tag:theconversation.com,2011:/uk/topics/seasonal-affective-disorder-12507/articlesSeasonal affective disorder – The Conversation2024-01-15T17:10:15Ztag:theconversation.com,2011:article/2208192024-01-15T17:10:15Z2024-01-15T17:10:15ZMusic can ease the January blues – but the types of songs that work depend on your age and mindset<figure><img src="https://images.theconversation.com/files/568706/original/file-20240110-19-gz90xq.jpg?ixlib=rb-1.1.0&rect=0%2C11%2C4000%2C2646&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/active-family-3-female-generations-retired-1928590115">fizkes/Shutterstock</a></span></figcaption></figure><p>Music can significantly boost your mental health – delivering benefits <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790186">similar to</a> those provided by exercise or weight loss. It can also reduce feelings of anxiety and physiological measures of stress and, as neuropsychologist Daniel Levitin <a href="https://www.wired.com/2006/08/music-makes-your-brain-happy/">argues</a>, even create the same “neurochemical cocktail” as other pleasurable activities, like orgasms or eating chocolate.</p>
<p>So what type of music should you turn to in order to boost your mood? <a href="https://www.tandfonline.com/doi/epdf/10.1080/02699931.2021.1995331?needAccess=true">Researchers have found</a> that music with a fast tempo, written in the major mode (such as Led Zeppelin’s Rock and Roll) evokes a sense of happiness, whereas music with a slow tempo in the minor mode (like Johnny Cash’s sombre cover of Hurt) evokes a sense of sadness. But, as illogical as it may seem, that sensation of sadness may actually help lead to positive emotions. </p>
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<figcaption><span class="caption">Led Zeppelin’s Rock and Roll has a fast tempo and is written in the major mode – ideal happy music.</span></figcaption>
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<p>A <a href="https://www.jstor.org/stable/10.1086/670609?seq=1#metadata_info_tab_contents">2013 research paper</a> says that mood-congruent experiences of art – like listening to sad music when feeling sad – offers a sense of emotional sharing, akin to interacting with an empathic friend. And <a href="https://www.tandfonline.com/doi/epdf/10.1080/17439760.2019.1590625?needAccess=true">research from 2018</a> on music’s effect on mood confirms that “sad” music can have a positive effect, with the researchers arguing that “when experiencing sadness, focusing on sad music can be a positive and even a strengthening experience”. </p>
<p>This links with philosopher Aristote’s theory of catharsis, <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0110490">which suggests that</a> we experience the emotion of sadness through music in order to purge the emotion from ourselves in real life.</p>
<p>Professor of musicology Kim Cunio agrees that lifting your mood with music probably isn’t as simple as listening to up-tempo music in a major key. She suggests that to reap the mood-boosting benefits of music, listeners need to “<a href="https://www.theguardian.com/australia-news/2022/mar/24/music-improves-wellbeing-and-quality-of-life-research-suggests">follow the heart</a>” and choose the music that most resonates with them.</p>
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<figcaption><span class="caption">Dancing Queen is a mood-boosting choice for those aged over 25.</span></figcaption>
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<p>But what about the lyrics? It may be the case that sad sounding songs have a positive effect on mood, but can the same be said about sad words? </p>
<p>A 2020 study on <a href="https://digitalcommons.lesley.edu/cgi/viewcontent.cgi?article=1257&context=expressive_theses">trauma processing</a> noted that lyrics that were relatable helped patients feel supported when processing their emotions and struggles. </p>
<p>This is supported by a research paper by psychologists <a href="https://journals.sagepub.com/doi/pdf/10.1177/0305735613483667?casa_token=ZBvUTir8PzMAAAAA:utkK4K5IMGUrejAKhyrh9mqXGM7wdIy2IILPA4SRk9nIs7vczAgqUY6JZwuKsrZ950ir6WC3tnw">Kazuma Mori and Makoto Iwanaga</a> who reported that when listening to a sad song, listeners could identify with the lyrics and felt as if the singer knew their own
sad experiences. This made them feel understood, bringing about an experience of pleasure.</p>
<p>Research has already suggested that our musical tastes change as we get older. For example, our preference for classical music increases as we age while our preference for rock <a href="https://www.cambridge.org/core/services/aop-cambridge-core/content/view/D309D79E5285892969CE72795E9D41D7/S0144686X09990778a.pdf/div-class-title-musical-taste-and-ageing-div.pdf">decreases</a>. But further findings have shown that <a href="https://journals.sagepub.com/doi/full/10.1177/0305735620988793">a listener’s age</a> can also affect the types of music that improve their low mood. </p>
<p>Young adults report a preference for listening to sad music to lift their mood, compared with adults over the age of 25, who tend to report more positive feelings being evoked by <a href="https://journals.sagepub.com/doi/abs/10.1177/03057356221081164?casa_token=1MwZuXqmt4AAAAAA%3AlUTN0MDVe1XVwydUGCfwzqz7fRL3vU9hEf6I4erGMe5B1LfJ4rpoInBmhbfujneS5BhpIF475h8&journalCode=poma">happy music</a>. </p>
<p>So, if you’re suffering from the January blues, and you are over the age of 25, it might be a better idea to listen to Abba’s Dancing Queen or Justin Timberlake’s Can’t Stop The Feeling instead of The Cure or Billie Eilish. In my case, though, as a devotee of what my family categorise as “misery music”, this may just make things worse.</p>
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<p class="fine-print"><em><span>Glenn Fosbraey does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Researchers have found that music with a fast tempo, written in the major mode evokes a sense of happiness.Glenn Fosbraey, Associate Dean of Humanities and Social Sciences, University of WinchesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2173502023-12-14T13:13:03Z2023-12-14T13:13:03ZWinter brings more than just ugly sweaters – here’s how the season can affect your mind and behavior<figure><img src="https://images.theconversation.com/files/562242/original/file-20231128-15-6g8udc.jpg?ixlib=rb-1.1.0&rect=672%2C84%2C5212%2C4063&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Short winter days can influence your brain chemistry.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/holiday-cottage-in-the-dark-in-winter-royalty-free-image/1443007227">Schon/Moment via Getty Images</a></span></figcaption></figure><p>What comes to mind when you think about winter? Snowflakes? Mittens? Reindeer? In much of the Northern Hemisphere, winter means colder temperatures, shorter days and year-end holidays.</p>
<p>Along with these changes, <a href="https://doi.org/10.1177/17456916231178695">a growing body of research in psychology</a> and related fields suggests that winter also brings some profound changes in how people think, feel and behave.</p>
<p>While it’s one thing to identify seasonal tendencies in the population, it’s much trickier to try to untangle why they exist. Some of winter’s effects have been tied to cultural norms and practices, while others likely reflect our bodies’ innate biological responses to changing meteorological and ecological conditions. The natural and cultural changes that come with winter often occur simultaneously, making it challenging to tease apart the causes underlying these seasonal swings.</p>
<p><a href="https://scholar.google.com/citations?hl=en&user=mbqOySoAAAAJ&view_op=list_works&sortby=pubdate">With</a> <a href="https://scholar.google.com/citations?user=InwaMwEAAAAJ&hl=en&oi=ao">our</a> colleagues <a href="https://scholar.google.com/citations?user=GsJOu0sAAAAJ&hl=en&oi=ao">Alexandra Wormley</a> and <a href="https://scholar.google.com/citations?user=7BGThtkAAAAJ&hl=en&oi=ao">Mark Schaller</a>, we recently conducted an <a href="https://doi.org/10.1177/17456916231178695">extensive survey of these findings</a>.</p>
<h2>Wintertime blues and a long winter’s nap</h2>
<p>Do you find yourself feeling down in the winter months? You’re not alone. As the days grow shorter, the American Psychiatric Association estimates that <a href="https://www.psychiatry.org/patients-families/seasonal-affective-disorder">about 5% of Americans will experience</a> a form of depression known as seasonal affective disorder, or SAD.</p>
<p><a href="https://doi.org/10.1016/S0140-6736(98)01015-0">People experiencing SAD</a> <a href="https://doi.org/10.1176/ajp.146.7.829">tend to have feelings of hopelessness</a>, decreased motivation to take part in activities they generally enjoy, and lethargy. <a href="https://doi.org/10.1111/j.1600-0447.1998.tb09954.x">Even those who don’t meet the clinical threshold</a> for this disorder may see increases in anxiety and depressive symptoms; in fact, some estimates suggest <a href="https://doi.org/10.1001/archpsyc.1989.01810090065010">more than 40% of Americans experience these symptoms</a> to some degree in the winter months.</p>
<p>Scientists link SAD and more general increases in depression in the winter to decreased exposure to sunlight, which <a href="https://doi.org/10.1001/archpsyc.65.9.1072">leads to lower levels of the neurotransmitter serotonin</a>. Consistent with the idea that sunlight plays a key role, SAD tends to be more common <a href="https://doi.org/10.1176/ajp.149.9.1176">in more northern regions of the world</a>, like Scandinavia and Alaska, where the days are shortest and the winters longest.</p>
<p>Humans, special as we may be, are not unique in showing some of these seasonally linked changes. For instance, our primate relative the <a href="https://doi.org/10.1016/j.bbr.2015.07.005">Rhesus macaque shows seasonal declines in mood</a>.</p>
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<span class="caption">It can feel hard to get out of bed on dark mornings.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/side-view-of-a-tired-man-in-bed-royalty-free-image/1411640794">Lighthouse Films/DigitalVision via Getty Images</a></span>
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<p>Some scientists have noted that <a href="https://doi.org/10.31887/DCNS.2007.9.3/rlevitan">SAD shows many parallels to hibernation</a> – the long snooze during which brown bears, <a href="https://theconversation.com/gut-microbes-help-hibernating-ground-squirrels-emerge-strong-and-healthy-in-spring-175610">ground squirrels</a> and many other species turn down their metabolism and skip out on the worst of winter. Seasonal affective disorder may have its roots in adaptations that conserve energy at a time of year when food was typically scarce and when <a href="https://doi.org/10.1002/ajpa.23071">lower temperatures pose greater energetic demands</a> on the body.</p>
<p>Winter is well known as a time of year when many people put on a few extra pounds. Research suggests that <a href="https://doi.org/10.1093/aje/kwz087">diets are at their worst</a>, and <a href="https://doi.org/10.1038/sj.ejcn.1602346">waistlines at their largest</a>, during the winter. In fact, a <a href="https://doi.org/10.1016/j.physbeh.2014.03.018">recent review</a> of studies on this topic found that average weight gains around the holiday season are around 1 to 3 pounds (0.5 to 1.3 kilograms), though those who are overweight or obese tend to gain more.</p>
<p>There’s likely more going on with year-end weight gain than just overindulgence in abundant holiday treats. In our ancestral past, in many places, winter meant that food became more scarce. <a href="https://doi.org/10.1038/sj.ejcn.1602346">Wintertime reductions in exercise</a> and increases in how much and what people eat may have been an evolutionary adaptation to this scarcity. If the ancestors who had these reactions to colder, winter environments were at an advantage, evolutionary processes would make sure the adaptations were passed on to their descendants, coded into our genes.</p>
<h2>Sex, generosity and focus</h2>
<p>Beyond these winter-related shifts in mood and waistlines, the season brings with it a number of other changes in how people think and interact with others.</p>
<p>One less discussed seasonal effect is that people seem to get friskier in the winter months. Researchers know this from analyses of condom sales, sexually transmitted disease rates and <a href="https://doi.org/10.1007/s10508-012-9996-5">internet searches for pornography and prostitution</a>, all of which <a href="https://doi.org/10.1111/j.1741-3737.2002.00871.x">show biannual cycles</a>, <a href="https://doi.org/10.1080/07448481.1993.9940826">peaking in the late summer</a> and then <a href="https://doi.org/10.1177/014107689909200204">in the winter months</a>. Data on birth rates also shows that in the United States and other countries in the Northern Hemisphere, babies are <a href="https://theconversation.com/tis-the-season-for-conception-106663">more likely to be conceived in the winter months</a> than at other times of the year.</p>
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<span class="caption">There’s more to a holiday bump in romance than just opportunity.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/multi-ethnic-young-couple-in-love-enjoying-a-home-royalty-free-image/1424097623">RgStudio/E+ via Getty Images</a></span>
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<p>Although this phenomenon is widely observed, the reason for its existence is unclear. <a href="https://doi.org/10.1108/09654280810842120">Researchers have suggested many explanations</a>, including health advantages for infants born in late summer, when food may historically have been more plentiful, changes in sex hormones altering libido, desires for intimacy motivated by the holiday season, and simply increased opportunities to engage in sex. However, changes in sexual opportunities are likely not the whole story, given that winter brings not just increased sexual behaviors, but greater <a href="https://doi.org/10.1007/s10508-012-9996-5">desire and interest in sex</a> as well.</p>
<p>Winter boosts more than sex drive. Studies find that during this time of year, people may have an easier time paying attention at school or work. Neuroscientists in Belgium found that performance on <a href="https://doi.org/10.1073/pnas.1518129113">tasks measuring sustained attention</a> was best during the wintertime. Research suggests that seasonal changes in levels of serotonin and dopamine driven by less exposure to daylight may help explain <a href="https://doi.org/10.1073/pnas.1518129113">shifts in cognitive function during winter</a>. Again, there are parallels with other animals – for instance, African striped mice <a href="https://doi.org/10.1007/s10071-015-0892-y">navigate mazes better</a> during winter.</p>
<p>And there may also be a kernel of truth to the idea of a generous Christmas spirit. In countries where the holiday is widely celebrated, rates of charitable giving tend to <a href="https://doi.org/10.1016/j.jebo.2018.07.004">show a sizable increase around this time of year</a>. And <a href="https://doi.org/10.1016/j.jebo.2013.10.014">people become more generous tippers</a>, leaving about 4% more for waitstaff during the holiday season. This tendency is likely not due to snowy surroundings or darker days, but instead a response to the altruistic values associated with winter holidays that encourage behaviors like generosity.</p>
<h2>People change with the seasons</h2>
<p>Like many other animals, we too are seasonal creatures. In the winter, people eat more, move less and mate more. You may feel a bit more glum, while also being kinder to others and having an easier time paying attention. As psychologists and other scientists research these kinds of seasonal effects, it may turn out that the ones we know about so far are only the tip of the iceberg.</p><img src="https://counter.theconversation.com/content/217350/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Varnum has received past grant funding from the National Science Foundation and the China Postdoctoral Science Foundation.</span></em></p><p class="fine-print"><em><span>Ian Hohm does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Some of winter’s effects have been tied to cultural norms and practices, while others likely reflect our bodies’ innate biological responses to shorter days and colder weather.Michael Varnum, Associate Professor of Psychology, Arizona State UniversityIan Hohm, Graduate Student of Psychology, University of British ColumbiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2169512023-11-21T16:54:17Z2023-11-21T16:54:17ZSAD lamps: do they work? Experts explain how they help the winter blues<p>Have you ever noted that you sleep more in the winter months? Or eat more carbs or have low energy? If you do, then you might be one of the around <a href="https://www.theguardian.com/lifeandstyle/2017/oct/30/sad-winter-depression-seasonal-affective-disorder">6% of the</a> higher latitude populations with seasonal affective disorder (SAD). </p>
<p>If you’ve searched the internet for <a href="https://news.sky.com/story/seasonal-affective-disorder-or-sad-isnt-just-winter-blues-12983739">tips on how to fight the winter blues</a> you’ve probably been advised to buy a therapy lamp. So you may be wondering what research says about whether they are effective and how they work. </p>
<p>Before we examine the evidence for light therapy it’s important to understand why mood might be affected by sunlight. Vitamin D is produced <a href="https://www.tandfonline.com/doi/full/10.4161/derm.24494">when your skin is exposed to sunlight</a> and some scientists believe there is a link between <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10255717/">depression and low vitamin D levels</a>. </p>
<p>Studies have found about 10% of the population of <a href="https://www.tandfonline.com/doi/full/10.2147/PRBM.S114906">the far north</a>, for example in Alaska and Finland, experience SAD. Interestingly, Icelanders, who also live in these very northern latitudes, <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/496414">do not appear to suffer so much from SAD</a>. This might be <a href="https://www.ifis.org/blog/icelands-diet-health-problems-solutions-part-1#:%7E:text=Icelanders%20typically%20dine%20on%20a,%2C%20Arctic%20char%2C%20and%20monkfish.">because of their fish-packed diet</a>, which is rich in vitamin D. </p>
<p>Light also stimulates your visual system, regulating activity in the so-called circadian pacemaker. This is the <a href="https://www.sciencedirect.com/topics/neuroscience/suprachiasmatic-nucleus">suprachiasmatic nucleus</a> (SCN), a small region of the brain. The SCN gets direct input from the retina and is also packed with melatonin receptors. Melatonin supplements are now being touted as a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060443/">treatment for depression</a>. So there are multiple reasons why <a href="https://pubmed.ncbi.nlm.nih.gov/37239299/">light might be important for mood</a>.</p>
<p>SAD was first described around 1980 in the US when a man, who experienced the symptoms outlined above, invented a light box to treat himself. </p>
<p>There have been many studies since examining light therapy in SAD with mixed and contradicting results. However, data from all these studies can be combined and examined using <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/meta-analysis">meta-analyses</a> to give a more accurate overall picture. A meta-analysis merges the findings of several independent studies. There have been several meta-analyses of this topic and most show that light therapy has a positive effect, not only on SAD, but also on major depression.</p>
<h2>Does light intensity matter</h2>
