SAD: How I Beat The Winter Blues, The Independent, 21st October 2008

SAD: How I Beat The Winter Blues, The Independent, 21st October 2008

Photo by Carlos Jasso

I am one of those people for whom Nik Kershaw’s “I Won’t Let The Sun Go Down On Me” is a heartfelt anthem. I once heard a joke linking that song to Freud’s work on the Oedipus complex, but the sentiment is no laughing matter for a sufferer of Seasonal Affective Disorder (SAD), the medical condition whereby low light levels depress the mood.

Ever since I can remember, I have been afflicted by the winter blues, as SAD is sometimes known, though winter blues is often shorthand for a less profound form of the condition. SAD is believed to arise because of a light-triggered biochemical imbalance in the hypothalamus, which controls the body clock. With SAD, there is not enough light in winter to halt the production of the hormone melatonin that gets us ready for bed at night. The continuation of melatonin production into the morning means sleep, mood and appetite are all disturbed. On top of this, melatonin production depletes the level of serotonin, the neurotransmitter that is believed to maintain a happy state of mind. It’s a cocktail of gloom that will be stirred by the end of British Summer Time this weekend.

For me, low light levels, especially in winter, herald a depression that takes the form of shutdown or enforced hibernation. I feel so lethargic that it is difficult to get out of bed. I need more sleep, and when I am up, I’m fractious and my concentration is fragmented. I’ve also experienced stomach problems that I thought might be the onset of an ulcer, but were stress-related problems particular to winter.

The longer nights make me more inclined to withdraw socially, although my work as a comedy critic has been helpful in making sure I go out into the night (night almost being a relief if the day has been almost as dark) and if I am lucky, my serotonin level will get a laughter boost. The effects of the day are obvious to my friends when they meet me. “Oh my God, here’s Johnny…,” one of them would joke when she greeted me after a hard day’s heart-palpitating anxiety after which, as she had correctly identified, I was about ready to break through a door with an axe à la Jack Nicholson.

Conversely, summer, or good, bright, weather (as the two are no longer synonymous) brings a “turbocharged” element to the life of a SAD sufferer. My flatmate often remarks on how much more energetic I am on a bright morning. The difference in outlook is tangible, everything seems possible.

It doesn’t have to be winter for the light to be low and I feel my symptoms on overcast days throughout the year – far too many for my liking in these times of unsettled climate.

Like many SAD sufferers, I am self-diagnosed. I knew instinctively it was the label for my curse when I first heard this medical buzz word being bandied about. It’s a label that is listed in the bible of mental afflictions, the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Meanwhile, the World Health Organisation’s International Statistical Classification of Diseases and Related Health Problems includes SAD under the diagnosis of recurrent depressive disorder.

WHO spokesman Dr Geoffrey Reed explains: “the term ‘depressive’ is more specific than ‘affective’ in this instance. He adds: “This placement in the system is based on the determination that seasonal depressive disorder is not distinguishable in its clinical presentation from other episodes of depression, but rather in its pattern over time – and the treatment methods that may be effective.”

Whether you call it SAD or SDD, the affliction has created a new business area, namely the manufacture of SAD lamps. There are support groups, clinics (such as one run by John Eagles, psychiatrist at the Royal Cornhill Hospital, Aberdeen), and a charity helping to combat the condition. And anecdotal evidence from other sufferers has chimed with my own experiences to an uncanny degree.

You don’t have to be predisposed to depression to get SAD. Yet the condition can be dramatic: suicide rates are generally higher the further north you travel. Even if you are not in extreme danger, if you don’t tackle the problem you will drive yourself to distraction. Although a survey by SAD lamp manufacturer Lumie suggests that 94 per cent of GPs recognise SAD as a medical condition and 74 per cent would recommend light treatment, I have, like others, been told by a doctor to take a winter holiday. I was disappointed to find they weren’t available on prescription. I started to consider whether I could emigrate. I felt helpless in the face of relentless greyness. I had to take some action and I wasn’t quite ready to retire to Miami.

I am glad to say I’m better now, if not cured. I already knew that exercise was important to a SAD state of mind and played football regularly. But I decided to make sure I kept that regime going in the face of overcast mornings. Diet soon fell into line with exercise and advice from smoothie-drinking, wheatgrass-chomping female friends started to sink in. Now, fruit and veg are my five-a-day essentials, each dose a bundle of energy I will need to make it through the day. I am the proud owner of a juicer.

But it was the purchase of a SAD lamp last year that has really taken the edge off my suffering. SAD lamps (bona fide ones should be class 2a medical devices with VAT exemption) work by imitating daylight and thereby address interruptions to our body clock, or circadian rhythm, by giving the user a blast of high-level, or high-“lux” light.

Numerous SAD lamps are available. They vary in size, shape, duration of usage (eg, 30-minute “dawn simulators” to wake you up) and different use of white and/or blue light. Exposure time goes from 20 minutes to two hours, depending on the strength and style of usage of the light. Morning is the best time to use an SAD lamp. Your biggest concern in choosing one may be down to design and portability.

But while a “surrogate sun” could prove useful, there is another measure that would help all those affected by SAD. The end of British Summer Time, this weekend, has been described as “the jail door slamming shut” by SAD sufferers. This concern goes beyond SAD and it begs the question of why we, as a nation, put ourselves through such misery ostensibly for the sake of some hill farmers in Scotland. On hearing that I was writing this article, a friend echoed my beliefs about the effects of lack of light on the public mood: “everybody is affected by the light, you just have to look around my office when it’s bright to see the difference”.

In response to a parliamentary question, the Government recently told daylight-saving campaigner Tim Yeo MP that extending British Summer Time would have “no overall effect” on the incidence of SAD. Maybe so on overcast days, but on brighter days it would make a huge difference. Besides, longer days (supported by the Royal Society for the Prevention of Accidents and the British Association of Leisure Parks, Piers and Attractions) would not only benefit SAD sufferers. It is argued they could cut road accidents, energy consumption, combat child obesity (with more “playing out time”), and make the elderly feel safer. With all these possible benefits from extending BST, the campaign touches all our lives – but does so in the face of indifference from governments. Summing up his second Private Member’s Bill on the subject, Tim Yeo said: “With such weight of evidence in favour of this move, I am at a loss to understand why the Government refuses to allow a properly assessed three-year trial.”

Whether or not the UK will change its very own circadian rhythm, sufferers of SAD will feel more than a pinch as the clocks go back. Luckily, there’s plenty of advice to help to shed light on the condition and to help make winter more of a walk in the park.