Beating the ‘Winter Blues’

By DR. JUDITH COCHE
“Judith, I can feel winter coming on… it’s time for me to get to the warm.”  Ivan, a small, hefty man, looked down at his stomach, and then lifted his head to meet my eyes. “I can feel the SAD approaching.”
I double checked my calendar… Nov. 26. Outside my office window, Shelter Haven Bay in Stone Harbor was cloaked in gray mist as winter rolled in day by day.
“Pretty soon now I’ll begin to succumb to the winter blues just like I do every year. Then I must take an anti-depressant to get me through the dark winter skies.”
I knew what Ivan meant: the SAD is his seasonal affective disorder that feels awful to him. Seasonal Affective Disorder is a type of recurrent major depressive disorder in which episodes of depression occur during the same season each year, usually winter. This condition is sometimes called the “winter blues.”
“Ivan, how do you know this is your annual depression?” As we went through his symptoms, I could confirm that he felt sad, even hopeless.
He found it hard to get up in the morning and had too little energy during the day. And he quickly felt rejected, so he avoided social situations.
“You share your illness with 10 million Americans. Of these people, there are four times more women than men.
“Many begin to experience SAD between ages 18 and 30. How old were you when this started and what do you try to do about it?”
Ivan looked directly at me. “Glad you asked. It started after college and it seems to help if I eat potato chips and drink beer.” He looked at me out of the corner of his eye to see if I was laughing at him.
“Yes, many people eat lots of sweets and salty snacks filled with carbohydrates to feel better, but we have more scientific ways to help.  Cognitive behavioral therapy (CBT) is based on the idea that the way we think and behave affects the way we feel. Changing the way, you think about situations and what you do about them can help you feel better.
“We can do about six meetings over the next three months. They will teach you how to think differently to enable relief from feeling hopeless and listless. And we can send you to the internet for in-between help.”
“Doc, that seems good but what can I try to do today? This stuff feels bad.”
“Let’s start with the cognitive therapy. It is easy to learn.
“Cognitive Behavior Therapy, or CBT, assumes that we can help you learn to think more positively and that this shift in your thinking can relieve your depression. We help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts, shifting your thinking from negative to positive.
“We’ll break down your problems into your thoughts, physical feelings and actions, work to decide if your thoughts are unhelpful, and help you change them. Then you can practice changing them on your own until you can apply the skills you have learned to your daily life.
“The power of the treatment is that you shift your own thinking from depressive to realistic.”
“Does it work? I don’t want to practice useless stuff.” Ivan looked straight at me to see if I would be honest.
Yes, it can be as effective as medication in treating your winter blues by giving you the tools to shift your thinking from discouraged to hopeful. For example, here are three tips to deal with your winter blues:
1.     Warm sunshine. A daily walk in sunlight, finding well-lit spaces inside, and dressing warmly help. You want to feel physically bright and cheerful.  
2.      Contact others you care about. Try to keep in touch with people you care about. Talk through your worries with those you love.
3.      Share your worries with someone you trust. Talk with your wife and your buddies about how you try to push away your winter blues. This really helps.
I looked at Ivan to see his reaction to my suggestions. “Doctor Judith, this is not what I wanted to hear. I wanted to hear that beer and chips help, but I know you are right.
“We can try this CBT and see how it goes. Sounds like SAD has the better of me and I need to push back. I’m pretty good at that.”
I smiled. “Ivan, I bet we can get you on the road to a better winter.” And I meant it. 
To consider: Whom do you know that feels sad during winter, avoids socializing, snacks on sugar and chips, and complains about how cold and lonely it feels each winter? Might that person have SAD? If so, could you help?  Would you? Why?
To explore: To explore how SAD is treated, go to www.nhs.uk/conditions/seasonal-affective-disorder-sad/treatment.
Dr. Coche practices clinical psychology in Stone Harbor and Philadelphia. She invites responses through her website, www.cochecenter.com.