<p>Light intensity is <a href="https://www.britannica.com/science/lux">measured in lux</a>. A <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.1999.tb07236.x">1999 meta-analysis</a> of 39 scientific papers found that strong light intensity (6,000-10,000 lux) had a greater effect than medium light intensity (1,700-3,500 lux). Medium light intensity had a greater effect than dim lighting (less than 600 lux) on depressive symptoms in people with SAD. A <a href="https://pubmed.ncbi.nlm.nih.gov/31574513/">2019 meta-analysis</a> of 19 studies also found that brighter light (greater than than 1,000 lux) is needed to treat SAD.</p>
<figure class="align-center ">
<img alt="Young woman reading by a therapy lamp" src="https://images.theconversation.com/files/558066/original/file-20231107-252894-tstzhi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/558066/original/file-20231107-252894-tstzhi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/558066/original/file-20231107-252894-tstzhi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/558066/original/file-20231107-252894-tstzhi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/558066/original/file-20231107-252894-tstzhi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/558066/original/file-20231107-252894-tstzhi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/558066/original/file-20231107-252894-tstzhi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Therapy lamp.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-light-therapy-171525149">Image Point Fr/Shutterstock</a></span>
</figcaption>
</figure>
<p>You might be wondering whether light colour matters.</p>
<p>A <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.1997.tb09915.x">1997 meta-analysis</a> looked at 40 scientific papers examining different colours of light. It revealed that light of short to medium wavelengths (blue, green and yellow) were effective but that red or UV wavelengths did not seem to treat SAD. This study also reviewed the timing of the phototherapy. The data, although not significant (which means more studies are needed), suggested that phototherapy in both the morning and the evening was more effective than morning or evening alone.</p>
<h2>Does phototherapy work in non-seasonal depression?</h2>
<p>A <a href="https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.162.4.656?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">2005 meta-analysis</a> of 23 studies found phototherapy worked for people with SAD and for people with non-seasonal depression. This paper reviewed six studies of combined treatment for non-seasonal depression. It found that phototherapy, although effective alone, did not produce a greater effect on depression symptoms when given together with antidepressant medication. </p>
<p>However, more recent studies agree that the combination treatment is more effective. A <a href="https://pubmed.ncbi.nlm.nih.gov/27835725/">2016 meta-analysis</a> of ten studies did find phototherapy augmented drug treatment of depression. A <a href="https://pubmed.ncbi.nlm.nih.gov/31600678/">2019 meta-analysis</a> of seven studies also found it increased the power of antidepressants.</p>
<p>So if you suffer from non-seasonal depression, then phototherapy may work as a first line treatment and will probably boost the effects of any antidepressant drug that you may be taking. </p>
<p>There is also a condition called <a href="https://www.sciencedirect.com/science/article/pii/S0165032707003515">sub-syndromal SAD</a> (SSAD or sub-SAD) affecting about <a href="https://www.theguardian.com/lifeandstyle/2017/oct/30/sad-winter-depression-seasonal-affective-disorder">10-15%</a> of higher latitude populations, where symptoms are milder or less frequent than SAD. Sub-SAD can also be treated with light therapy. </p>
<p>Vitamin D is <a href="https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/">essential for physical health</a> as well as mental health as it regulates calcium and phosphate levels, is critical for good bone density and for muscle and teeth health. It’s also essential for a healthy immune system. </p>
<p>There are other studies that look at <a href="https://pubmed.ncbi.nlm.nih.gov/29498416/">lighting in the workplace</a> and the effect on employees, for example certain types of light might improve alertness, while other lighting might increase headaches.</p>
<p>If you suffer from SAD, choose a higher intensity light for a faster effect, use the light for longer, for example, both morning and evening sessions. Avoid UV light which is ineffective for SAD and can lead to sunburn or skin cancer. And don’t forget to eat some fish to boost your vitamin D levels too.</p><img src="https://counter.theconversation.com/content/216951/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>SAD is a debilitating condition affecting many people, but there is light at the end of the tunnel.Colin Davidson, Professor of Neuropharmacology, University of Central LancashireClaire Hutchinson, Professor of Experimental Psychology, University of the West of ScotlandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2052732023-06-23T12:27:31Z2023-06-23T12:27:31ZLess sleep, less exercise and less relaxation – here’s the data on just how much busier moms are during the school year<figure><img src="https://images.theconversation.com/files/529187/original/file-20230530-25-aog7gq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Moms get about 25 minutes less sleep each weeknight when their kids' school is in session. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/son-waking-up-sleeping-mother-royalty-free-image/142740298">Jose Luis Pelaez Inc/DigitalVision Collection/Getty Images</a></span></figcaption></figure><p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em></p>
<h2>The big idea</h2>
<p>Moms of school-age children get significantly less sleep during the school year than during the summer.</p>
<p>We are <a href="https://www.toddrjones.com/">economists</a> <a href="https://scholar.google.com/citations?user=TdNR3AIAAAAJ&hl=en">who specialize</a> in <a href="https://scholar.google.com/citations?user=EaLMFY0AAAAJ&hl=en&oi=ao">education and health research</a>. We combined <a href="https://www.toddrjones.com/papers/School_Crime_most_recent.pdf">extensive data</a> on <a href="https://publicholidays.com/us/school-holidays/">school district schedules</a> with information derived from the <a href="https://www.bls.gov/tus/">American Time Use Survey</a> to explore the ways <a href="http://www.doi.org/10.3386/w31177">families use their time differently</a> depending on whether school is in session or out for summer.</p>
<p>We observed mothers on average tend to sleep 25 minutes less, have 28 minutes less free time and allocate seven minutes less for exercise on weekdays during the school year than during the summer. For comparison, fathers reduce sleep by 11 minutes during the school year relative to the summer, have 21 minutes less free time and five fewer exercise minutes.</p>
<p>Conversely, mothers spend about half an hour more per day during the school year taking care of others, including kids, and five additional minutes on travel – which often involves driving their kids to and from school.</p>
<p>Interestingly, even though both mothers and fathers spend more time physically present with children in their household during summer months, both spend more time actively engaged with the children – such as helping with homework or reading together – during the school year. However, the effect is almost three times greater for women than it is for men: Moms spend an extra 34 minutes per day during the school year actively engaged with the children versus an extra 12 minutes for dads. </p>
<p>Our study also observed teenagers ages 15-17, as they are the only children included in the time use survey. </p>
<p>During the school year, teenagers sleep about one hour and 20 minutes – or 13% – less than they do during the summer, and they have over two hours – or 33% – less free time each day. This reduction in free time includes nearly an hour and a half less time spent each day on television, games – including video games – and computer use. </p>
<p><iframe id="UmBRW" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/UmBRW/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<h2>Why it matters</h2>
<p><a href="https://doi.org/10.1016/j.jebo.2020.08.013">Prior research</a> has shown there is a <a href="https://doi.org/10.1002/hec.4570">gender gap</a> in mental health, with women faring worse than men on measures such as anxiety and depression. Women are also <a href="https://www.womenshealth.gov/blog/seasonal-affective-disorder-spotlight">four times as likely</a> as men to be diagnosed with seasonal affective disorder, a type of depression that typically occurs in fall and winter.</p>
<p>Our results suggest the possibility that these issues are exacerbated by the greater demands placed on mothers during the school year. </p>
<p>Regarding teenagers getting more sleep, our findings support <a href="https://www.scientificamerican.com/article/high-school-students-need-more-sleep-and-later-school-start-times/">arguments for later school start times</a> so that teens can <a href="https://www.doi.org/10.1126/sciadv.aau6200">get more sleep</a>. The American Academy of Pediatrics has recommended middle and high schools start <a href="https://doi.org/10.1542/peds.2014-1697">no earlier than 8:30 a.m.</a> so that adolescents can get sufficient sleep to support mental health and <a href="https://doi.org/10.1016/j.econedurev.2019.05.011">academic achievement</a>. However, the average start time <a href="https://nces.ed.gov/pubs2020/2020006/index.asp">for U.S. high schools is 8 a.m.</a>. </p>
<p>Our results also suggest that when school is out, teenagers may be especially susceptible to <a href="https://www.npr.org/sections/health-shots/2023/05/17/1176452284/teens-social-media-phone-habit">media overconsumption</a>. Teens themselves <a href="https://www.pewresearch.org/internet/2018/08/22/how-teens-and-parents-navigate-screen-time-and-device-distractions/">say they spend too much time</a> on screens.</p>
<h2>What we still don’t know</h2>
<p>We do not yet know how these changes in schedules affect teen mental health. While some measures of teen mental health <a href="https://www.doi.org/10.3386/w30795">improve during summer months</a>, we found that teenagers spend the lion’s share of their extra summer free time in front of screens, and studies have linked excessive screen time to <a href="http://www.doi.org/10.1001/jamapediatrics.2019.1759">higher levels of depression</a> and <a href="https://doi.org/10.1007/s13679-020-00401-1">poorer mental health</a>.</p>
<p><em>This article was updated on July 31, 2023 with a new chart.</em></p><img src="https://counter.theconversation.com/content/205273/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Parents spend more time actively engaged with their kids – such as helping with homework or reading together – during the school year than during summer. But the difference is almost three times greater for moms than for dads.Todd Jones, Assistant Professor of Economics, Mississippi State UniversityBenjamin Cowan, Associate Professor of Economics, Washington State UniversityJeff Swigert, Assistant Professor of Economics, Southern Utah UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2028312023-04-05T04:06:07Z2023-04-05T04:06:07Z3 reasons you feel hungrier and crave comfort foods when the weather turns cold<figure><img src="https://images.theconversation.com/files/519444/original/file-20230405-16-e8gas5.jpg?ixlib=rb-1.1.0&rect=0%2C1866%2C3360%2C2369&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/crop-unrecognizable-woman-with-fork-enjoying-yummy-bolognese-pasta-6287539/">Klaus Neilson/Pexels</a></span></figcaption></figure><p>As we move through Autumn, parts of Australia are starting to see cooler weather. For some of us, that can mean increasing feelings of hunger and cravings for “comfort food” such as as pasta, stews and ramen. </p>
<p>But what’s happening in our body?</p>
<h2>3 things change when it gets cold</h2>
<p><strong>1. Our body conserves heat</strong> </p>
<p>It sends this energy it conserves to our internal organs so they can maintain their temperature and work properly. The body can also perform heat-generating activities (such as shivering), which uses <a href="https://pubmed.ncbi.nlm.nih.gov/21261804/">energy</a>. The body will then look for additional energy through calories from eating food. </p>
<p><strong>2. Our body warms up when eating</strong> </p>
<p>When we eat, the body needs to expend energy to digest, absorb, and metabolise the nutrients. This process requires the use of energy, which generates heat in the body, leading to an increase in body temperature termed “<a href="https://pubmed.ncbi.nlm.nih.gov/36012714/">diet-induced thermogenesis</a>”. </p>
<p>However, the amount of energy used to keep us warm is quite <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/nonshivering-thermogenesis">modest</a>.</p>
<p><strong>3. Some people experience a drop in the neurotransmitter called serotonin</strong></p>
<p>This is partly because the rate our body produces serotonin is related to <a href="https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673602117375.pdf">sunlight</a>, which is lower in winter. </p>
<p>Serotonin helps to regulate mood, appetite, and sleep, among other things. When serotonin levels are low, it can lead to increased hunger and decreased satiety (feeling that you’ve had enough to eat), making us feel hungrier and less satisfied after meals. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/519452/original/file-20230405-24-2hw4e0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="dish of freshly cooked pie with potato topping, one portion taken out" src="https://images.theconversation.com/files/519452/original/file-20230405-24-2hw4e0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/519452/original/file-20230405-24-2hw4e0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/519452/original/file-20230405-24-2hw4e0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/519452/original/file-20230405-24-2hw4e0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/519452/original/file-20230405-24-2hw4e0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/519452/original/file-20230405-24-2hw4e0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/519452/original/file-20230405-24-2hw4e0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Shepherds pie – vegetarian or meat-based – might be just the thing.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/vegan-shepherds-pie-lentils-mashed-potatoes-1900996696">Shutterstock</a></span>
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<h2>Why we love comfort food in winter</h2>
<p>Many of us struggle to eat salad in winter and crave mum’s chicken soup or a slow cooked, brothy ramen. </p>
<p>Research shows our brain detects the cold weather and looks for warm <a href="https://www.mdpi.com/2072-6643/9/6/592">food</a>. Warm food can provide a sense of comfort and cosiness, which is particularly appealing during the colder months when we spend more time indoors. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-psychology-of-comfort-food-why-we-look-to-carbs-for-solace-135432">The psychology of comfort food - why we look to carbs for solace</a>
</strong>
</em>
</p>
<hr>
<p><a href="https://www.sciencedirect.com/science/article/pii/S1878450X16300786">Comfort food</a> can mean something different for everyone. They are foods we reach for in periods of stress, nostalgia, discomfort (like being cold), or emotional turmoil. For most of us, the foods we often over-indulge in are rich and carbohydrate heavy.</p>
<p>A drop in serotonin has also been shown to stimulate an urge to eat more <a href="https://pubmed.ncbi.nlm.nih.gov/16340952/">carbohydrate-rich</a> foods such as gnocchi, pasta, ragout, mashed potatoes. </p>
<h2>What happens to those extra calories?</h2>
<p>If you consume more energy in cooler weather, some of it will be used to keep you warm. Beyond keeping us warm, extra calories we consume are stored.</p>
<p>While most humans today have access to a year-round food supply, some research shows our bodies may still have some leftover instincts related to storing energy for the cooler months when food was harder to come by. </p>
<p>This behaviour may also be driven by biological factors, such as changes in hormone levels that regulate appetite and <a href="https://www.frontiersin.org/articles/10.3389/fnins.2013.00140/full">metabolism</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/gaining-weight-in-winter-isnt-inevitable-unless-you-decide-you-will-40320">Gaining weight in winter isn't inevitable, unless you decide you will</a>
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<hr>
<p>A fundamental principle of nutrition and metabolism is that the balance between the energy content of food eaten and energy expended to maintain life and to perform physical work affects body <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302369/">weight</a>. This means any excess energy that we don’t use will be stored – usually as fat.</p>
<p>Using mathematical modelling, researchers <a href="https://royalsocietypublishing.org/doi/10.1098/rspb.2015.2443">have predicted</a> weight gain is more likely when food is harder to find. Storing fat is an insurance against the risk of failing to find food, which for pre-industrial humans was most likely to happen in winter. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/519453/original/file-20230405-28-gdqfpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="hands cradle a bowl of pumpkin soup" src="https://images.theconversation.com/files/519453/original/file-20230405-28-gdqfpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/519453/original/file-20230405-28-gdqfpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/519453/original/file-20230405-28-gdqfpr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/519453/original/file-20230405-28-gdqfpr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/519453/original/file-20230405-28-gdqfpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/519453/original/file-20230405-28-gdqfpr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/519453/original/file-20230405-28-gdqfpr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Winter is coming … so it’s soup time.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/bowl-warm-pumpkin-soup-hands-holding-1176327610">Shutterstock</a></span>
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<h2>It doesn’t have to be unhealthy</h2>
<p>No matter your cravings during cooler months, it’s important to remember your own personal health and wellbeing goals. </p>
<p>If you’re worried about excess energy intake, a change in season is a great time to rethink healthy food choices. Including lots of whole fresh vegetables is key: think soups, curries, casseroles, and so on. </p>
<p>Including protein (such as meat, fish, eggs, legumes) will keep you feeling fuller for longer.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/a-nice-warm-bowl-of-porridge-3-ways-plus-a-potted-history-137007">A nice warm bowl of porridge: 3 ways plus a potted history</a>
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</em>
</p>
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<img src="https://counter.theconversation.com/content/202831/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lauren Ball works for The University of Queensland and receives funding from the National Health and Medical Research Council. She is a Director of Dietitians Australia, a Director of the Darling Downs and West Moreton Primary Health Network and an Associate Member of the Australian Academy of Health and Medical Sciences.</span></em></p><p class="fine-print"><em><span>Emily Burch works for Southern Cross University.</span></em></p>Reaching for pasta or a bowl of comforting soup? Here’s how the cooler months can affect our cravings.Lauren Ball, Professor of Community Health and Wellbeing, The University of QueenslandEmily Burch, Dietitian, Researcher & Lecturer, Southern Cross UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1982002023-02-06T12:19:56Z2023-02-06T12:19:56ZCurious Kids: why do I feel happier when the sun is out?<figure><img src="https://images.theconversation.com/files/507644/original/file-20230201-10491-cnbcpu.jpg?ixlib=rb-1.1.0&rect=19%2C13%2C4341%2C2890&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/happy-child-outdoors-spring-sunflower-field-173333366">Sunny studio/Shutterstock</a></span></figcaption></figure><p><strong>Why do I feel happier when the sun is out? – Mabli, aged 13, Barry, Wales</strong></p>
