When a lack of energy and depression come back in the dark half of the year, people speak of autumn and winter depression. What do you need to know about it?
The rhythm of the seasons affects our feelings and our behaviour. In some people these seasonal changes bring sharp swings of mood and energy. Autumn - winter depression comes back year after year. It is one of the seasonal disorders of emotional life, which is why it is also called seasonally dependent depression.
What is particular about autumn-winter depression and what treatments are there?
1. Question: What is meant by autumn-winter depression?
Autumn-winter depression is a subtype of depressive illness. It occurs at set intervals at a particular point in the year. Hence the term “seasonally dependent depression”. The “autumn blues”, which shows itself in low mood and sluggishness, is one of the mildest forms. In medical terminology this is called minor depression (subsyndromal depression).
2. Question: What are the signs of autumn-winter depression?
Winter depression has many faces. Some patients notice nothing more than a vague feeling of being unwell or a slightly low mood, while others may show the signs of full-blown depression.
SYMPTOMS ON THE MENTAL LEVEL
- persistent, depressed moods, hopelessness and fear of the future
- indifference
- sluggishness and loss of interest in hobbies
- reduced cognitive ability, poor concentration, poor memory and slowed thinking
- a sense of inadequacy and of social disconnection
SYMPTOMS ON THE PHYSICAL LEVEL
- problems with sleep (waking early in the morning above all)
- tiredness and an increased need for sleep
- increased appetite, especially for food rich in carbohydrates
- weight gain
- headache and back pain
- dizziness and problems with the heart
3. Question: Why does autumn-winter depression occur in the dark half of the year?
The lack of natural daylight and the lower intensity of light in autumn and winter are held to be the main cause of seasonal depression. Melatonin is a hormone that governs the body's day and night rhythm. The hormone is produced only in darkness. The concentration of melatonin in the blood is far higher at night than during the day. Because of the low light levels in the autumn and winter months, melatonin levels stay high during the day as well. This also explains the increased need for sleep in autumn-winter depression. A high level of melatonin, in turn, goes together with a low level of serotonin. The body turns serotonin into melatonin. If we are short of this “good mood hormone”, our mood drops too.
4. Question: How does autumn-winter depression differ from ordinary depression?
The symptoms of seasonally dependent depression are very much like those of ordinary depression. What all the people affected have in common is depression without an obvious reason, along with a lack of drive and energy. The main differences lie in sleeping and eating behaviour. In winter depression people often crave foods rich in carbohydrates, sweets for instance. As a result some people put on weight. Ordinary depression, by contrast, shows itself in loss of appetite and loss of weight. People with seasonally dependent depression also have a markedly increased need for sleep. The sleep itself, however, is not experienced as restful.
5. Question: How does autumn-winter depression show itself in children and adolescents?
Some of the symptoms match behaviour that is usually seen in teenagers of adolescent age. This can include apathy, a craving for sweet things or fast food, irritability and a lack of motivation. That makes it hard to recognise. A warning sign may be that your child shows these signs at the same time every year, namely in autumn and winter. Alongside the symptoms mentioned, vague physical signs such as stomach ache or headache sometimes point to autumn and winter depression.
6. Question: How is autumn-winter depression diagnosed?
The most important diagnostic criterion is the link in time between the appearance of the symptoms and the time of year. If the classic signs appear in autumn or winter for at least 2 years in a row, it is most likely seasonally dependent depression.
Important: let a doctor find out the cause of your complaints. Similar symptoms are often linked to physical illnesses such as an underactive thyroid or anaemia.
7. Question: Autumn and winter depression - how can light therapy help?
A lack of daylight shifts the rhythm of day and night (the circadian rhythm). A hormonal imbalance sets in, bound up with exhaustion and low mood. In treating autumn and winter depression it is important to replace the light that is missing. Lamps with a very strong light output are used here, giving the eye an exposure of 10,000 lux.
For comparison: on a clear summer day it is around 100,000 lux, on an overcast day around 20,000 lux, yet the average level of light in offices is only 250 to 700 lux.
You normally begin light therapy with sessions of 15-30 minutes. The amount and the frequency can be increased step by step. Improvement comes only after a few days. The whole retina takes part in the positive, mood-lifting response. Around its edges it has many sensory cells that catch the light.
8. Question: Autumn-winter depression - what can you do yourself?
More light!
Bring more light into your life and into your everyday routine. Extra ceiling lights and floor lamps give brighter light indoors and at the same time create a pleasant atmosphere.
Exercise in the open air
Sport, too, proves its worth in the fight against dark thoughts. Especially in combination with the effect of light. That means: sport in the open air above all encourages the production of mood-lifting endorphins.
Eat with pleasure
Make sure, as well, that you keep to a balanced diet. Some food ingredients, such as the protein component tryptophan or the amino acid tyrosine, stimulate the body's own production of serotonin. Serotonin is also known as the “good mood hormone”.
Medicinal herbs
St John's wort is also of use in mild to moderate depression. It should be borne in mind, however, that at a daily dose of 900 milligrams the mood-lifting effect usually appears only after the 2nd week of taking it.
Vitamin C
From my own observations of my patients, giving vitamin C intravenously markedly improves not only immunity and recovery but the mental state as well. Patients describe it as light, pleasant, "nothing is bothering me", steady.
