shows that light box therapy can be effective for some people suffering Seasonal Affective Disorder. Image: Getty
Tips to ease Seasonal Affective Disorder
Create a calendar
Blashski suggests creating a calendar for the week and maintaining a routine. “Firstly, it’s important to get enough sleep. One suggestion is to put away screens and social media by about 11pm, and I also suggest recharging your phone outside your bedroom overnight to give your mind a rest,” he says.
Exercise
There is scientific evidence that exercise can improve your mood and help you deal with mental health issues. It can be hard when it’s cold outside, however, indoor exercise or even going to the gym, if you can afford it, can be great for your mental health.
“When managing SAD, it’s important to establish good habits and, if possible, do some exercise every day, even just 20 minutes,” Blashki says. “Go outside at lunch time and get some light on your face, which helps reset your body clock.”
Healthy eating
“Healthy food is important too. There is some evidence that the Mediterranean diet is good for your mood and the Food and Mood Centre at Deakin University has useful resources about this emerging approach,” Blashki says. “From a practical point of view, make a point of organising your meals in advance, have healthy food in the home and eat regular fish, fruit and vegetables.”
Eating healthy meals can help improve your mood. Image: Unsplash
Artificial and natural light
Research also indicates that light boxes can be effective for some people with SAD. Blashki advises speaking to a doctor first to find out if this is an appropriate treatment for you.
“Speak to your doctor about getting the right sort of lamp, usually one with the brightness of 10,000 lux,” he says. “It is usually used for 30 minutes or an hour, especially first thing in the morning.
"It’s also important not to sit inside in a dark office all day—get outside at lunchtime, go for a walk, and get some sun on your face”
Chase the sun
For those who can afford it, one way of getting more sunlight is to travel to sunny locations closer to the equator for a holiday. There’s no evidence that this is a magic cure for SAD, but the rest and relaxation can provide a reset and rejuvenation.
Cognitive Behavioural Therapy
Medical research indicates that a psychological approach called CBT (cognitive behavioural therapy) can greatly help people deal with negative thinking, anxiety, and depression.
Blashki says it’s not always easy to get to see a psychologist but there are some good resources, such as the book Change Your Thinking by Sarah Edelman, which can help people to better manage their negative thinking and mood disorders. Beyond Blue also has extensive resources.
“There is also a free interactive website, Moodgym, which was developed by the Australian National University, and teaches people basic CBT skills, for example how to tackle common negative ‘warpy thoughts’,” he says.
Beyond Blue also has extensive resources online, and the Beyond Blue Support Service provides 24/7 advice and support.