<p>That is exactly the same question I asked many years ago when I was sitting on a nice sunny beach, far away on a lovely warm island. I remember thinking, “Oh gosh, tomorrow I need to fly back to rainy London where the weather is horrible. I don’t want to go; the weather will make me unhappy.”</p>
<p>I actually <a href="https://onlinelibrary.wiley.com/doi/10.1111/manc.12126">did some research</a> into whether sunshine does make us happier. I’m a professor of economics, and I wanted to look at whether higher temperatures, more sunshine and less rainfall on a given day makes people happier. Happiness matters to economists because it is an important way of measuring quality of life. Did you know that the Office of National Statistics has been collecting <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/measuresofnationalwellbeingdashboardqualityoflifeintheuk/2022-08-12">happiness data</a> for more than 10 years?</p>
<p>My own <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/manc.12126">research</a> has shown that while sunshine matters as a seasonal factor, it doesn’t matter much whether it’s sunny on any given day here in the UK. The sunlight you get over the course of a season is what’s important. You may generally feel a bit unhappier in the winter, but it won’t matter much whether it’s a sunny or a cloudy winter’s day. </p>
<p>Medically, exposure to sunlight causes your brain to produce the hormone <a href="https://my.clevelandclinic.org/health/articles/22572-serotonin">serotonin</a> inside your body. Hormones are complex chemicals that play an important role in regulating many of your body functions. </p>
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<img alt="" src="https://images.theconversation.com/files/282267/original/file-20190702-126345-1np1y7m.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/282267/original/file-20190702-126345-1np1y7m.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=293&fit=crop&dpr=1 600w, https://images.theconversation.com/files/282267/original/file-20190702-126345-1np1y7m.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=293&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/282267/original/file-20190702-126345-1np1y7m.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=293&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/282267/original/file-20190702-126345-1np1y7m.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=368&fit=crop&dpr=1 754w, https://images.theconversation.com/files/282267/original/file-20190702-126345-1np1y7m.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=368&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/282267/original/file-20190702-126345-1np1y7m.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=368&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><a href="https://theconversation.com/au/topics/curious-kids-36782">Curious Kids</a> is a series by <a href="https://theconversation.com/uk">The Conversation</a> that gives children the chance to have their questions about the world answered by experts. If you have a question you’d like an expert to answer, send it to <a href="mailto:curiouskids@theconversation.com">curiouskids@theconversation.com</a> and make sure you include the asker’s first name, age and town or city. We won’t be able to answer every question, but we’ll do our very best.</em></p>
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<p>Two functions that are affected by serotonin are your mood and your sleep quality. When you’re exposed to sunlight your body will make more serotonin, which can boost your mood and make you feel better. High levels of serotonin will make you a feeling positive and full of energy.</p>
<p>At night, when it is dark, your body produces another hormone called <a href="https://www.nhs.uk/medicines/melatonin/">melatonin</a>. Melatonin helps your body relax and will make you feel tired. It’s a chemical produced by your body to prepare you for a good night’s sleep. A good balance between these two chemicals is very important in regulating your energy levels, giving you a good night’s rest and making you feel well during the day.</p>
<h2>Not enough sunshine</h2>
<p>However, for many people it is hard to balance sunlight with darkness. People who work indoors a lot, or live in parts of the world where it gets dark for a long time – like countries near the North Pole in the winter – may not get enough sunlight. </p>
<p>There is <a href="https://www.sciencedirect.com/science/article/pii/S0140673698010150?casa_token=s-i479aPLeAAAAAA:n3sPnD68j0wxaXpKJSHxqW3ltORsZ6Bc70CGdkmiu-bDgq6FF_5hYVY6kF8Imrg8cryFIbpR">typically 100 times less light</a> in a house and 25 times less light in an office when compared to a nice sunny day outside. This is why getting outside in the sun is a great way to get some exercise, enjoy the fresh air, and boost your mood all at the same time. </p>
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<img alt="Three girls outside in warm clothes" src="https://images.theconversation.com/files/507659/original/file-20230201-13415-orsgzp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/507659/original/file-20230201-13415-orsgzp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/507659/original/file-20230201-13415-orsgzp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/507659/original/file-20230201-13415-orsgzp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/507659/original/file-20230201-13415-orsgzp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/507659/original/file-20230201-13415-orsgzp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/507659/original/file-20230201-13415-orsgzp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">It’s important to spend time outside, all year round.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/trio-pretty-multiethnic-cheerful-teen-girls-1828137389">Prostock-studio/Shutterstock</a></span>
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<p>People who live in places where there is less daylight are more likely to suffer from <a href="https://www.nhs.uk/mental-health/conditions/seasonal-affective-disorder-sad/overview/">seasonal affective disorder</a> (Sad). Sad is a type of depression that often occurs in the autumn and winter. </p>
<p>People with Sad may experience symptoms such as low energy, sadness, sleep problems, and a decreased interest in activities they normally enjoy. The most common treatment for Sad is light therapy where you sit underneath bright artificial lights for some time. This mimics sunshine and will trick your body into creating serotonin. </p>
<h2>We need the light</h2>
<p>However, there is more to sunlight than just hormones. Your skin produces Vitamin D from sunlight and this is important for strong bones and being healthy. From April to September most people in the UK make <a href="https://www.britishskinfoundation.org.uk/sunlight-and-vitamin-d">enough Vitamin D from sunshine alone</a>. In the winter, though, you won’t get enough from sunshine, which is why <a href="https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/">the UK government recommends</a> that everyone should consider taking vitamin D supplements in the autumn and winter. </p>
<p>There is also an evolutionary component. Human eyesight is designed for daylight. We don’t have good night vision like cats. A long time ago in the past, when we didn’t have streetlamps, long periods of darkness might have made our ancestors nervous, fearful, and therefore unhappy. And while you don’t have to worry about being eaten by a lion at night any more, you may still have some of that fear from <a href="https://www.tandfonline.com/doi/full/10.1080/02699931.2022.2029358?needAccess=true">your ancestors 5,000 years ago</a>.</p>
<p>Please remember that while sunlight can have many positive effects on your mood and health, it’s also important to be safe in the sun. This means wearing sunscreen, wearing a hat and sunglasses, and avoiding being in direct sunlight for too long. And never look at the sun directly. That’s super dangerous.</p>
<p><em>This article has been updated to better represent government advice on taking Vitamin D.</em></p><img src="https://counter.theconversation.com/content/198200/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Franz Buscha does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Day to day, sunshine might not affect our mood – but light and dark seasons do.Franz Buscha, Professor of Economics, University of WestminsterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1944172022-12-05T13:28:18Z2022-12-05T13:28:18ZShorter days affect the mood of millions of Americans – a nutritional neuroscientist offers tips on how to avoid the winter blues<figure><img src="https://images.theconversation.com/files/496594/original/file-20221121-18490-5tf8u2.jpg?ixlib=rb-1.1.0&rect=8%2C0%2C5742%2C3837&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">For those prone to seasonal affective disorder, a shift in the sleep cycle can impact energy levels.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/girl-alone-royalty-free-image/1129211268?phrase=seasonal%20affective%20disorder&adppopup=true">Ben Akiba/E+ via Getty Images</a></span></figcaption></figure><p>The annual pattern of winter depression and melancholy – better known as <a href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651">seasonal affective disorder, or SAD</a> – suggests a strong link between your mood and the amount of light you get during the day. </p>
<p>To put it simply: The less light exposure one has, the more one’s mood may decline.</p>
<p>Wintertime blues are common, but about 10 million Americans are affected every year by a longer lasting depression called <a href="https://www.bu.edu/articles/2019/seasonal-affective-disorder/">seasonal affective disorder</a>. Along with low mood, symptoms include anxious feelings, low self-esteem, longer sleep duration, constant craving for carbohydrates and low physical activity levels.</p>
<p><a href="https://www.binghamton.edu/decker/health-wellness-studies/profile.html?id=lina">I am a nutritional neuroscientist</a>, and my research focuses on the effects of diet and lifestyle factors on <a href="https://scholar.google.com/citations?user=sOMbzQ0AAAAJ&hl=en">mood and brain functions</a> such as mental distress, resilience and motivation. </p>
<p>Through my research, I have learned that seasonal affective disorder can strike anyone. However, people with a <a href="https://doi.org/10.1034/j.1600-0447.2000.101003176.x">history of mood disorders are at a higher risk</a>. In particular, young adults and women of all ages <a href="https://doi.org/10.1016/j.jadr.2021.100157">have an increased susceptibility</a>. </p>
<h2>Why seasonal depression happens</h2>
<p>When daylight saving time ends each fall, the one-hour shift backward reduces the amount of light exposure most people receive in a 24-hour cycle. As the days get shorter, people can experience general moodiness or a longer-term depression that is tied to a shorter exposure to daylight.</p>
<p>This happens due to a misalignment between the sleep-wake cycle, eating schedules and other daily tasks. Research shows that this mismatch may be associated <a href="https://doi.org/10.1038/s41398-020-0694-0">with poor mental health outcomes</a>, such as anxiety and depression. </p>
<p>Our sleep-wake cycle is controlled by the <a href="https://nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx">circadian rhythm</a>, an internal clock regulated by light and darkness. Like a regular clock, it <a href="https://theconversation.com/why-does-night-shift-increase-the-risk-of-cancer-diabetes-and-heart-disease-heres-what-we-know-so-far-190652">resets nearly every 24 hours </a> and controls metabolism, growth and hormone release. </p>
<p>When our brain receives signals of limited daylight, it <a href="https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know">releases the hormone melatonin to support sleep</a> – even though we still have hours left before the typical bedtime. This can then affect how much energy we have, and when and how much we eat. It can also alter the brain’s ability to adapt to changes in environment. This process, called <a href="https://www.sciencedirect.com/topics/neuroscience/neuronal-plasticity">neuronal plasticity</a>, involves the growth and organization of neural networks. This is crucial for brain repair, maintenance and overall function.</p>
<p>It is possible to <a href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/diagnosis-treatment/drc-20364722">readjust the circadian rhythm</a> to better align with the new light and dark schedule. This means getting daylight exposure as soon as possible upon waking up, as well as maintaining sleep, exercise and eating routines that are more in sync with your routine prior to the time change. Eventually, people can gradually transition into the new schedule. </p>
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<figcaption><span class="caption">Sleeping too much or too little, bingeing on junk food and withdrawing from others are three symptoms of seasonal affective disorder.</span></figcaption>
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<h2>The intimate connection between serotonin and melatonin</h2>
<p>Serotonin is a chemical messenger in the brain that is a key player in regulating several functions such as <a href="https://my.clevelandclinic.org/health/articles/22572-serotonin#">mood, appetite and the circadian rhythm</a>. Serotonin also converts to melatonin with lower light intensity. As mentioned above, melatonin is a hormone that regulates the sleep-wake cycle and signals the brain that it’s time to sleep.</p>
<p>Less daylight exposure during winter months leads to the conversion of serotonin into melatonin <a href="https://doi.org/10.1126/science.7434030">earlier in the evening</a>, since it gets dark earlier. As a result, this untimely melatonin release causes a disruption in the sleep-wake cycle. For some people this can cause moodiness, daytime sleepiness and loss of appetite regulation, typically leading to unhealthy snacking. People with seasonal affective disorder often <a href="https://doi.org/10.1016/S0149-7634(02)00004-0">crave foods rich in simple sugars, such as sweets</a>, because there is an intimate connection between <a href="https://doi.org/10.1093/cdn/nzab049_009">carbohydrate consumption, appetite regulation and sleep</a>. </p>
<h2>Strategies to combat the winter blues</h2>
<p>In winter, most people leave work when it’s turning dark. For this reason, <a href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298">light therapy is typically recommended</a> for those who experience seasonal affective disorder, or even shorter periods of seasonal funk. </p>
<p>This can be as simple as getting some light shortly after awakening. Try to get at least one hour of natural light during the early morning hours, preferably about <a href="https://www.cdc.gov/niosh/emres/longhourstraining/light.html#:%7E:">one hour after your usual morning wake-up time</a> when the circadian clock is most sensitive to light. This is true no matter what your wake-up time is, as long as it’s morning. For people living at northern latitudes where there’s very little sun in winter, light therapy boxes – <a href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298">which replicate outdoor light</a> – can be effective. </p>
<p>You can also improve your sleep quality by avoiding stimulants like coffee, tea or heavy meals close to bedtime. <a href="https://doi.org/10.1113/JP276943">Exercising during the day is also good</a> – it increases serotonin production and supports circadian regulation. A balanced diet of complex carbs and healthy proteins <a href="https://doi.org/10.1016/j.jand.2022.01.007">supports steady serotonin and melatonin production</a>, and practicing downtime before bed can reduce stress. </p>
<p>Taking these small steps may help the circadian rhythm adjust faster. For the millions with mood disorders, that could mean happier times during what are literally the darkest days.</p><img src="https://counter.theconversation.com/content/194417/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lina Begdache does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Research shows that young adults and women are particularly susceptible to seasonal affective disorder.Lina Begdache, Associate Professor of Health and Wellness Studies, Binghamton University, State University of New YorkLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1924532022-10-25T10:52:28Z2022-10-25T10:52:28ZSeasonal depression: small things you can do every day to cope<figure><img src="https://images.theconversation.com/files/491627/original/file-20221025-225-bjkp7h.jpg?ixlib=rb-1.1.0&rect=24%2C0%2C4118%2C2906&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Daylight is important, so try to get outside for a walk in the morning and afternoon.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/two-happy-carefree-multiracial-girlfriends-walking-2180000637">Dasha Petrenko/ Shutterstock</a></span></figcaption></figure><p>Many of us tend to feel sad or not like our usual self as autumn and winter approach. But for some, these feelings persist until spring arrives. </p>
<p>Known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673349/">seasonal affective disorder</a> (or Sad), it’s a type of depression that occurs only during specific seasons. Alongside persistent low mood, some people may find they feel more lethargic than usual, have difficulty getting up in the morning and crave more carbs than normal.</p>
<p>If you’re someone who has Sad (or think you might), here are a few things you can do to improve your mood during the colder months. </p>
<h2>What to do every day</h2>
<p>Since Sad happens during seasons when the days are shorter and we get less sunlight, it’s thought to be caused by a disruption of our body clocks (also known as circadian-rhythm disturbance). We all have a “master clock” in the brain that uses daylight to control all of our body’s processes – from hunger to when we feel ready for bed.</p>
<p>Circadian rhythm disturbance has been linked to sleep disturbances, changes in mood and our eating patterns and metabolism, all of which are <a href="https://www.jci.org/articles/view/148286">affected by Sad</a>.</p>
<p>This is why getting outside and into natural daylight can be so important for people who have Sad. </p>
<p>In the morning, aim to get outside for at least a few minutes. Since light sends direct signals to your master body clock to tell it it’s time to wake up, morning light will help you feel more alert throughout the day. It may also help you <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751071/">fall asleep earlier in the evening</a>.</p>
<p>At lunch, try again to get outside and get more natural light exposure. But if you can’t get outside or it’s overcast, you may want to try bright-light therapy. This exposes people to bright fluorescent light using a special lamp or mask. Research shows that 30 minutes of bright light therapy daily can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746555/">help reduce symptoms of Sad</a>. </p>
