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'Winter blues' may be more serious condition

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By Leslie Moore

 

Feelings of extreme sadness, loneliness and hopelessness are how local resident Alicia Irwin describes her decades-long struggle with seasonal affective disorder, a form of depression that occurs during the winter season.

Now 54, Irwin said she has experienced depression in the wintertime since early adulthood.

“I didn’t realize what it was until they gave a name to it later, but I knew that I had more problems with depression in the winter months than I did in the summer,” Irwin said.

According to local clinical psychologist Dr. Vicki Van Cleave, seasonal affective disorder is related to light and temperature changes that are associated with the seasons and the days getting shorter.

“We used to think it was just related to light, but we have a little bit of evidence now that it’s also related to temperature,” Van Cleave said.

Seasonal affective disorder has received a lot of media coverage in recent years. However, according to local clinical psychologist and Campbellsville University Professor Eric L. Bruns, general depression is more common than seasonal affective, and because it, too, is often experienced in the wintertime, this can lead to misguided self-diagnoses.

“In the mental health world, we have to be very, very careful when choosing treatments because if we have a wrong diagnosis ... treatment may do more harm than good,” Bruns said.

Van Cleave said changes in seasons and number of daylight hours impacts everyone, so having a dip in mood and energy in the winter followed by an elevated mood and a spike in energy in the spring is normal. When making a diagnosis of seasonal affective disorder, she said she looks for these dips and spikes in the extreme.

Irwin said her depression is, for the most part, confined to the winter months and she doesn’t experience many problems in spring and summer.

Local psychiatrist Dr. Mark Hyatt said the best treatment for seasonal affective disorder is light treatment therapy, which involves sitting under a special bulb that emits light intended to mimic the effects of sunlight.

“You may extend your light exposure up to four hours a day,” Hyatt said. “It’s not very convenient, but it’s very effective.”

Van Cleave said the light equipment ranges in cost from $200 to $500, but in some cases can be covered by insurance. For patients without insurance, or for those whose insurance will not cover the light equipment, Van Cleave recommends the use of sunlight lamps. Though their intended use is to aid the growth of indoor flowers and plants, sunlight lamps are a cheaper alternative.

“It’s a little more cost effective,” Van Cleave said. “There’s not as much research on it. I have more kind of anecdotal information out of 20 years of practice, but people say that it works some.”

Van Cleave stressed that going to a tanning bed is not an effective treatment for seasonal affective disorder. Although some sufferers claim that tanning beds work wonders for them, Van Cleave said it doesn’t offer any long-term benefits.

“It’s more like a Band-Aid, and the risks kind of outweigh the benefits,” Van Cleave said, referring to the association between tanning beds and skin cancer.

The use of antidepressants to treat seasonal affective disorder is controversial.

“I try to manage seasonal affective disorder without any meds to start off with,” Van Cleave said.

In some cases, she says, antidepressants can even make symptoms worse. However, she said some patients might benefit from them.

According to Hyatt, although antidepressants will not completely prevent the symptoms of seasonal affective disorder, they can be beneficial for many patients, especially for those who cannot afford light therapy.

Hyatt said he often prescribes his seasonal affective disorder patients antidepressants in September to give the medication plenty of time to work so when symptoms set in at the first of winter, they will be much less severe.

Irwin said she takes an antidepressant and it has been very helpful in treating her depression and migraines.

According to Dr. Susan Howell, psychologist and professor at CU, many sufferers of depression are reluctant to take antidepressants, which can hinder treatment.

“I think a lot of people have an attitude that medication is negative, and I think some of that comes from fear of addiction,” Howell said. “But some of the newer generation medications have little risk of that.”

According to Bruns, an effective treatment for milder cases of seasonal affective disorder and depression is exercise.

“When you feel the inclination to do nothing, you need to combat that by actually getting up and being active,” Bruns said. “If you can stimulate yourself to do a cardiovascular activity on a regular basis ... it will increase [your] energy.”

While Irwin said she tries to stay physically active, an artificial hip hinders her from doing much exercise outside of walking. And while she enjoys walking around CU in the warmer months, she is prone to bronchitis and must stay indoors when it is cold and rainy.

According to Irwin, one of the most useful treatments for her depression has been making an extra effort to socialize with friends and keep busy with projects.

“We have a great Sunday School class, and so we meet for coffee a lot, and I would also encourage people to mix with friends because if you isolate yourself, it gets worse,” Irwin said.

Quilting, baking cookies, making candy and working puzzles are some hobbies she says are good for the times when she is alone.

Irwin said her most of her family and friends have been supportive and understanding of her struggle with depression, but she has encountered a few people who do not take depression seriously.

“Unfortunately, I guess we’re in the Bible Belt, and a lot of people think that if you have enough faith, you can overcome depression, but that’s not true,” Irwin said.

While this story will make Irwin’s struggle public, she said she thinks being open about her depression might be helpful to others experiencing it.

“If I can help anybody, that would be great because I saw the shape [my mother] got in by not getting help,” Irwin said. “She had to be hospitalized several times because she was suicidal.”

Irwin said she knows living with someone going through depression or experiencing other mental illness is rough, and not wanting to put her children through that keeps her motivated to continue treatment.

Howell said those who think they might be experiencing seasonal affective disorder or other forms of depression shouldn’t hesitate to seek treatment. She said it is a good idea to start with a regular doctor who can refer to a psychiatrist or counselor.