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Health & Fitness Special Section Archives The Altamont Enterprise, February 11, 2010

Wash away your winter woes

By Zach Simeone

As the seasons change, so do we, and as the weather turns colder, drier, and grayer, so does the mind.

One common result is seasonal affective disorder, sometimes called SAD for short, or the winter blues. But the decrease in sunlight, the drop in temperature, and the effect of the weather on people’s social lives and exercise habits can exacerbate many psychological conditions, according to two local psychologists and a Hilltown physician.

Dr. Rudy Nydegger, a professor of management and psychology at Union College in Schenectady and chief of Ellis Hospital’s psychology division, has written a book called Understanding and Treating Depression: Ways to Find Hope and Help, in which he addresses winter’s effect on moods.

“Basically, the further away you are from the equator, and the less sun you get, it makes people a little more vulnerable to depression,” Nydegger told The Enterprise this week. “There are some people who will have seasonal depression, and that’ll be it. But, if a person has depression before the winter sets in, you can be sure that, in most cases, the effect of the winter will be problematic.”

While the exact role that sunlight plays in people’s moods is still debated, he went on, sunlight promotes the development of vitamin D, and lower levels of vitamin D may increase a person’s vulnerability to depression.

“We also know that the decreased sunlight will increase the production of the sleep hormone melatonin, which can only be produced by the body in the dark,” Nydegger said. “Some people tend to be more sensitive to melatonin. It doesn’t really cause you to sleep, but it enables you to sleep. But, in people very sensitive to it, it may cause some symptoms that are common with depression.”

Dr. Frank Doberman of Karner Psychological Associates in Guilderland is also a clinical professor of counseling at the University at Albany, a clinical associate professor of pediatrics at Albany Medical Center, and a certified school psychologist.

“One thing that’s kind of interesting: In countries like Iceland, where it’s dark all the time, studies show people get depressed in the sunlight,” said Doberman. “It’s what you adapt to. In our culture, it’s the presence of sunlight which seems to support better mood, but it’s not in every culture.”

Other studies have shown that the Icelandic people very rarely have seasonal affective disorder; the same was found of a group of Canadians that were examined, all of Icelandic descent. Some who have studied the phenomenon have said there is a genetic factor, while others have said that the lower levels of SAD in Iceland are due to the large of amounts of fish eaten there — more than 200 pounds a year per person, as opposed to 50 in the United States and Canada — as fish is high in vitamin D, and contains docosahexaenoic acid, an omega-3 fatty acid. Research has shown that docosahexaenoic acid may lessen neurological problems.

Both Doberman and Nydegger believe that the holiday season plays a role as well.

“I think that the change in clocks, to have it get darker earlier during that period of time before you start getting a sense that it’s getting lighter again, occurring with timing of the calendar with holiday stress, certainly increases many individuals’ sense of distress,” said Doberman. “So, in our kind of practice, we do see an increase in people seeking support during that time.”

Dr. Myria Emeny runs a 300-patient micropractice at the Anna W. Perkins Helderberg Health Center in Westerlo.

“I see a ton of seasonal affective disorder,” Emeny said. “Some people I can pick it up in, but they deny it. They’ll go, ‘Oh, that’s not me; I’m fine.’” Emeny estimates that about 10 percent of her patients — about 30 out of roughly 300 — exhibit signs of seasonal affective disorder.

Though Emeny sees patients of all ages, she said about 60 percent are elderly, and that the winter brings some age-specific issues.

“If you have decreased vitamin D, you have increased arthritis pain and osteoporosis pain,” Emeny said. “I also get more complaints of pain that turns out to be secondary to depression. So, you get increased pain from arthritis in the cold, and the inability to go out. But you also get increased pain from the seasonal affective disorder.”

In addition to the direct changes in the body caused by decreased sunlight, people tend to socialize and exercise less in the winter, Nydegger said.