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<img alt="A woman uses a fluorescent lightbox in her home to help treat her seasonal depression." src="https://images.theconversation.com/files/491629/original/file-20221025-19-drdye6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/491629/original/file-20221025-19-drdye6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/491629/original/file-20221025-19-drdye6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/491629/original/file-20221025-19-drdye6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/491629/original/file-20221025-19-drdye6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/491629/original/file-20221025-19-drdye6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/491629/original/file-20221025-19-drdye6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Light therapy may help on days that are overcast.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-light-therapy-171526115">Image Point Fr/ Shutterstock</a></span>
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<p>If you find it difficult to convince yourself to get away from your desk at lunchtime, try to organise some activities to do that may help you get outside. For example, try to organise a <a href="https://www.semanticscholar.org/paper/Group-Versus-Individual-Approach-A-Meta-Analysis-of-Burke-Carr%C3%B3n/a60d9f8de8d41ad85b7c07089680b09fa0bd9d6b">daily lunchtime group walk</a> with your colleagues or neighbours. Alongside getting you out into the daylight, exercising in a group can also boost <a href="https://psycnet.apa.org/record/2022-03784-001">positive emotions and connectedness</a>, which is good for wellbeing and mental health. </p>
<p>Another activity you could try during your lunchtime walk is the “<a href="https://www.emerald.com/insight/content/doi/10.1108/JPMH-02-2021-0029/full/html">three good things in nature</a>” task. The aim of this activity is to boost mindfulness and appreciation of nature by taking note of at least three things from the natural environment while you’re on your daily walk. Not only will this get you outside, it may also help improve your mood and wellbeing. </p>
<p>In the evenings, aim to set aside time to do things you enjoy. This may help to improve your mood and may ease some symptoms of Sad.</p>
<p>Other things you can do during winter months to improve your mood include:</p>
<p><strong>Practise humour</strong><br>
<a href="https://pubmed.ncbi.nlm.nih.gov/32749027/">Introducing more humour into your life</a> may help balance out your negative emotions and could even improve sleep quality, mood and reduce symptoms of depression. </p>
<p>In the evening, take ten minutes to think of some <a href="https://link.springer.com/article/10.1007/s10902-012-9380-0">funny things</a> that happened during the day. Or think of a <a href="https://www.tandfonline.com/doi/abs/10.1080/17439760.2015.1137624?journalCode=rpos20">challenging situation</a> you faced and instead try to think about how you’d deal with it in a funny way in the future. Making the time to <a href="https://scielo.isciii.es/pdf/enefro/v22n3/2255-3517-enefro-22-03-256.pdf">watch something funny</a> on TV three or four times a week may also help to boost your mood.</p>
<p><strong>Find a hobby</strong><br>
Start a new hobby or pick up one you haven’t practised for a while. Engaging in a hobby will keep your mind less idle and more engaged, leaving you with less time to ruminate, if that’s something you tend to do. Perhaps try <a href="https://pubmed.ncbi.nlm.nih.gov/32245337/">learning to knit</a>. This is associated with increased mindfulness, calmness and a boost of positive emotions. Mastering <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071848/">new recipes</a> may also be a great way of boosting wellbeing. </p>
<p>It doesn’t matter what hobby you choose, as long as it stretches your skills and helps you get into a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983950/">state of flow</a>. This is the feeling of “losing yourself” in what you’re doing and is a major component in experiencing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636857/">subjective happiness</a>. You might not feel better while you are doing your hobby (as it requires concentration), but as soon as you complete your task, you will experience a sense of accomplishment and a boost of positive emotions. </p>
<p><strong>Keep your body clock in rhythm</strong><br>
Since Sad is thought to be caused by circadian-rhythm disturbance, keeping your circadian rhythm in time may help to reduce symptoms of Sad.</p>
<p>Sleep plays a big role in keeping your body clock in check. So in the evenings, try to avoid too much bright light as this will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751071/">delay your sleep</a>. You should also try to keep similar times for going to sleep and waking up both during the week and on weekends. Alongside proper sleep, eating your meals at regular times may also help to keep your body clock in time. </p>
<p>While it may be normal to feel a dip in your mood after the clocks first change, if you’re finding that symptoms are lingering for many weeks or are having a big effect on your life, you may want to speak to your doctor. In the meantime, remember that even just a few small changes every day may help keep Sad symptoms at bay.</p>
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<p><em>If you are struggling or feel you could benefit from mental health support, please speak to your GP, and/or try contacting supportive organisations such as <a href="https://www.sada.org.uk/">The Seasonal Affective Disorders Association</a>, <a href="https://www.samaritans.org/">The Samaritans</a> or <a href="https://www.thecalmzone.net/">Campaign Against Living Miserably</a> (CALM).</em></p><img src="https://counter.theconversation.com/content/192453/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Annie Curtis has received funding from Science Foundation Ireland and the Irish Research Council , and other similar funding bodies who provide funding for basic scientific research.</span></em></p><p class="fine-print"><em><span>Jolanta Burke does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>‘Sad’ is most common during the colder months.Jolanta Burke, Senior Lecturer, Centre for Positive Psychology and Health, RCSI University of Medicine and Health SciencesAnnie Curtis, Senior Lecturer, School of Pharmacy and Biomolecular Sciences (PBS), RCSI University of Medicine and Health SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1800632022-03-28T13:20:43Z2022-03-28T13:20:43ZDaylight savings: how an hour of extra sunlight can benefit your mental health<figure><img src="https://images.theconversation.com/files/454656/original/file-20220328-27-15lwr3i.jpg?ixlib=rb-1.1.0&rect=26%2C0%2C3000%2C1998&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/man-walking-dog-early-morning-by-562654981">Boris Medvedev/Shutterstock</a></span></figcaption></figure><p>In many northern hemisphere countries, people have now adjusted the clock one hour forwards and are enjoying an extra hour of daylight in the evenings. As the weather becomes a little warmer, too, this gives us that pleasant feeling that summer isn’t too far away.</p>
<p>But there are a variety of ways extra daylight can improve our wellbeing.</p>
<p>When sunlight hits a specific area of the retina in your eyes, this actually triggers the release of <a href="https://faseb.onlinelibrary.wiley.com/doi/full/10.1096/fj.14-268342">serotonin</a> (the “feel-good” chemical) in the brain. An increase in serotonin is linked to <a href="https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/serotonin-emotion-and-behaviour/">higher mood</a> levels.</p>
<p>In fact, a lack of sunlight can lead to a condition called <a href="https://theconversation.com/seasonal-depression-why-it-happens-and-how-to-manage-the-symptoms-171257">seasonal affective disorder</a> (SAD), sometimes called “winter depression”. This disorder, characterised by low mood, is most common during the winter months when there are fewer hours of daylight. </p>
<p>The sun is a source of vitamin D, which has some important functions in the body, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070857/">reducing inflammation</a>. Aside from its physical health benefits, a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908269/">lack of vitamin D</a> can cause people to feel low and anxious, while exposure to direct sunlight can improve mood. Just five to 15 minutes in the sun is enough to reap the benefits associated with vitamin D. </p>
<p>Sunlight also supports the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2290997/">production of melatonin</a>, the chemical that helps us to <a href="https://pubmed.ncbi.nlm.nih.gov/32156230/#:%7E:text=Results%3A%20Vitamin%20D%20receptors%20and,human%20circadian%20rhythms%20and%20sleep">sleep well</a> – insomnia is more common during the darker winter months. And getting a good night’s sleep has <a href="https://www.nhs.uk/live-well/sleep-and-tiredness/why-lack-of-sleep-is-bad-for-your-health/">a positive effect</a> on our wellbeing.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/seasonal-depression-why-it-happens-and-how-to-manage-the-symptoms-171257">Seasonal depression: why it happens – and how to manage the symptoms</a>
</strong>
</em>
</p>
<hr>
<p>More hours of daylight can also encourage people to socialise more. Socialising and connecting with other people is associated with <a href="https://journals.sagepub.com/doi/full/10.1177/000486741772399">improved mood and wellbeing</a>. </p>
<p>More light in the evenings also gives many people more of an opportunity to go outside at the end of the day. While the physical and mental health benefits of doing exercise are well known, simply being <a href="http://www.awp.nhs.uk/news-publications/trust-news/2021/may/embracing-the-power-of-nature-to-boost-mental-health/">outdoors in nature</a> can improve our wellbeing. It can have a calming effect on the mind and can create a feeling of peace. It can also help us to cope with everyday stresses and mental fatigue.</p>
<p>The therapeutic benefit of being outside in nature is such that “nature therapy”, “<a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01389/full">ecotherapy</a>” or “green therapy” are often recommended as part of treatment for conditions such as depression.</p>
<figure class="align-center ">
<img alt="A group of people socialising outdoors." src="https://images.theconversation.com/files/454675/original/file-20220328-21-sc6519.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/454675/original/file-20220328-21-sc6519.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/454675/original/file-20220328-21-sc6519.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/454675/original/file-20220328-21-sc6519.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/454675/original/file-20220328-21-sc6519.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/454675/original/file-20220328-21-sc6519.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/454675/original/file-20220328-21-sc6519.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">We might socialise more when the days are longer.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/six-adult-friends-enjoying-party-on-785101684">Monkey Business Images/Shutterstock</a></span>
</figcaption>
</figure>
<p>With all this in mind, it’s perhaps not surprising that evidence shows that when the clocks go back in the autumn the rate of mental and emotional problems <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302868/">increases</a> compared to when the clocks go forwards in spring. </p>
<h2>Making the most of it</h2>
<p>After two years of the COVID pandemic, and as the war continues to rage in Ukraine, taken with the worries of everyday life, it’s natural to be feeling stressed and emotionally fatigued. Making the most of the extra daylight is a small thing you can do which might boost your mood. </p>
<p>Simply going out into your garden to enjoy the longer hours of daylight can be revitalising. If you don’t have a garden – or even if you do – make the most of outdoor spaces such as parks.</p>
<p>You could also try mindfulness meditation. This involves sensing what’s happening around you in the moment (such as the noises and the smells) and allowing yourself to think up positive imagery (such as lying on a sandy beach with the waves crashing in the distance) without judging or interpreting what you are thinking about. Sometimes referred to as “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176042/">guided imagery</a>”, practising this can help you to relax both your body and mind, which can in turn reduce feelings of stress and anxiety.</p>
<p>Being in and around nature can enhance this process, allowing you to pay attention to the sounds of birds, the smells of flowers, the warm sensation of the sun on your skin. Find somewhere peaceful to sit quietly, and focus on taking slow breaths. As with any new skill, this needs to be built up incrementally. Start with five minutes, and with regular practice, you’ll soon be able to do it for much longer.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-the-clocks-changing-are-great-for-your-brain-86003">Why the clocks changing are great for your brain</a>
</strong>
</em>
</p>
<hr>
<p>The extra hour of light at the end of the day should be even more meaningful to us because of all the extra time over the past two years we’ve spent stuck indoors. So use this valuable daylight – get away from your desk, take a walk, and pay attention to what’s around you. There’s a good chance you’ll feel better for it.</p><img src="https://counter.theconversation.com/content/180063/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>From boosted mood, to improved sleep, to more impetus to be outdoors and socialise, longer daylight can have a variety of direct and indirect benefits on our wellbeing.Anne Fothergill, Principal Lecturer, Mental Health, University of South WalesShaun Hough, Senior Lecturer, Mental Health, University of South WalesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1712572021-11-15T12:07:47Z2021-11-15T12:07:47ZSeasonal depression: why it happens – and how to manage the symptoms<figure><img src="https://images.theconversation.com/files/431929/original/file-20211115-27-1lxvqpg.jpg?ixlib=rb-1.1.0&rect=0%2C7%2C4800%2C3190&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Colder weather and less daylight may have you feeling a bit more down lately.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/highangle-shot-young-caucasian-man-blue-787102492">nito/ Shutterstock</a></span></figcaption></figure><p>With the weather getting colder and the days becoming shorter, some people are noticing they have less energy and aren’t feeling as positive as they usually do. While these feelings may be temporary for some, around <a href="https://www.sciencedirect.com/science/article/abs/pii/S0924933815006781">one in three people</a> consistently struggle through the autumn and winter months with a type of depression known as <a href="https://www.nhs.uk/mental-health/conditions/seasonal-affective-disorder-sad/overview/">seasonal affective disorder</a> (Sad). </p>
<p>Symptoms of Sad can vary from mild to severe, but typically include: </p>
<ul>
<li>Low mood,</li>
<li>Loss of interest or pleasure in things you previously enjoyed,</li>
<li>Change in appetite (usually eating more than usual),</li>
<li>Change in sleep (typically too much sleep),</li>
<li>Feeling worthless.</li>
</ul>
<p>Researchers aren’t yet clear on what causes Sad, but it’s likely to be complex and multifaceted. Some research suggests it could be due to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323254/?report=reader">malfunctioning hypothalamus</a> (the area of the brain that regulates mood, sleep and appetite) or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1450113/">producing too much melatonin</a> (a hormone that controls our sleep-wake cycle, which is produced by the brain’s pineal gland). Some researchers theorise it could also be due to having a <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/497745">disrupted circadian rhythm</a> – the natural, internal process that regulates our sleep-wake cycle. </p>
<p>Of course, there may be other factors at play too. For example, some research has indicated that women may be <a href="https://www.sciencedirect.com/science/article/pii/S0165032717318566">more likely</a> to experience Sad – though, due to a lack of specific research, it’s uncertain whether these <a href="https://reader.elsevier.com/reader/sd/pii/S030105119800043X?token=850BBB7E968814AC0010577E85AAFF3E62B2D04E0B3C6402B708FC865C32EAC961795B52B6C2A96B35C39295BAB1856D&originRegion=eu-west-1&originCreation=20211108100303">gender differences</a> really exist and if so, why. </p>
<h2>Getting through it</h2>
<p>Some people notice that their symptoms start to improve when the seasons begin to change and spring approaches. But this doesn’t mean that there aren’t many things people can do during the winter months to help them cope with their symptoms. </p>
<p>For people with Sad, the main <a href="https://www.nice.org.uk/guidance/cg90">recommended treatments</a> include psychological interventions (such as talking therapies) or taking medication (such as an antidepressant). Research shows that <a href="https://www.sciencedirect.com/science/article/pii/S0005789408000853?via%3Dihub">cognitive behavioural therapy</a> (which focuses on challenging our distressing thoughts and changing our behaviour) is an effective treatment for Sad. </p>
<p>In one study, researchers showed that cognitive behavioural therapy (CBT) was associated with significantly lower depression when followed up one year later when compared to light therapy (another treatment sometimes used for Sad, which involves sitting in front of, or below, a box which emits a very bright light, for around 20-30 minutes or more daily).</p>
<figure class="align-center ">
<img alt="An older woman sitting on a bench in a park looking at the autumn leaves." src="https://images.theconversation.com/files/431930/original/file-20211115-19-vsmzvv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/431930/original/file-20211115-19-vsmzvv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/431930/original/file-20211115-19-vsmzvv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/431930/original/file-20211115-19-vsmzvv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/431930/original/file-20211115-19-vsmzvv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/431930/original/file-20211115-19-vsmzvv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/431930/original/file-20211115-19-vsmzvv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Getting more natural light everyday may also help improve symptoms.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/depressed-sad-old-woman-on-bench-531981634">Nikodash/ Shutterstock</a></span>
</figcaption>
</figure>
<p>A key part of CBT is supporting patients in a technique called <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0100100">behavioural activation</a>, which aims to improve mood by encouraging people to structure their day and engage in meaningful, pleasurable activities – a hobby, for example. Research also indicates that <a href="https://www.sciencedirect.com/science/article/pii/S0165032718308966">certain antidepressants</a> (specifically SSRIs) may be particularly effective in treating symptoms of Sad. </p>
<p>Light therapy is also being investigated as a treatment for Sad. Given it’s still an emerging therapy, research regarding its effectiveness as a standalone treatment for Sad <a href="https://www.sciencedirect.com/science/article/pii/S0165032707003369">remains inconsistent</a>. But one study has shown that light therapy can be an effective way of <a href="https://www.sciencedirect.com/science/article/pii/S0165032707003369">managing Sad symptoms</a> when used in combination with antidepressants. Light therapy is not usually available on the NHS, so if you do want to try it be sure to only choose a product that is medically approved for the treatment of Sad – and follow instructions for use or consult your GP.</p>
