Winter Blues Girls

Tired, grumpy, always hungry? Why grey-skies syndrome may be to blame...

Winter blues sufferers can still function, but they find it harder to wake up and get going in the mornings, even though normally they have slept longer than usual

'I just wanted to sleep all the time,' said Felicity Newman
'By December, I was feeling really down and some mornings I couldn't get out of bed. Then I started to miss deadlines at work,' said Felicity

Felicity Newman started feeling increasingly gloomy last October as the long dark evenings began to draw in.

The project manager commutes to London from Hove in East Sussex —  it’s dark when she gets up and dark  when she returns, so she rarely sees  the daylight.

‘I just wanted to sleep all the time,’ recalls Felicity, 25.

‘I’d be tucked up in bed by nine every night and still be napping on the train to and from work.’

She also began to feel constantly hungry, craving sweet things and stodgy carbohydrates such as potatoes and bread.

‘I could demolish half a packet of biscuits in no time,’ she adds.

‘I was always snacking, even after a big meal, and I started to pile on the weight — well over one-and-a-half stone in six weeks.

'Everything felt like too much effort. I didn’t even have the energy to call or text my friends. Food and sleep were the only two things I was interested in.

‘By December, I was feeling really down and some mornings I couldn’t get out of bed.

'Then I started to miss deadlines at work. I just couldn’t concentrate.’

Felicity had the classic signs of the winter blues, or SAD lite.

A milder form of Seasonal Affective Disorder (SAD), the winter blues is triggered by grey skies and characterised by sleepiness, low energy levels, a craving for carbohydrates, weight gain and reduced sex drive.

Unlike SAD, which can have a completely debilitating effect, winter blues sufferers can still function, but they find it harder to wake up and get going in the mornings, even though normally they have slept longer than usual.

They may also feel anxious or tearful, irritable and generally ‘down’.

Because they won’t feel fully awake, they can suffer from concentration problems at work, too, says Chris Thompson, former professor of psychiatry at Southampton University Medical School and now medical director of The Priory Group.

The winter blues affects around 17 per cent of  the population, but thanks to a grey summer and an extra gloomy winter, experts believe the numbers this year will be higher.

 ‘It’s been an absolutely appalling winter for winter blues and SAD, the worst in a long time,’ says Professor Thompson.

‘Our consultants report that lots of people who wouldn’t normally be affected by the weather are feeling it this year.

‘I’ve even got a mild form of the winter blues myself this year — I’m finding it difficult to wake up in the mornings and keep snacking on biscuits and cheese in the afternoons.’

Not only are more people affected by winter blues, but this year more may have full SAD, adds Professor Anne Farmer, honorary consultant psychiatrist at South London and the Maudsley NHS Trust.

‘It has been a tough old winter and it’s gone on so long.

'Many people with depression normally see their symptoms start to lift at this time of year, but my experience is that many of them are still struggling with a depressive phase now,’ she explains.

SAD is triggered by insufficient light reaching the hypothalamus, an area of the brain which regulates the production of melatonin.

This hormone controls the body clock and appetite, and also affects the production of serotonin, a ‘feel-good’ brain chemical that controls mood.

The problem is that this winter and last summer were greyer than usual.

There were just 37.3 hours of sunshine in January this year compared with 58.3 last year, according to the Met Office (the usual January average is 44.7 hours).

February wasn’t much better, with just 56.7 hours of sunshine compared with 62.6 in 2012 and the usual average of 65.4.

While sunshine normally increases dramatically in March — the average is 101.7 hours — there were only 45.9 hours of sunshine up until the 17th.

This follows last year’s bad summer, the least sunny for 25 years.

Some people may be more prone to the winter blues or SAD. A recent study from the University of Virginia suggested a genetic mutation in the eye may make sufferers less sensitive to light.

The study, which involved 220 people with SAD and 130 with no mental illness, found the SAD patients had lower levels of a receptor that helps regulate alertness and the 24-hour body clock.

The risk with winter blues is that it can develop into SAD.

‘These sufferers are at the more extreme end of the spectrum of winter blues and their depression is more severe,’ says Professor Thompson.

‘They are more likely to need medical treatment.’

Under guidelines from  the National Institute for Clinical Excellence (NICE), SAD should be treated like depression — with psychological therapies and antidepressants known as selective serotonin reuptake inhibitors (SSRIs), thought to boost serotonin levels.

Light therapy with a SAD lamp is also beneficial, says Professor Thompson, who is also president of the International Society for Seasonal Affective Disorder.

The lamps simulate summer light conditions so melatonin levels are reset to the amount produced in the summer.

A bright, sunny day provides around 100,000 LUX (the measure of brightness) — typical indoor domestic lighting only has 200-500 LUX, so most people use SAD lamps with 10,000 LUX.

The advice is to use the lamps daily for varying periods, depending on light intensity in autumn and winter, but also in summer if there is no sun.

However, you have to buy or hire lamps privately as NICE says there isn’t enough evidence to support long-term use.

When it comes to winter blues, symptoms usually aren’t severe enough to warrant medical treatment unless they are making other health problems worse, says Professor Farmer.

‘The danger is that if you go to your GP with winter blues, you may be prescribed antidepressants because it’s the easiest and quickest thing they can do to help you.

‘But actually, for mild depression you might be better off having psychological therapies, including cognitive behavioural therapy (CBT).

'Even this late in the season, CBT is worth considering because if you have a recurring problem it will give you a tool kit and strategies for dealing with it next time.

‘Getting outdoors for at least an hour a day is also good for winter blues — preferably at midday when the sun is brightest, but any time spent outdoors is better than none.

'Try to get out in your lunch hour; it may seem like a small thing, but it will make a difference.

'Exercise helps too. The herbal remedy St John’s Wort has also been shown to be effective in treating mild to moderate depression.

'However,  it does interact with a number of prescription drugs including the contraceptive pill, HRT and warfarin, so check with your doctor if you are already taking medication.’

Professor Farmer warns that different brands have different strengths, ‘so stick to the same one so you get a consistent dose to keep your symptoms under control’.

St John’s Wort also cannot be taken at the same time as light box therapy because there is a risk of photosensitivity.

Not everyone is convinced that the winter blues exist. Swedish-born psychiatrist Dr Lars Davidsson, medical director of the Anglo European Clinic in London, says some symptoms are just part of winter.

‘I don’t necessarily feel it’s a medical illness to feel a bit down about the winter. It’s just part of life and you have to get on with it.

‘Obviously if the symptoms start to have a severe impact on your life, you may have full-blown SAD, and that is quite different.’

When Felicity’s work started to suffer, she decided it was time to take action and in December she started taking St John’s Wort.

‘I began to cheer up after a few weeks and came out of hibernation mode,’ she says.

‘I now find it easier to get up in the mornings.

‘I still have carb cravings, but I’m controlling my eating habits.

'I’m also getting out more in daylight hours by walking from the station to work and getting out at lunchtime.

‘I put my symptoms purely down to the bad weather — and like most people I’m hoping spring is just around the corner.’

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