Winter edition

I was in my twenties by the time I realized that I didn't have normal feelings toward winter. It took some time to recognize the pattern - that the onset of fall would fill me with feelings of doom and cosmic dread, that come January or February of each year, there would be a raw, jagged feeling of inevitable hopelessness that occurred, leading me to my most emo of selves. A feeling of mentally screaming toward spring, clawing my way out of winter as ferociously as the first spring flowers. It can feel like I'm hanging on by my fingernails. I really thought that this was how everyone felt about winter.

Turns out, most people don't find themselves enmeshed in the winter crusades each year. That, there are many people who actually look forward to the season, with its twinkling lights and skiing and hygge. It was a revelation to me, but also a challenge to try to transform myself into someone who could tolerate winter.

I have Seasonal Affective Disorder. It's quite boring, as far as "disorders" go - it's very common in people who live in colder climates with longer winters. It's four times more common in women than in men.

Some things to understand about SAD: 

It's not really about the cold. 
I always have to explain this to people, because most people think that SAD is about hating being cold and in the snow.

Instead, SAD is about being solar powered. For most people, the low light of winter changes their circadian rhythm, that light-powered hormonal heartbeat of most living things, which influences (among other things) sleep, metabolism, digestion, body temperature, and brain function. The composer of this rhythm is something called the suprachiasmatic nucleus (a bunch of nerve cells) which is housed in the brain's hypothalamus. The SCN gets its signaling directly from the eyes. As the NIH so gracefully puts it, "Changing the light-dark cycles can speed up, slow down, or reset...circadian rhythms." With the onset of winter and less light entering the eyes, most people's circadian rhythm's take note and adapt accordingly. 

While most people biologically respond to a change in light, people with SAD don't adequately adapt respond to this change. Aspects of maladaptation include dysregulated serotonin, vitamin D, and melatonin levels, which leads to those of us with this maladaptive function to pretty much feel awful during the winter months and then boop back up again to normalcy once the days are longer and more in synch with our own clocks. 

But, it's kind of about the cold
The issue with winter is that, things like low vitamin D levels can be easily rectified by exposure to sunshine. Evolutionarily, it's likely that the reason we don't generally obtain vitamin D through our diets is because we didn't need to - we got more than enough from just being outside. Similarly, serotonin regulation is impacted, in part, by physical activity; when we had to move in order to live, even a reduction in movement didn't mean we weren't moving. 

Unfortunately, in winter, due to the cold, not only are we moving less, we're covered up more and less likely to be out of doors. So activities that naturally regulate vitamin D, serotonin and melatonin are suppressed.

There may be evolutionary reasons that we're this way
I should mention that there's still a lot of research to be done on SAD. In my opinion, it's likely that SAD is actually more of a categorical disorder than a singular disorder, similar to things like headaches - where you could have a migraine headache or a nutritional deficiency headache or a tension headache, which all get lumped under the category of "headache," despite having different etiologies. For some people, there appear to be genetic predispositions to SAD; for others, it may be more tied to things like nutritional deficiencies or sleep disorders or environmental factors, such as night shifts. 

There are some scientists who actually believe that SAD may be an evolutionary adaptation. The theory goes something like this: the symptoms of SAD - lethargy, increased craving for carbohydrates, increased social detachment, increased sleep requirements - all mimic conditions of pregnancy. Some researchers believe that SAD may be an evolutionary push toward conception- creating conditions that optimize conception and pregnancy during winter months, so that women give birth in spring, which increases survival odds for their offspring because of the increased availability of food. This could, in part, be the reason why SAD is so much more common in women than in men. 

I don't really know how to feel about this theory; nature is a cruel, cruel mistress when it comes to women, so it wouldn't surprise me. But more research is needed. And my guess is that even if this disorder has some evolutionary underpinnings, again, it may be a certain subset of a larger, broader disorder category which doesn't. And regardless, it still sucks when it's happening to you. 

Some things I've tried that have helped (and some that haven't)

• antidepressants - I took antidepressants twice in my early twenties, before the diagnosis of SAD. They didn't really help me. This is likely because they take so long to kick in that, by the time I was miserable enough to ask for them (i.e., end of January), there were only 6-8 weeks left of winter. Which meant that they'd really only started to kick in by the time I started feeling better anyway and stopped taking them. To be clear: I think people who take anti-depressants are doing exactly the right thing and if it works for you, I think you should do it. I personally didn't see a lot of benefit from them for something that is a short-term as SAD. The withdrawal issues associated with these medications are real and should not be understated. It's not something that you can pulse on and pulse off easily.
• light box  - Light exposure has been clinically tested and found to be effective for many people. I sometimes do light exposure. I've found that having a light alarm clock (a clock that doubles as a light box and wakes you up by gradually getting lighter) has been SUPER helpful for me, because it's really easy to just lie in bed and check your phone while you're getting your daily light dose. I love my light alarm clock. It's a con though for people with partners who are sensitive sleepers because the gradual change in light over the course of an hour or 45 minutes might mean a light sleeping partner is getting up an hour earlier than they wanted to. 
• vitamin D supplements - Some years I've found vitamin D supplements to be very helpful and others I haven't. In order for them to be most effective, you need to start supplementing additional vitamin D in the early fall or late summer and then you need to be consistent with it over the course of the winter. Vitamin D supplements themselves are often suspect because the FDA doesn't regulate them, which means you could essentially just be chugging placebo pills. There is differential evidence on whether supplementation of vitamin D works. However, it's unlikely to harm you (unless you take insane dosages), so it's not unworthy of a test go. 
• vacations to sunny places - I know everyone rolls their eyes when I talk about vacations because I'm a travel person, so it can just seem like another excuse to get up and go, but I have personally seen an overall difference in my winters when I am able to get the heck out of Dodge and spend a few days soaking in the sun on a beach somewhere. This can be a costly approach to treatment, but it's also a good excuse to plan cool vacations during the winter. Drawbacks to this might include having partners who like the winter and want to use good winter time for things that winter-loving people enjoy, like skiing. 
• getting outside every single day - this really, really works for me. I see drastic and dramatic differences in my SAD in weeks when I'm outside in winter - walking in it, hiking in it, skiing in it - and weeks when I'm shut indoors because I'm on a deadline or too busy to make that time for myself. This is probably the biggest thing for me, and yet it's much harder to do consistently than scheduling a fun vacation. Getting some good warm clothes and going outside probably has the biggest impact on me. 
• exercising - serotonin is influenced by physical activity. If you can't get outside during the day (or even if you can), busting your butt and sweating it out a little bit really does help. For me, this is even HARDER than going outside, but it does really make a difference.
•  st johns wort - see antidepressants above. 
• vitamin B supplements - have helped somewhat. Winter always seems to mean I'm taking a cocktail of supplements: magnesium, vitamin D, vitamin B, etc. Placebo effect? Maybe. 
• meditation - I suck at meditation. I'm working on it, but I suck at consistency across the board in terms of everything. However, meditation has been found to improve serotonin levels (potentially because it reduces anxiety and stress, which sap you of serotonin in order to make cortisol) and I can say that in the few times where I've managed to consistently meditate during the winter, it has appeared to help. 
• therapy - I find therapy extremely helpful for some things. For SAD, less so. With that being said, I haven't ever specifically gotten a therapist who specialized in SAD, so it's possible it could be very useful to someone else. Everyone can benefit from therapy for one reason or another - if SAD's a problem for you and you haven't tried therapy, it's one of the few ways that's been clinically proven to help. 

Of all of them, the things that have helped me the most have been 1) getting outside every day, 2) exercising, and 3) vacations, in that order.