<p>Aside from seeking professional help, there are a couple of other things that people can do to help them cope with Sad during their day. </p>
<p>Going outside and getting some natural daylight is one thing people experiencing Sad can do for themselves. According to one study, getting more natural light during the day <a href="https://pubmed.ncbi.nlm.nih.gov/8731073/">may help improve symptoms</a>. The researchers of the study had participants either go for a daily one-hour outdoor walk, or use a low-dose artificial light box for 30 minutes per day for a period of one week. </p>
<p>The participants who went for a daily walk showed significant improvements in all depressive symptoms, compared to those exposed to artificial light. While it’s uncertain exactly why daylight may improve symptoms, this may still be an easy and effective thing that people can do to improve their mood each day. </p>
<p><a href="https://www.sciencedirect.com/science/article/pii/S0165032713000694">Research</a> also shows that lifestyle factors (such as exercise levels and diet) can play an important role in both causing and managing depression. When it comes to Sad in particular, there’s some <a href="https://pubmed.ncbi.nlm.nih.gov/12000205/">evidence</a> to suggest that exercising (on it’s own or in combination with light therapy), may improve symptoms. </p>
<p>Again, it’s still unclear why this is the case. But research has indicated that it may be related to changes in our <a href="https://www.tandfonline.com/doi/full/10.1080/09291010802067171?scroll=top&needAccess=true">circadian rhythm</a>. A review that looked at the <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004366.pub6/full">effect of exercise</a> on depression has pointed to both the psychological (such as exercise providing distraction from negative thoughts and a means to socialise) and physiological (such as changes in endorphin or cortisol levels) benefits.</p>
<p>While there are many things people can do to manage symptoms of Sad throughout the winter months, it’s important to consult your GP about symptoms and feelings – especially if symptoms don’t improve, or if the condition becomes difficult to manage.</p>
<hr>
<p><em>If you are struggling or feel you could benefit from mental health support, please speak to your GP, and/or try contacting supportive organisations such as <a href="https://www.sada.org.uk/">The Seasonal Affective Disorders Association</a>, <a href="https://www.samaritans.org/">The Samaritans</a> or <a href="https://www.thecalmzone.net/">Campaign Against Living Miserably</a> (CALM).</em></p><img src="https://counter.theconversation.com/content/171257/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Harriet Bowyer does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>One in three people struggle throughout the winter months with seasonal affective disorder.Harriet Bowyer, Lecturer in Applied Psychology/Clinical Psychologist, Glasgow Caledonian UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1496012020-11-11T15:17:46Z2020-11-11T15:17:46ZWinter exercise is important for maintaining physical and mental health<figure><img src="https://images.theconversation.com/files/368884/original/file-20201111-15-j60aw5.jpg?ixlib=rb-1.1.0&rect=16%2C0%2C5590%2C3741&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Exercise improves physical health, immunity, and can reduce fatigue.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/male-runner-man-running-autumn-on-148056548">Maridav/ Shutterstock</a></span></figcaption></figure><p>As winter descends on the northern hemisphere and the temperature drops and daylight hours shorten, many people may want to spend more time indoors. And those of us under lockdown for the second time may feel even less inclined to get outside and exercise. But staying indoors may have unintended health consequences, due to both a lack of physical activity and exposure to daylight. </p>
<p>Being physically active all year long has many benefits to both physical and mental health. Exercise may even counter some of the negative effects winter weather can have on our energy levels and mood. </p>
<p>Research shows people exercise for an average of <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.462.5322&rep=rep1&type=pdf">eight minutes less</a> during the cooler months. People also drop other activities they do during warmer months, such as <a href="https://doi.org/10.1016/j.socscimed.2016.06.024">active travelling</a>. Light intensity activity (such as slow walking and housework) is shown to decrease during the winter, while time spent <a href="https://www.tandfonline.com/doi/full/10.3109/03014460.2013.827737">sitting and sleeping increased</a>. </p>
<p>But, despite decreases in light intensity activity and sleeping more, researchers did not find <a href="https://www.tandfonline.com/doi/full/10.3109/03014460.2013.827737">any differences</a> in terms of sleep quality, nor did it find a drop in moderate and vigorous activities – such as planned exercise classes or walking the dog – which people still did, despite the weather. A pre-print (not yet peer-reviewed) study also suggests that <a href="https://osf.io/preprints/sportrxiv/qu73a/">activity levels were lower</a> during the first spring lockdown. This could mean people may be even less active this winter.</p>
<p>There are many reasons we may lose our motivation to exercise during the winter months. In the winter, low levels of ambient light coupled with shorter days reduces exposure to vitamin D. This causes us to <a href="https://doi.org/10.1016/j.smrv.2011.09.002">feel tired or fatigued</a>. People often experience <a href="https://doi.org/10.1016/S2215-0366(18)30139-1">disrupted sleep</a> during winter months as well, further contributing to low energy levels. </p>
<p>Seasonal mood disturbances may also make it difficult to find the motivation to get up and move. Many people (<a href="https://doi.org/10.1016/j.jad.2017.12.106">particularly women</a>) <a href="https://doi.org/10.1016/j.psychres.2016.02.023">experience low mood</a> as the weather gets colder. Some even develop mental health disorders such as seasonal affective disorder (SAD), in which a person experiences symptoms of depression during <a href="https://doi.org/10.1016/j.eurpsy.2015.11.001">the winter months</a>.</p>
<p>The reasons why we exercise can also affect our motivation levels. For example, motivation is shown to waver if the primary focus of our exercise is on improving health and body image, rather than exercising for <a href="https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-9-78">enjoyment and accomplishment</a>. Research also shows that people who exercise outdoors <a href="https://doi.org/10.1080/14927713.2017.1399816">all year round</a> are better at finding the time to stick to their routine, and are more motivated by their enjoyment, or the challenge of their exercise compared too those who are only active during warmer months. So it’s easy to see how a person’s mood can lead to a more sedentary lifestyle. </p>
<h2>Exercise benefits</h2>
<p>The benefits of engaging in regular physical activity are <a href="http://dx.doi.org/10.1016/%20S0140-6736(12)61031-9">widely reported</a> for physical health – including reductions in weight, coronary heart disease, type 2 diabetes, strokes and certain types of cancer. It’s also associated with <a href="https://doi.org/10.3389/fphys.2018.00763">greater immune function</a>.</p>
<p>Physical activity is also <a href="https://doi.org/10.3389/fphys.2018.00763">important for wellbeing</a>. It’s been shown to <a href="https://doi.org/10.3390/ijerph17186535">reduce fatigue and enhance job satisfaction</a>), <a href="https://doi.org/10.1123/jsep.17.3.246">optimism</a>, <a href="https://doi.org/10.1249/00005768-198906000-00018">self-esteem</a> and <a href="https://doi.org/10.1038/s41569-020-00437-9">better stress management</a>. Exercise can also be used effectively to treat mental health conditions such as <a href="https://doi.org/10.1007/s00702-008-0092-x">depression and anxiety</a> <a href="https://doi.org/10.1080/09291010802067171%20(although%20this%20evidence%20base%20is%20very%20small)">SAD</a>, and promotes <a href="https://doi.org/10.1080/00223980.2018.1470487">positive mood</a>. </p>
<p>Though winter weather might not always allow it, exercising outdoors is also great at <a href="https://www.fs.fed.us/nrs/pubs/jrnl/2018/nrs_2018_kondo_004.pdf">reducing mental fatigue and stress</a>, improving <a href="https://www.mdpi.com/1660-4601/17/5/1526/htm">wellbeing</a>, <a href="https://www.mdpi.com/1660-4601/17/21/7769">life satisfaction and happiness</a>. Adolescents in particular benefit mentally from <a href="https://doi.org/10.1002/fee.2035">being in natural spaces</a>. Blue spaces – such as coastal regions and inland waterways – also have similar <a href="https://doi.org/10.1093/heapro/day103">restorative benefits for mental health</a>. </p>
<figure class="align-center ">
<img alt="Family walking their dog in the woods during autumn." src="https://images.theconversation.com/files/368885/original/file-20201111-23-1w8lafa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/368885/original/file-20201111-23-1w8lafa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/368885/original/file-20201111-23-1w8lafa.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/368885/original/file-20201111-23-1w8lafa.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/368885/original/file-20201111-23-1w8lafa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/368885/original/file-20201111-23-1w8lafa.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/368885/original/file-20201111-23-1w8lafa.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Exercising in nature is beneficial for mental health.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/family-walking-dog-through-winter-woodland-199078127">Monkey Business Images/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Outdoor exercise also provides more <a href="https://www.mdpi.com/1660-4601/13/4/363">opportunities for social interaction</a>, which, if allowed, is important for our health and wellbeing during this winter lockdown. Exercising outdoors in natural light is also linked to improvements in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241899/">sleep quality, physical health and wellbeing</a>. </p>
<p>To achieve these mental and physical benefits, it’s important to make sure you’re getting enough exercise. The UK’s NHS recommends a <a href="https://www.nhs.uk/live-well/exercise/">weekly health target</a> of 150 minutes of moderate intensity activity (or 75 minutes of vigorous intensity), which can easily be broken down into smaller chunks of ten minutes throughout the week. Moderate activity is enough to raise your heart rate, make you feel warmer and breathe faster. An easy way to tell is that you can still talk but find it difficult to sing. Two days of the week should also focus on strengthening activities. </p>
<p>Though it can sometimes be hard to find the motivation to exercise, carrying an activity monitor (wearable accelerometer) or phone app that records activity (such as step count) can motivate and enable people to <a href="https://www.sciencedirect.com/science/article/abs/pii/S0738399108005855">set and achieve goals</a>. Committing to activity can also be easier if you have <a href="https://doi.org/10.1177/0017896919872230">someone to exercise with</a>. <a href="https://link.springer.com/article/10.1186/1479-5868-5-44">Increasing the challenge</a> – such as the number of activity sessions, the intensity (such as walking speed or weight lifted) or the time spent in each session – can also increase fitness and strength. </p>
<p>Thankfully, there are plenty of ways to be active during the winter. In addition to sport and forms of exercise, taking active transport (walking and cycling to work or school), or doing chores will all contribute. Of most importance is to break up time sitting with movement and activity outside, in daylight, to ensure you profit from the additional health benefits.</p><img src="https://counter.theconversation.com/content/149601/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Exercise can improve mood and mental health, which may drop during the winter months.Ruth Lowry, Reader in Exercise Psychology, University of EssexJo Barton, Senior Lecturer in Sports and Exercise Science, University of EssexLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1060352019-01-02T09:15:11Z2019-01-02T09:15:11ZSeasonal affective disorder: your eye colour might be why you have the ‘winter blues’<figure><img src="https://images.theconversation.com/files/249732/original/file-20181210-76977-1e8q2ad.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The amount of light your eyes can process might be one of the reasons why some people are more likely to experience SAD. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/eye-black-woman-shot-large-macro-696777070?src=nwmaOyfwjbK7AnzxLV0HpA-1-12">Hanna Kuprevich/ Shutterstock</a></span></figcaption></figure><p>You’re not alone if colder weather and longer nights make you feel down. This well-known phenomenon, called seasonal affective disorder (SAD), might explain why people feel <a href="https://www.nhs.uk/conditions/seasonal-affective-disorder-sad/symptoms/">low, irritable, and lethargic</a> in the winter months. For some, the condition can be <a href="https://uit.no/prosjekter/prosjekt?p_document_id=224637">serious and debilitating</a>. </p>
<p>Although SAD is a <a href="https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder">recognised form of clinical depression</a>, experts are still divided on what causes the condition, with some even <a href="https://theconversation.com/seasonal-affective-disorder-doesnt-exist-heres-the-science-53834">arguing it doesn’t exist</a>. But <a href="https://chembiopublishers.com/OAJBSP/OAJBSP180002.pdf">my own research</a> has found that your eye colour might actually be one factor determining whether or not you develop SAD. </p>
<p>A <a href="https://weather.com/en-GB/unitedkingdom/health/news/sad-debilitating-condition-or-evolutionary-survival-strategy-2014102">survey I conducted in 2014</a> found that around 8% of UK people self-reported changes with the seasons that can be classified as SAD. Another 21% reported symptoms of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673349/">sub-syndromal SAD</a>, which is a less severe form, often called the “winter blues”.</p>
<p>Though many people might suspect they have SAD, the condition is usually diagnosed using the <a href="https://www.mededportal.org/publication/9622/">seasonal pattern assessment questionnaire</a>. This asks people to answer a number of questions about seasonal behaviour, mood and habit changes. The higher people score on the questionnaire, the more serious their SAD is. However, these diagnostic tools may vary between organisations, which can sometimes lead to inconsistent diagnoses.</p>
<p>But what actually causes SAD is still debated. Some theories, like the <a href="https://www.ncbi.nlm.nih.gov/pubmed/2326393">latitude hypothesis</a>, suggest SAD is triggered by decreased exposure to sunlight during the winter. This suggests that SAD should be more common in countries that are further from the equator (such as Iceland). However, a <a href="https://www.ncbi.nlm.nih.gov/pubmed/14607389">number of studies</a> have failed to support this theory. Another theory suggests SAD happens when our <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768314/">circadian rhythm is disrupted</a> as the days grow shorter. </p>
<p>Other theories propose it happens due to an imbalance in serotonin and melatonin in the body. Serotonin makes us <a href="https://www.medicalnewstoday.com/kc/serotonin-facts-232248">feel energetic</a>, while the release of melatonin <a href="http://www.psychiatrictimes.com/sleep-disorders/role-melatonin-circadian-rhythm-sleep-wake-cycle">makes us feel sleepy</a>. Since melatonin is made from serotonin, people with SAD may potentially produce too much melatonin during the winter months, leaving them feeling lethargic or down.</p>
<p>All these studies are inconsistent and, in some cases, <a href="https://www.ncbi.nlm.nih.gov/pubmed/14607389">contradictory</a>. But because SAD is likely due to a combination of many biological and physiological factors working together, these different explanations for what causes SAD may well be interconnected.</p>
<h2>SAD and your eye colour</h2>
<p>We have uncovered evidence that a <a href="https://chembiopublishers.com/OAJBSP/OAJBSP180002.pdf">person’s eye colour</a> can have a direct effect on how susceptible they are to SAD. </p>
<p>Our study used a sample of 175 students from two universities (one in south Wales, the other in Cyprus). We found that people with light or blue eyes scored significantly lower on the seasonal pattern assessment questionnaire than those with dark or brown eyes. These results agree with previous research which found that brown or dark-eyed people were <a href="https://www.ncbi.nlm.nih.gov/pubmed/11816051">significantly more depressed</a> than those with blue eyes.</p>
<p>The reason that eye colour may make some people more susceptible to depression or mood changes might be because of the amount of light an individual’s eyes can process. </p>
<p>The retina is the part of our eyeball containing cells that are sensitive to light. When light enters the eye, these cells trigger nerve impulses that form a visual image in our brain. In 1995, scientists discovered that some retinal cells, rather than forming an image, simply send information about <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/cne.903520304">levels of brightness</a> from the back of the eye to the brain’s hypothalamus. The hypothalamus is an important part of the brain which <a href="https://www.hormone.org/hormones-and-health/brainy-hormones">secretes hormones (such as oxytocin)</a> that regulate temperature, hunger and sleep cycles.</p>
<p>As the amount of blue and green light reaching the hypothalamus increases, the amount of melatonin decreases. Eyes with lower pigment (blue or grey eyes) are more sensitive to light. This means they don’t need to absorb as much light as brown or dark eyes before this information reaches the retinal cells. As such, people with lighter eyes release less melatonin during the fall and winter. This mechanism might provide light-eyed people with some resilience to seasonal affective disorder (though a smaller proportion may still experience SAD).</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/249734/original/file-20181210-76968-1b910xt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/249734/original/file-20181210-76968-1b910xt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/249734/original/file-20181210-76968-1b910xt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/249734/original/file-20181210-76968-1b910xt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/249734/original/file-20181210-76968-1b910xt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/249734/original/file-20181210-76968-1b910xt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/249734/original/file-20181210-76968-1b910xt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Blue eyes may have evolved to help us absorb more vitamin D during winter months.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/closeup-portrait-smiling-young-man-85330090?src=0IO5ysSvfukaAkNW1zy2pQ-1-13">Photobac/Shutterstock</a></span>
</figcaption>
</figure>
<p>Two theories have traditionally been used to explain why blue eyes occur in Western populations living farther from the equator. First, it might be seen as more attractive to the opposite sex, so it might provide a <a href="https://www.ncbi.nlm.nih.gov/pubmed/18172690">reproductive advantage</a>. </p>
<p>Second, blue eyes <a href="https://www.ncbi.nlm.nih.gov/pubmed/21813346">may be a side effect</a> of the same mutation that causes lighter skin colour. This mutation evolved because it helps the body make more vitamin D from the sun’s ultra-violet light in parts of the world that receive less radiation, especially during the winter.</p>