“Decreased socialization will interfere will the production of certain neurochemicals like serotonin, which can cause depression,” he said. “If we think of the problems that come about in the winter, like being socially isolated, not working out or exercising often — these are all stress-reducing things, and any problems we have are going to be worse in the winter because we don’t have those things to reduce our stress levels. People are in-doors, they’re in contact with more germs, they get sick more often, and we see more anxiety.”

Doctor’s orders

These three doctors concur: Exercising and spending time with friends is a must. But there are other ways to manage depressions that are either caused or enhanced by the cold.

“I also give a lot of supplements,” said Emeny.

One is SAMe, an over-the-counter antidepressant, “so people don’t feel like they have to do a prescription,” she said. SAMe, or S-adenosylmethionine, is a synthetic version of a compound that the body produces naturally. Studies have shown that the supplement may treat depression by increasing the availability of serotonin and dopamine, two neurochemicals produced by the brain that have a heavy bearing on mood and other functions.

Another supplement Emeny recommends is St. John’s wort, an herbal treatment derived from the Hypericum perforatum plant, “which they start a month before it gets dark and gloomy out,” she said.

St. John’s wort is used to treat both anxiety and depression, as one can cause the other, Emeny said.

“A lot of folks who have depression will have anxiety because they’re not controlling their depression — ‘I’m anxious I didn’t get this done, because I didn’t have the energy, because I have the depression,’” Emeny explained.

Patients may also look into light-therapy products, often called light boxes, “where people can sit in front of them for four to six hours, and it’ll increase vitamin D production and decrease melatonin,” said Nydegger.

But, he said, these instruments are expensive, potentially costing hundreds of dollars, and he reiterated that remaining physically and socially active will have benefits similar to the effects of the artificial light.

“You want to keep it bright inside,” he said. “Don’t sit in a gloomy, dark room with the television on.”

Some of Emeny’s Hilltown patients use light boxes.

“I actually currently have a note on my mirror to remind me to find a light box for a patient who has seasonal affective disorder,” Emeny said. “The lights mimic the sun, and it helps people with seasonal affective disorder if they sit in front it for one to two hours a day. Four to six hours — I never get anyone to comply with that; but, if I get them to sit still for two hours a day, they do get some benefit.”

In areas of the world where daylight is sparse, light cafés — like Iglo Ljuscafé in Stockholm, Sweden — provide customers with artificial sunlight, so they can fill up on vitamin D for a better mood.

“They have a light box up at Greenville Physical Therapy,” Emeny said. “You get the same rays that you’d get from the sun, and it can help to keep psoriasis under control, too.”

Doberman recommends good “sleep hygiene” as a means to fight off the winter blues.

“Sleep is a hugely underestimated component of sadness, as is activity,” said Doberman. “You have to put energy into your wellness in the winter.”

Nydegger, like Emeny, sees many patients who deny that they are experiencing depression. But, he said, people should talk to doctors as soon as they see a change in themselves.

“A lot of it has to do with how well read or sophisticated people are,” said Nydegger. “I think a lot of people have heard of seasonal affective disorder, so, I think many people experiencing it would accept it and say, ‘It’s winter, and I get more depressed. That’s just what happens.’ They may have a general understanding, but they would not pursue treatment.”

Others, he said, might not even notice the change in their moods, but the people around them would.

“A lot of times, when people are experiencing something like depression, but they don’t have the insight, they might say, ‘Well, it’s a stressful time at work,’ or, ‘My kids are stressing me out,’” Nydegger said. “But, when we look at depression, we’re never really trying to find out what one thing is involved, because it’s never just one thing; it’s usually several.”

Further, alcohol and drug abuse and overeating should be avoided, as they may serve as short-term solutions, but will likely make matters worse in the end.

“When people notice that they’re down and not feeling the way they usually do, and they think there might be a seasonal component to it, I would be very aggressive about making yourself get out — be physically active, go to the gym, or just get out and walk; even 15 minutes a day can make a difference in how people feel,” Nydegger concluded. “Push yourself to be more socially and physically active, get as much sunlight as you can, and avoid the things that may make the problem worse.”

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