<p>But given that blue-eyed people in our study reported lower levels of SAD than their brown-eyed counterparts, this mutation may have occurred as an “anti-SAD” adaptation as a result of the considerable variations in light exposure that our prehistoric ancestors experienced as they migrated to northerly latitudes. </p>
<p>Eye colour is, of course, not the only factor here. People who spend too long indoors are also more susceptible to both winter blues and full-blown SAD. Fortunately for those with SAD, simply going outside for a regular walk, especially at times when it’s sunny, will help improve their mood. </p>
<p>If that doesn’t work, <a href="https://www.nhs.uk/conditions/seasonal-affective-disorder-sad/treatment/">“phototherapy”</a>, which involves sitting in front of a light box for an hour daily, could also help. People I have advised to use these methods (whether brown or blue eyed) almost invariably have reported a noticeable improvement. However, people with SAD are advised to consult a GP regardless, especially if their symptoms do not improve, or if the condition becomes difficult to manage.</p><img src="https://counter.theconversation.com/content/106035/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lance Workman received funding from The Weather Channel to support his study of SAD in 2014. </span></em></p>One study found that people with brown eyes were more susceptible to the disorder.Lance Workman, Visiting Professor in Psychology, University of South WalesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1061522018-11-13T23:23:21Z2018-11-13T23:23:21ZWhy natural depression therapies are better than pills<figure><img src="https://images.theconversation.com/files/245382/original/file-20181113-194503-k1hmra.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Antidepressants bring in almost $17 billion a year for the pharmaceutical industry, and yet science shows their benefit to be small. Natural therapies such as diet, exercise, light therapy and cognitive behavioural therapy are just as effective. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Winter is upon us. And with it comes the annual <a href="https://doi.org/10.1016/j.comppsych.2014.07.021">worsening of depressive symptoms</a>. Sadly, in the United States, suicide continues to claim more lives than firearms, and suicide rates are <a href="https://www.cdc.gov/media/releases/2018/p0607-suicide-prevention.html">increasing in nearly all states</a>. The U.S. Centers for Disease Control and Prevention reports that death by suicide has increased by 30 per cent since 1999 and <a href="https://globalnews.ca/news/4274136/suicide-rates-women-men-canada/">a similar trend is observed in Canada</a>. </p>
<p>I was distressed but not surprised to learn that these increases occurred over a period of time in which use of antidepressants <a href="https://www.cbsnews.com/news/antidepressant-use-soars-65-percent-in-15-years/?fbclid=IwAR1bVoojcdVJ25ekS9pJC3Lvv8fqYSqGfANqm6A7NWXKBrFmsFyN2fGc7s4">skyrocketed by 65 per cent</a>. By 2014, around one in eight Americans over the age of 12 reported recent antidepressant use.</p>
<p>I practice critical-care medicine in Guelph, Ontario. Sadly, 10 to 15 per cent of my practice is the resuscitation and life support of suicide and overdose patients. </p>
<p>It is not uncommon for these patients to have overdosed on the very antidepressants they were prescribed to prevent such a desperate act. The failures of antidepressants are a clear and present part of my clinical experience. </p>
<h2>Wedded to drugs that barely work</h2>
<p>Ten years ago, when finishing medical school, I carefully considered going into psychiatry. Ultimately, I was turned off by my impression that thought leaders in psychiatry were mistakenly wedded to a drug treatment that barely works. </p>
<p>A 2004 review by the Cochrane Foundation found that when compared against an “active” placebo (one that causes side effects similar to antidepressants), antidepressants were statistically of <a href="https://www.ncbi.nlm.nih.gov/pubmed/14974002">almost undetectable benefit</a>. </p>
<p>Studies that <a href="https://www.ncbi.nlm.nih.gov/pubmed/22393205">compared antidepressants to “dummy” placebos</a> showed larger but still underwhelming results. On the 52-point Hamilton Depression Rating Scale (HDRS), patients who took the antidepressants fluoxetine (Prozac) or venlafaxine (Effexor) experienced an average decrease of 11.8 points, whereas those taking the placebo experienced an average decrease of 9.6 points. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=391&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=391&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=391&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=491&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=491&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=491&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Symptoms of depression can peak over the winter months.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>I am not suggesting that antidepressants do not work. I am suggesting that they are given a precedence in our thinking about mental health that they do not deserve. </p>
<p>I leave it to readers to look at the <a href="https://www.psychcongress.com/saundras-corner/scales-screeners/depression/hamilton-depression-rating-scale-ham-d">Hamilton Depression Rating Scale</a> and decide for themselves whether a drop of 2.5 points is worth taking a pill with myriad potential side effects including <a href="https://www.ncbi.nlm.nih.gov/pubmed?term=9065681">weight gain</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed?term=19295509">erectile dysfunction</a> and <a href="https://doi.org/10.1016/j.cgh.2014.06.021">internal bleeding</a>. </p>
<p>It might be, but do note that taking an antidepressant does not seem to <a href="https://doi.org/10.1176/appi.ajp.160.4.790">decrease the risk of suicide</a>. </p>
<h2>Natural therapies that work</h2>
<p>The far more exciting and underplayed point, to me, is that multiple non-drug treatments have been shown to be as effective. As a staunch critic of alternative medical regimes such as chiropractic, acupuncture and homeopathy, it surprises me to note that the following “natural” therapies have rigorous, peer-reviewed scientific studies to support their use:</p>
<h2><em>1. Exercise</em></h2>
<p>In 2007, researchers at Duke University Medical Center in North Carolina randomly assigned patients to 30 minutes of walking or jogging three times a week, a commonly prescribed antidepressant (Zoloft), or placebo. Their results? <a href="https://www.researchgate.net/publication/5994774_Exercise_and_Pharmacotherapy_in_the_Treatment_of_Major_Depressive_Disorder">Exercise was more effective than pills!</a></p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Taking an antidepressant is not associated with a decreased risk of suicide.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>A 2016 <a href="https://doi.org/10.1016/j.jad.2016.03.063">review of all the available studies of exercise for depression </a> confirms it: Exercise is an effective therapy. And it’s free!</p>
<h2><em>2. Bright light therapy</em></h2>
<p>You know how you just feel better after an hour out in the sun? There probably is something to it. Bright light therapy is an effort to duplicate the sun’s cheering effects in a controlled fashion. Typically, patients are asked to sit in front of a “light box” generating 10,000 Lux from 30 to 60 minutes first thing in the morning. </p>
<p>A <a href="https://doi.org/10.1016/j.jad.2016.03.016">review of studies using this therapy</a> showed significant effect. The <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.2005.00574.x">largest study</a> showed a 2.5 point drop on the HDRS, roughly equal to that seen from antidepressants.</p>
<p>The sun gives 100,000 lux on a clear day and I can’t think of a reason why sunlight itself wouldn’t work, weather permitting. </p>
<h2><em>3. Mediterranean diet</em></h2>
<p>This one surprised me when it came out last year. <a href="https://doi.org/10.1186/s12916-017-0791-y">Researchers in Australia</a> randomly assigned depressed patients to receive either nutritional counselling or placebo social support. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=436&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=436&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=436&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=548&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=548&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=548&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Physicians have a responsibility to talk about options such as diet before writing a prescription.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>The nutritionists recommended a Mediterranean diet, modified to include local unprocessed foods. </p>
<p>Thirty-two per cent of the depressed dieters experienced remission versus eight per cent of those who only received social support, a far larger effect than seen in antidepressant trials. </p>
<h2><em>4. Cognitive Behavioural Therapy (CBT)</em></h2>
<p>This is the best recognized of the “natural” treatments for depression and the <a href="https://doi.org/10.1177/070674371305800702">evidence is indisputable</a>. </p>
<p>CBT is as effective as antidepressants but more expensive in the short term. However, antidepressants stop working when you stop taking them, whereas the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748674/">benefits of CBT seem to last</a>. </p>
<p>And as an aside, it is very difficult to overdose fatally on a bottle of therapy. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Evidence shows cognitive behavioural therapy to be effective in the long term.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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</figure>
<p>I freely admit that the trials I have mentioned are smaller than the major antidepressant trials. But whereas <a href="http://time.com/4900248/antidepressants-depression-more-common/">antidepressants are projected to bring in almost $17 billion a year for the pharmaceutical industry globally by 2020</a>, the jogging and sunlight industries will never have the resources to fund massive international trials. With this in mind, I am convinced that they are at least as worthwhile as the pills. </p>
<p>Physicians have a responsibility to at least talk to their patients about these options before reaching for the prescription pad.</p>
<p><em>Dr. Strauss does not recommend changing one’s medication or course of treatment for depression without consulting a physician. If you are feeling suicidal or are concerned about a friend, family member or work colleague, visit www.suicideprevention.ca to find a crisis centre near you.</em></p><img src="https://counter.theconversation.com/content/106152/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Matt Strauss does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>These four “natural” therapies for depression have rigorous, peer-reviewed scientific studies to support their use.Matt Strauss, Fellow in Global Journalism, University of Toronto and Assistant Clinical Professor, General Internal Medicine, McMaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1027062018-09-05T02:49:20Z2018-09-05T02:49:20ZDementia patients’ thinking ability may get worse in winter and early spring<figure><img src="https://images.theconversation.com/files/234957/original/file-20180905-45169-1713aem.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Thinking ability declines with age in those with dementia.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/tUyYnO_VdP0">Sam Wheeler/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>The seasons may affect the memory and thinking abilities of healthy older adults. A new study suggests changes in cognitive function may be associated with the time of year, declining significantly in winter and early spring. We also see new cases of mild cognitive impairment and dementia in these seasons.</p>
<p>Published today in the journal <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002647#pmed.1002647.ref002">PLOS Medicine</a>, the study suggests fluctuations in memory and thinking performance across seasons are equivalent to an approximate four-year difference in age. That is, the performance of people given memory and thinking tests in the summer and autumn would be equivalent to those about four years younger than when tested in spring and winter.</p>
<p>The authors also found new cases of <a href="https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment">mild cognitive impairment</a> (a transitional diagnosis given prior to a dementia diagnosis) and dementia were 30% more likely in spring and winter relative to summer and autumn. </p>
<p>Dementia is when a person experiences a significant deterioration in memory and thinking abilities (cognitive function), noticed by themselves or a significant other. This goes together with a decline in their ability to perform everyday tasks such as paying bills, keeping on top of work, or even keeping themselves oriented to time and place, as well as mood changes.</p>
<p>These findings suggest there may be a need for more dementia care resources and community awareness during these colder months.</p>
<h2>What the research showed</h2>
<p>A group of researchers from Canada and the United States sought to answer the question of whether the season might influence poorer cognition in healthy adults, as well as those with dementia. Their questioning was based on previous findings in other areas of human biology, such as <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/493246">seasonal affective disorder</a> (depression associated with seasonal changes) and <a href="https://www.cambridge.org/core/journals/psychological-medicine/article/seasonality-of-symptom-onset-in-firstepisode-schizophrenia/BAFC8A432C269852168600809A6A5163">first-episode schizophrenia</a>. These findings suggest an association with time of year. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/seasonal-affective-disorder-why-you-feel-under-the-weather-937">Seasonal Affective Disorder: why you feel under the weather</a>
</strong>
</em>
</p>
<hr>
<p>Researchers have suggested these seasonal peaks in psychosis could be associated with stress and other social factors that may correspond with seasonal trends.</p>
<p>In the current study, the authors investigated data on around 2,700 healthy older adults from Chicago and around 500 dementia patients from Toronto. They found individuals tested in the months of July to October (summer-autumn in the Northern Hemisphere) displayed better performance than those tested in other months. This was true for both healthy adults and those with a dementia diagnosis.</p>
<p>They also found working memory (the ability to hold things in mind for a short time, such as memorising someone’s phone number) and speed of processing (how quickly someone is able to perform a task such as drawing a clock on a piece of paper) were most affected by the season. And the findings did not change if they accounted for the person’s mood, level of physical activity, sleep quality, time of day of testing, or thyroid integrity. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/234964/original/file-20180905-45143-1wizpia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/234964/original/file-20180905-45143-1wizpia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/234964/original/file-20180905-45143-1wizpia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/234964/original/file-20180905-45143-1wizpia.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/234964/original/file-20180905-45143-1wizpia.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/234964/original/file-20180905-45143-1wizpia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/234964/original/file-20180905-45143-1wizpia.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/234964/original/file-20180905-45143-1wizpia.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The study authors argue being less physically active during the colder months wouldn’t make a difference to the findings.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/78hTqvjYMS4">Matthew Bennett/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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</figure>
<p>So, the authors argued this association was unlikely to be driven by outside environmental factors such as lower physical activity in winter months. Other confounding influences cannot be discounted. These include season-related injuries or pain such as arthritis, social isolation, changes in exposure to pollution or unaccounted-for biological factors. </p>
<h2>Biological changes</h2>
<p>Researchers also found changes in the biology of Alzheimer’s disease associated with the season. Alzheimer’s disease is a form of dementia mainly defined by two hallmark pathologies in the brain – a buildup of proteins called amyloid and tau. </p>
<p>In the purest sense, Alzheimer’s disease can only be diagnosed after death. But it is possible to measure levels of amyloid and tau during life using an imaging technique known as positron emission tomography (PET). This technology is still largely confined to research.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-causes-alzheimers-disease-what-we-know-dont-know-and-suspect-75847">What causes Alzheimer’s disease? What we know, don’t know and suspect</a>
</strong>
</em>
</p>
<hr>
<p>Amyloid is known to become abnormal very early in the disease process. Examining spinal fluid extracted from participants, researchers found amyloid protein fluctuations in the cerebrospinal fluid of healthy older adults became more abnormal during winter months.</p>
<p>While the authors could not provide an explanation for this cyclical pattern in amyloid levels in the spinal fluid, they pointed out this aligned closely with memory and thinking patterns seen in the same adults.</p>
<h2>How should we read the findings?</h2>
<p>These findings are interesting and are some of the first in this area. But they need to be interpreted with a degree of scientific caution. </p>
<p>One major drawback is they’re predicated entirely on cross-sectional data. That is, people were not specifically followed during each season across the year to determine changes in their cognition. Researchers analysed data already available. </p>
<p>Further, these studies rely entirely on Northern Hemisphere data. This might not be applicable to the Southern Hemisphere.</p>
<p>These findings are correlational, so it cannot be said a particular season causes cognitive decline – it is merely associated with it. What one can imply from these data is more dementia care resources and community awareness may be needed during these months. </p>
<p>At a population level, these findings suggest a trend towards poorer cognitive performance and greater incidence of dementia cases in spring and winter, which might not simply be a case of “the winter blues”. These findings remind us to be mindful of dementia in our community, and that some may be particularly vulnerable at certain times of the year. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/getting-the-temperature-just-right-helps-people-with-dementia-stay-cool-97374">Getting the temperature just right helps people with dementia stay cool</a>
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</em>
</p>
<hr>
<p>What remains to be done are studies specifically set up to measure cognitive performance in individuals throughout each season to determine if there really is something to feeling a bit mentally sluggish in the winter months.</p>
<hr>
<p><em>We are looking for volunteers to take part in our ongoing study to understand brain health and ageing. If you are interested, and between the ages of 40 and 65, please head to <a href="https://www.healthybrainproject.org.au/">The Healthy Brain Project</a>.</em></p>
<p><em>This article originally stated the research was published in the journal PLOS One. This has been corrected to PLOS Medicine.</em></p><img src="https://counter.theconversation.com/content/102706/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rachel Buckley receives funding from the National Health and Medical Research Council and Australian Research Council with a Dementia Research Fellowship. </span></em></p>Have you noticed your thinking ability drops during winter and spring? A new study of healthy adults and dementia patients found cognitive function declines in the colder months.Rachel Buckley, Research Fellow, Harvard Medical School, Research Fellow, Florey Institute of Neuroscience and Mental HealthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/892102017-12-21T23:35:19Z2017-12-21T23:35:19ZWhat psychiatrists have to say about holiday blues<figure><img src="https://images.theconversation.com/files/200260/original/file-20171220-4995-1m62ykc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Even Santa can get worn out, which can lead to getting the blues.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sad-santa-claus-having-headache-on-758492533?src=cg-yLMqvCXdSdx9uS_V3YA-1-30">Stokkete</a></span></figcaption></figure><p>This time of the year brings a lot of changes to the usual day-to-day life of hundreds of millions of people: The weather is colder, trees are naked, snowy days become plentiful and friendly critters are less visible around the neighborhood. Especially in the Western Hemisphere, this time of the year is also linked to a lot of joyous celebrations and traditions. Most children and many adults have been excited for this time of the year to come for months, and they love the aura of celebrations, with their gatherings, gifts, cookies, emails and cards. </p>
<p>Alas, there are also millions who have to deal with darker emotions as the world literally darkens around them. </p>
<p>The <a href="https://www.psychologytoday.com/blog/evidence-based-living/201712/what-we-know-about-the-holiday-blues">holiday blues</a> – that feeling of being in a lower or more anxious mood amid the significant change in our environment and the multitude of stressors that the holidays can bring – is a phenomenon that is yet to be researched thoroughly. However, as academic psychiatrists and neuroscience researchers, we have seen how several factors contribute to this experience.</p>
<h2>Why feel blue in the red and green season?</h2>
<p>There are many reasons to feel stressed or even downright overwhelmed during this time of year, in addition to the expectations set around us.</p>
<p>Memories of holidays past, either fond or sad, can create a sense of loss this time of year. We may find ourselves missing people who are no longer with us, and carrying on the same traditions without them can be a strong reminder of their absence. </p>
<p>The sense of burden or obligation, both socially or financially, can be significant. We can get caught up in the commercial aspects of gift giving, wanting to find that perfect item for family and friends. Many set their sights on special gifts, and we often can feel stretched thin trying to find a balance between making our loved ones happy and keeping our bank accounts from being in the black. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/200261/original/file-20171220-4980-10f6csf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/200261/original/file-20171220-4980-10f6csf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=316&fit=crop&dpr=1 600w, https://images.theconversation.com/files/200261/original/file-20171220-4980-10f6csf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=316&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/200261/original/file-20171220-4980-10f6csf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=316&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/200261/original/file-20171220-4980-10f6csf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=398&fit=crop&dpr=1 754w, https://images.theconversation.com/files/200261/original/file-20171220-4980-10f6csf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=398&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/200261/original/file-20171220-4980-10f6csf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=398&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Holiday parties, fun though they may be, can also bring conflict.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-multi-ethnical-friends-santa-claus-765732040?src=kdpX-pcz8LPvPLzBg4hnBQ-1-21">My Agency/Shutterstock.com</a></span>
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<p>It’s also a time for gathering with those close to us, which can stir up many emotions, both good and bad. Some may find themselves away from or without close connections and end up isolated and withdrawn, further disconnected from others. On the other hand, many people find themselves feeling overwhelmed by the combination of potlucks and Secret Santas stacking up through multiple invitations, be it at school, work, or from friends and family – leaving us with the difficult position of not wanting to disappoint others, while not getting totally depleted by all the constant socializing.</p>
<h2>Great expectations</h2>
<p>People often feel disappointed when reality does not meet expectations. The larger the mismatch, the worse the negative feelings. One of us (Arash) often finds himself telling his patients: Childhood fairy tales can set an unrealistic bar in our minds about life. I wish we were told more real stories, taking the bad with the good, as we would get hurt less when faced with difficult realities of life, and learn how to especially appreciate our good fortunes.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/200266/original/file-20171220-4965-14ze074.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/200266/original/file-20171220-4965-14ze074.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/200266/original/file-20171220-4965-14ze074.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/200266/original/file-20171220-4965-14ze074.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/200266/original/file-20171220-4965-14ze074.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/200266/original/file-20171220-4965-14ze074.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/200266/original/file-20171220-4965-14ze074.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Fairy tales rarely come true, but people seem to hold out hope that they do.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/beautiful-christmas-fairytale-picture-winter-cabin-749442682?src=1Jf7erubQk-J0Y71z7i0Jg-1-13">Shamilini/www.shutterstock.com</a></span>
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<p>These days viewers are showered with Christmas and New Year’s Eve movies, almost all of which sound and feel like fairy tales. People get married, get rich, fall in love or reconnect with their loved ones. Even unhappy events within “A Christmas Carol” conclude with a happy ending. These all, besides exposure to only happy moments and beautiful gifts (courtesy of Santa), dazzling Christmas decorations, and picturesque family scenes on social media, often set an unrealistic expectation for how this time of the year “should” feel. </p>
<p>Reality is different, though, and at its best is not always as colorful. There may be disagreements about hows, wheres, whats and whos of the celebration, and not all family members, friends and relatives get along well at parties. And as we feel lonelier, we may find ourselves spending more time immersed in TV and social media, leading to more exposure to unrealistic views of the holidays and feeling all the worse about our situation. </p>
<h2>When is blue a red flag?</h2>
<p>While many experience the more transient “holiday blues” this time of year, it is important not to miss more serious conditions like seasonal mood changes, which in its most severe case leads to clinical depression, including <a href="https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml">Seasonal Affective Disorder</a>. SAD consists of episodes of depression or a worsening of existing depression during the late fall and early winter. The person may feel depressed and hopeless, or they may find it difficult to focus, sleep, or be motivated – they can even feel suicidal. As our emotions can color our thoughts and memories, a depressed person may remember more negative memories, have a more negative perception and interpretation of the events, and feel upset about the holidays. </p>
<p>In such cases, the sadness is “coincident” with the holidays and not caused solely by its circumstances. It is important to seek professional help with SAD, as we have effective treatments available, such as medications and <a href="https://www.mayoclinic.org/tests-procedures/light-therapy/about/pac-20384604">light therapy</a>.</p>
<h2>What to do to minimize the blues?</h2>
<ul>
<li><p>Set realistic expectations: One readily available strategy is simply reframing the beliefs we have about what the holidays “should” be like. Not all parties will go perfectly. Some decorations may break, or kids may wake up grumpy or not be exhilarated by their gifts – but it doesn’t have to stop us from enjoying all the good moments.</p></li>
<li><p>Set firm boundaries: Too many invitations to social events? Too many financial demands? Set clear limits about what you are able and willing to do, whether that means declining some social events and setting your own limit on spending this year, focusing more on meaningful experiences over expense. This can be spending time with loved ones or getting creative with homemade gifts.</p></li>
<li><p>Feeling alone? There are many ways to steer clear of isolating this time of year. Reaching out to friends, volunteering at animal shelters, local charities or attending community meetups or religious events can be a great way to stay connected while also bringing happiness to ourselves and others. </p></li>
<li><p>Making new memories: Starting a new tradition, either solo or with loved ones, can help create fond new memories of the holidays, no longer overshadowed by the past. </p></li>
<li><p>Take care of yourself: It’s important to remember the value of self-care, including eating and drinking in moderation (as alcohol can worsen a depressed mood), exercising (even a short walk), and treating yourself this holiday season by doing something you enjoy. </p></li>
</ul>
<p>While the holiday blues are most often temporary, it’s important to identify when things have crossed over into clinical depression, which is more severe and longer lasting. It also impairs daily functioning. For these symptoms it is often helpful and necessary to seek professional help. This can consist of counseling or use of medications, or both, to help treat symptoms.</p><img src="https://counter.theconversation.com/content/89210/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Have you ever felt more like singing the blues during the holidays than “Deck the Halls”? You’re not alone. Two psychiatrists explain why people feel blue during this time and share tips for how to take care.Linda Saab, Assistant Professor of Psychiatry, Wayne State UniversityArash Javanbakht, Assistant Professor of Psychiatry, Wayne State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/538342016-02-09T10:14:24Z2016-02-09T10:14:24ZSeasonal Affective Disorder doesn’t exist – here’s the science<figure><img src="https://images.theconversation.com/files/110641/original/image-20160208-2637-1kpptnx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Cheer up, it'll be dark soon.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/dl2_lim.mhtml?src=1uXn2cWOebLm2MvT8XMX0A-1-9&clicksrc=download_btn_inline&id=68148160&size=huge_jpg&submit_jpg=">Shutterstock</a></span></figcaption></figure><p>A flurry of newspaper headlines have called into question the <a href="http://www.telegraph.co.uk/news/health/news/12113712/Seasonal-Affective-Disorder-is-probably-a-myth-say-psychologists.html">existence of SAD</a>, or <a href="http://www.nhs.uk/conditions/Seasonal-affective-disorder/Pages/Introduction.aspx">Seasonal Affective Disorder</a>. Scientists, they reported, appear to have debunked a widespread conviction, that feeling low in winter time is a genuine illness caused by disturbed levels of brain chemicals and that demands treatment. </p>
<p>A visit to any number of Seasonal Affective Disorder (SAD) websites leads to online questionnaires offering “diagnosis”, treatment recommendations, and advertisements for <a href="http://www.amazon.co.uk/s/?ie=UTF8&keywords=sad+lightboxes&tag=googhydr-21&index=aps&hvadid=87579440600&hvpos=1t1&hvexid=&hvnetw=g&hvrand=16832544698761814989&hvpone=&hvptwo=&hvqmt=b&hvdev=c&ref=pd_sl_oyitwthm8_b">light boxes</a> – gadgets that simulate daylight and compensate for poor exposure to the real thing. SAD is identified as a form of depression caused by disturbances of hormonal rhythms sensitive to daylight, primarily melatonin. Unusually, intense exposure to artificial light often is advocated as a treatment. There is even a <a href="http://www.bodykind.com/product/browse/0/0/0/0/0/0/0/0/12/0/8050_16-Lucimed-Luminette-2-Light-Therapy-Visor-SAD-Light-Glasses.aspx">device</a> that can be worn on the head, allowing the patient to use a light box on the move.</p>
<h2>Where’s the evidence?</h2>
<p>The <a href="http://cpx.sagepub.com/content/early/2016/01/18/2167702615615867.abstract">publication</a> prompting the news story is a large US survey associating the experience of depression with season, latitude and sunlight exposure. Although various models confirm associations between the experience of depression and variables such as age, gender, education, employment and marital status, it found there were no associations between depression and season, latitude, a combination of the two, or sunlight exposure – as derived from knowledge of the respondent’s location and US Naval Observatory records. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/110644/original/image-20160208-31387-ozevcp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/110644/original/image-20160208-31387-ozevcp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=403&fit=crop&dpr=1 600w, https://images.theconversation.com/files/110644/original/image-20160208-31387-ozevcp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=403&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/110644/original/image-20160208-31387-ozevcp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=403&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/110644/original/image-20160208-31387-ozevcp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=506&fit=crop&dpr=1 754w, https://images.theconversation.com/files/110644/original/image-20160208-31387-ozevcp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=506&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/110644/original/image-20160208-31387-ozevcp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=506&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Norway: are they any sadder?</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/dl2_lim.mhtml?src=ofPrVvXCOiUEw4CDUaUAgQ-1-10&clicksrc=download_btn_inline&id=311683259&size=huge_jpg&submit_jpg=">Shutterstock</a></span>
</figcaption>
</figure>
<p>These are high-quality data that have been analysed appropriately. They also confirm similar findings that are equally unable to associate reported mental distress and fluctuations in daylight length, even those of the <a href="http://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-12-225">extreme type</a> found in <a href="http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8264309&fulltextType=RA&fileId=S1121189X00002815">polar regions</a></p>
<h2>The sad truth</h2>
<p>So how might we reconcile the fact that seemingly conclusive research is unable to demonstrate an association between symptoms of depression and sunlight exposure, with the sheer number of people who believe they suffer from SAD?</p>
<p>According to one source, SAD prevalence ranges from <a href="http://www.psy-journal.com/article/0165-1781(90)90116-M/pdf">9.7% in New Hampshire to 1.4% in Florida</a>. In the UK, the estimate is that it affects 2.4% of the <a href="http://bjp.rcpsych.org/content/179/1/31">adult population</a>. These estimates represent a large number of people – and their conviction that they are suffering from a real illness is often a strong one. </p>
<p>Indeed, SAD can even carry the juridical significance of a formal disability. According to the <a href="http://articles.latimes.com/2010/mar/03/nation/la-na-sad-workplace4-2010mar04">Los Angeles Times</a>: “The US 7th Circuit Court of Appeals in Chicago ruled in October [2009] that a teacher could pursue a lawsuit against her former employer alleging that the school district had failed to accommodate her SAD, causing her mental health to deteriorate.” </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/110675/original/image-20160208-2611-mel62u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/110675/original/image-20160208-2611-mel62u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/110675/original/image-20160208-2611-mel62u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/110675/original/image-20160208-2611-mel62u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/110675/original/image-20160208-2611-mel62u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/110675/original/image-20160208-2611-mel62u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/110675/original/image-20160208-2611-mel62u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Can a lack of natural light make you depressed?</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/dl2_lim.mhtml?src=XNjvlfrIP-iZGPDkL0PC_g-1-9&clicksrc=download_btn_inline&id=237215602&size=medium_jpg&submit_jpg=">Shutterstock</a></span>
</figcaption>
</figure>
<p>The teacher in question had been obliged to work in a basement room without windows – and yet research is telling us that there is no measurable association between exposure to daylight and psychological well-being. Once again, in the field of “mental illness”, science and society are not singing in tune. Indeed, perhaps this is where the real conversation lies.</p>
<h2>It’s good to talk</h2>
<p>This story highlights several features of contemporary psychiatry that point to a need for changes in how the conditions it responds to are <a href="http://bjp.rcpsych.org/content/201/6/430">framed, understood and described</a>. Distressing difficulties concerning emotions are nothing new, but construing them as a family of illnesses to be treated by healthcare practitioners is. Reflections on the past half century’s exploration of this approach has to conclude that it is often <a href="http://www.palgrave.com/gb/book/9781137411365#reviews">deeply flawed</a>. </p>
<p>SAD and its treatment with lightboxes is not the only “mental illness” where hard evidence and conventional practice are no longer in tune. Critical review of data accumulated in the course of antidepressant drug trials is beginning to suggest that even these, very widely-prescribed medicines might be associated with more <a href="http://www.bmj.com/content/352/bmj.i217">harm than good</a>. </p>
<p>Suggesting this challenges numerous interests and positions, but the resulting debate is a healthy and invigorating one. There may well be no evidence for such a thing as SAD, but that doesn’t mean we shouldn’t talk about it – especially when the days are short and the skies grey.</p><img src="https://counter.theconversation.com/content/53834/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Hugh Middleton has received funding from the Welcome Trust, NIHR and ESRC. The views expressed in this article are only indirectly derived from that research and none of those organisations are direct beneficiaries.
He is Co-chair of the UK Critical Psychiatry Network. </span></em></p>SAD has entered popular mythology, but that doesn’t make it real.Hugh Middleton, Clinical Associate Professor, Faculty of Social Sciences, University of NottinghamLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/505692015-12-15T10:53:56Z2015-12-15T10:53:56ZFeeling SAD? Talk therapy gets better long-term results than light boxes<figure><img src="https://images.theconversation.com/files/102710/original/image-20151122-420-yt9r2w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Feeling SAD?</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-235862692/stock-photo-lonesome-woman-drinking-cup-of-coffee-by-the-window-of-her-living-room-while-the-snow-is-falling.html?src=cCMFqNFmUwx_RpFIvXRYBg-1-28">Woman holding mug via www.shutterstock.com</a></span></figcaption></figure><p>As the days get shorter and the nights grow longer, sometimes it can seem like we barely get a chance to see the sun. For most people, this can be frustrating; and for others, the slide into winter can actually lead to a subset of depression called seasonal affective disorder, or SAD. </p>
<p>SAD is a form of clinical depression that follows a seasonal pattern. The symptoms are present during the fall and winter months and resolve in the spring and summer. Common SAD symptoms include: depressed mood, loss of interest, fatigue, sleep changes (usually sleeping more), significant appetite changes (usually craving more starches and sweets), difficulty concentrating and sometimes thoughts of death or suicide. </p>
<p>SAD can be tough, but it is treatable. Some people might use daily therapy with a light box, but antidepressants are also used. My lab at the University of Vermont wanted to test another kind of treatment – cognitive-behavioral therapy. We wanted to see if using this talking-based therapy could deliver more lasting results than light therapy does. </p>
<h2>Who gets SAD and how it is different from depression?</h2>
<p>One popular misconception about SAD is that it affects everyone at northern locations, though it’s true that most people at high latitudes experience SAD symptoms to a certain extent. In the United States, the farther north you go, the more cases of SAD you find. SAD prevalence has been estimated to range from <a href="http://www.ncbi.nlm.nih.gov/pubmed/2326393">1% in Florida to 10% in Alaska</a>. While it is more common the farther north you go, only a minority of people living in these places actually have the number and severity of symptoms it takes to count as winter depression. </p>
<p>Everyone can experience some changes in behavior or outlook with the shift of the seasons, and many of these are normal. When it is cold, you might not want to go out as often. When the nights are longer and the days are shorter, your sleep patterns may change. </p>
<p>But SAD is different from these typical changes because the symptoms can make it difficult to function at work or school or in relationships and cause great distress. We can think of seasonal changes as on a continuum, ranging from no symptoms at all to seasonal affective disorder on the extreme end. In northern locations, most people fall in the middle, with mild changes in energy, sleep and food preferences in winter versus summer.</p>
<p>We don’t know why short days can lead to SAD, but several hypotheses have been proposed. For instance, a person’s biological clock may run slow, delaying circadian rhythms. Perhaps longer nights mean a longer period of release for melatonin, the “hormone of darkness” that signals sleep, which leads to a longer “biological night.” Both of these scenarios would lead to a mismatch between sleep and wake cycle and the light-dark cycle.</p>
<h2>Treating SAD</h2>
<p>One popular treatment for SAD is light therapy, which involves daily exposure to a device that produces 10,000 lux of full-spectrum light, minus the harmful ultraviolet rays. The idea is that it mimics sunlight. Light therapy usually takes place first thing in the morning to simulate a summer dawn and jump-start the circadian clock. It is an established, effective SAD treatment. Across studies, <a href="http://www.ncbi.nlm.nih.gov/pubmed/2679625">53% of SAD patients</a> experience complete relief from their symptoms with light therapy. </p>
<p>My laboratory has been conducting clinical trials to test an alternative treatment: cognitive-behavioral talk therapy (CBT). CBT is not a new treatment – it has been used and researched for nonseasonal depression for over 40 years. But, until now, it hasn’t been tested for SAD in clinical trials.</p>
<p>CBT involves recognizing and changing negative thoughts that feed sad moods and engaging in pleasurable activities that counteract depressed moods. In SAD specifically, a lot of these negative thoughts are gloomy thoughts about the winter season, short days and winter weather. </p>
<p>Dwelling on these negative thoughts and going into “hibernation mode” by withdrawing to the couch or bed breeds depression. In CBT for SAD, we try to get people to be proactive by questioning and reframing these negative thoughts and engaging in behaviors that make them approach winter rather than avoiding it, especially through increased social activities and keeping up hobbies and interests in the winter. </p>
<p>The basic idea is to tweak negative, helpless attitudes about winter (“Winter is a dreaded season to endure”) to be more positive and empowering (“I prefer summer to winter, but winter also offers opportunities for enjoyment if I take control of my mood rather than letting the season dictate how I feel”). </p>
<h2>Comparing talk therapy and light therapy</h2>
<p>We just finished a clinical trial at the University of Vermont where 177 adults with SAD were treated with either light therapy or CBT across six weeks in the winter and then followed for two years. </p>
<p>Initially, <a href="http://dx.doi.org/10.1176/appi.ajp.2015.15060773">we found</a> that light therapy and CBT were both effective SAD treatments. Both were associated with large improvements in SAD symptoms during treatment in the winter. However, by two winters later, there was a clear advantage of initial treatment with CBT over light therapy. </p>
<p>People who were treated with CBT had fewer relapses of their SAD: slightly less than one-half of the people in the light therapy group relapsed as compared to slightly more than one-quarter in the CBT group. The people treated with CBT also had less severe winter symptoms overall than those treated with light therapy. </p>
<h2>Why does the CBT seem to have a longer-lasting effect?</h2>
<p>These results suggest that the effect of CBT is more durable in the long run. </p>
<p>It might be that long-term compliance with light therapy – sitting in front of a light box for at least 30 minutes a day, every day during winter – is part of the problem. We found that slightly less than one-third of the people we treated with light therapy reported any light therapy use one or two winters later. This is an issue because light therapy is intended as a daily treatment during the fall and winter months that is continued until spring – with its increase in sunshine – arrives. </p>
<p>Although CBT involves effort to attend sessions, work with a therapist to change winter habits and “homework” to practice skills, it seems to pay off in the long run with better outcomes. It might be that teaching people to reframe their thoughts about winter can help them overcome SAD year after year.</p><img src="https://counter.theconversation.com/content/50569/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kelly Rohan receives funding from the National Institutes of Mental Health. Dr. Rohan receives book royalties from Oxford University Press for the treatment manual for the cognitive-behavioral therapy for SAD intervention.</span></em></p>It might be that teaching people to reframe their thoughts about winter can help them overcome seasonal affective disorder year after year.Kelly Rohan, Professor of Psychology, University of VermontLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/318872014-10-31T09:45:16Z2014-10-31T09:45:16ZExplainer: what is seasonal affective disorder?<figure><img src="https://images.theconversation.com/files/59930/original/g624246w-1411569247.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Don't blame it on the snow.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/bylally/3202410352/in/photolist-5SZc2A-92RkSX-51omyr-quRYx-98n3aW-brD1iD-4ekgYH-iDgcuE-7FY9fd-j74zy3-6zJapm-jhpEen-jbFPK1-iKovjX-kBX4fF-bzxzgr-iQ6UrV-k4Qkui-iUKE8K-jgbwEu-novF9U-4dVJSN-j647Tq-LEXtF-izKD9z-jrNPvb-7zyTR5-kMgVNJ-pah5WA-8ZtWhM-kupTwp-myD994-iBXmgR-49LUib-dT33WD-dpA2Sj-7qe9rC-7qe9tN-7qe9t1-7qe9qQ-j5qqJY-4kzW2Z-3FtbAo-kDg5uS-7qe9r7-5RP9f4-n4L56e-knj1Zr-jvnZUo-5PQXi5">Ilaria Coradazzi</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>It’s that time of year again - the end of daylight savings and the beginning of the dark season. While many of us look forward to seasonal festivities, millions can also expect feelings of depression, fatigue, irritability and poor sleep. This form of mental illness, commonly known as the “winter blues”, is Seasonal Affective Disorder (SAD). </p>
<p>SAD occurs most frequently in populations furthest from the equator. It is estimated that <a href="http://www.ncbi.nlm.nih.gov/pubmed/23286902">1-2% of North Americans</a> have a mood disorder with a seasonal pattern, with 10% of New Englanders versus 2% of Floridians affected. Symptoms include feelings of hopelessness, low concentration, sluggishness, social withdrawal, unhappiness and irritability. </p>
<h2>Circadian rhythms</h2>
<p>Decades of <a href="http://ajp.psychiatryonline.org/data/Journals/AJP/3296/1496.pdf">research</a> has uncovered the culprit behind SAD: lack of sunlight and disruption of <a href="https://theconversation.com/keeping-time-how-our-circadian-rhythms-drive-us-17">circadian rhythms</a>.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/59939/original/3cqjp997-1411572180.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/59939/original/3cqjp997-1411572180.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/59939/original/3cqjp997-1411572180.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/59939/original/3cqjp997-1411572180.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/59939/original/3cqjp997-1411572180.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/59939/original/3cqjp997-1411572180.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/59939/original/3cqjp997-1411572180.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Trapped by our body clocks.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/ell-r-brown/4883327296/in/photolist-8rwk5d-e6hMZZ-5FndwV-64bJzh-edMiC-65K3ss-4Usy1v-5AAH3q-7nfWjC-byFnXb-LX3yJ-8F4Bgf-5y9DrY-e8tZTH-boZDaK-a5TeYw-ekeGGf-8rwjso-6eQAXN-ef5r96-ecvngJ-ebBVZY-eB2wWh-edkhfj-ee1kPr-egUweB-es67WC-85GFKH-egbCom-eQJvSC-bULsP8-eiYjef-ceoFHh-9EyRb7-d7E4Uw-6xJpJ5-3H7SQM-8rtcLr-65wrZL-6ipR7k-6GnPSY-9eEZuh-6CBBV-5R1Amq-9oBBdb-61CAsv-ajC5te-61GMSo-9VYb6N-7HagC6">Elliott Brown</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>A circadian rhythm is a process the body goes through following a 24-hour cycle. Circadian rhythms are entrainable, that is, they can be reset based on an external influence like light. The human sleep cycle is an example of a circadian rhythm and is shifted based on light levels. </p>
<p>This is why we experience jet lag after travelling across time zones. Similarly, seasonal changes can affect circadian rhythms, due to shorter days and loss of daylight in winter months. </p>
<h2>Daylight and your brain</h2>
<p>Although most people are able to adapt to the change in seasonal light levels, what makes some vulnerable to seasonal depression? To understand how sunlight affects mental health, we need to first understand how our brains use sunlight to modulate certain behaviour and hormonal processes.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/59936/original/98q7kybn-1411570502.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/59936/original/98q7kybn-1411570502.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=389&fit=crop&dpr=1 600w, https://images.theconversation.com/files/59936/original/98q7kybn-1411570502.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=389&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/59936/original/98q7kybn-1411570502.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=389&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/59936/original/98q7kybn-1411570502.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=488&fit=crop&dpr=1 754w, https://images.theconversation.com/files/59936/original/98q7kybn-1411570502.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=488&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/59936/original/98q7kybn-1411570502.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=488&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The pineal gland.</span>
</figcaption>
</figure>
<p>In humans, the hormone <a href="http://www.sleepdex.org/melatonin.htm">melatonin</a> is an marker of external darkness. When darkness descends, melatonin is secreted from a structure called the <a href="http://www.britannica.com/EBchecked/topic/460967/pineal-gland">pineal gland</a>, a pine cone-shaped endocrine gland located in the center of the brain. This gland modulates sleep patterns in both circadian and seasonal rhythms. The secretion of melatonin from the gland corresponds to the length of darkness; as the nights get longer, melatonin secretion follows suit.</p>
<p>The timed production of melatonin is controlled by another area in the brain – the <a href="http://www.hhmi.org/biointeractive/human-suprachiasmatic-nucleus">suprachiasmatic nucleus</a> (SCN) of the hypothalamus. The hypothalamus is the primary hormone-producing structure of the brain, controlling body temperature, sleep, circadian rhythm, moods, sex drive, thirst, hunger, and the release of other hormones. The SCN is the “pacemaker” of the brain, consisting of about 20,000 neurons. It maintains an autonomous signal which operates on an approximate 24-hour cycle. Even outside the body, as seen in the laboratory, SCN neurons will continue their <a href="http://www.sciencedirect.com/science/article/pii/S0092867404010542">circadian cycling</a>. The SCN regulate sleep cycles, alertness, hormone levels, digestive activity, body temperature and immune function.</p>
<h2>The eyes have it</h2>
<p>Many studies have cited disruption in the circadian control center as a contributing factor to several mood disorders, including major depressive disorder and bipolar disorder. Even though these illnesses are not necessarily seasonal, both entail loss of consistent sleep/wake cycles as seen in SAD. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/60071/original/5pqqz286-1411660605.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/60071/original/5pqqz286-1411660605.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/60071/original/5pqqz286-1411660605.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/60071/original/5pqqz286-1411660605.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/60071/original/5pqqz286-1411660605.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/60071/original/5pqqz286-1411660605.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/60071/original/5pqqz286-1411660605.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The light therapist is in.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-167924150/stock-photo-woman-light-therapy.html?src=uZOUkufBoSL5PRcCMWtwAA-1-24">Light therapy image via www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>However, unlike depression and bipolar disorder, the major form of therapy for SAD is the use of artificial light, which alleviates symptoms in <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC181212/">50-60% of people</a>. </p>
<p>Light boxes provide relief to many, and come in a few varieties. Typically light boxes are advertised as broad spectrum light sources, which is pure white light. Some light boxes can also give full spectrum light, which has a broader range of wavelengths, including infrared to near ultraviolet light, and everything in between. </p>
<p>Although full spectrum light boxes provide a source closest to that of natural sunlight, they usually come with a screen to protect against UV rays. In this way, it is often preferable to use a broad spectrum light box to avoid UV ray exposure.</p>
<p>The use of light as a treatment indicates that it is not only the SCN implicated in the onset of this disorder, but there may be a contributing cause related to how we process light in the eye. In fact, <a href="http://news.virginia.edu/content/seasonal-affective-disorder-may-be-linked-genetic-mutation-study-suggests">various studies</a> have pointed to mutations in a retinal pigment called <a href="http://www.ncbi.nlm.nih.gov/pubmed/12481140">melanopsin</a> as a source of SAD.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/59938/original/bbnqk792-1411571684.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/59938/original/bbnqk792-1411571684.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=357&fit=crop&dpr=1 600w, https://images.theconversation.com/files/59938/original/bbnqk792-1411571684.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=357&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/59938/original/bbnqk792-1411571684.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=357&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/59938/original/bbnqk792-1411571684.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=448&fit=crop&dpr=1 754w, https://images.theconversation.com/files/59938/original/bbnqk792-1411571684.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=448&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/59938/original/bbnqk792-1411571684.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=448&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">More than meets the eye.</span>
<span class="attribution"><a class="source" href="http://commons.wikimedia.org/wiki/File:Iris_-_right_eye_of_a_girl.jpg">Laitr Keiows</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Melanopsin is a molecule which absorbs light in the eye, and through a chemical change, can translate external light levels into messages for the brain. Unlike rod and cone cells, melanopsin is found in specialized cells of the eye which react slowly to changes in light, and are known to regulate the timing of circadian rhythms. Whereas rods and cones are responsible for the detection of motion, color, images and patterns, studies have shown that melanopsin-containing cells contribute to various unconscious responses of the brain to the presence of light, including circadian rhythms.</p>
<p>Overall, melanopsin can translate messages directly from the eye to the SCN. This in turn influences the production of melatonin. The SCN not only projects to the pineal gland, but has wide-ranging connections to other important areas in the brain. So if there is disruption in melanopsin in the eye, which is passed on to the SCN, the potential exists for many areas to be affected.</p>
<p>Though SAD is not fully understood, genetic research into melanopsin, as well as <a href="http://www.ncbi.nlm.nih.gov/pubmed/10715354?dopt=Abstract&holding=npg">hypothalamic genes</a> associated with serotonin production, holds promise. </p>
<p>In the meantime, the use of antidepressants, therapy, and artificial light may help SAD sufferers through the upcoming dark months. And with holidays approaching, spending time with family, friends and good food is something we can all benefit from.</p><img src="https://counter.theconversation.com/content/31887/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>I have no conflicts of interest to disclose.</span></em></p>It’s that time of year again - the end of daylight savings and the beginning of the dark season. While many of us look forward to seasonal festivities, millions can also expect feelings of depression…Caitlin Millett, PhD graduate student in Neural and Behavioral Science, Penn StateLicensed as Creative Commons – attribution, no derivatives.