How scientists are shining light on the biology behind seasonal affective disorder | Mental health

Fat least the darkening days of autumn bring something more than the annual ritual of resurrecting wool sweaters and cranking up the central heating. The evenings draw near and the mornings become gloomy, the energy wanes and a heavy sadness sets in.

Although seasonal affective disorder (SAD) was only officially recognized by psychiatrists in the 1980s, the connection between the seasons, mood and vitality has been observed for a long time.

The Yellow Emperor's Classic of Medicine is a Chinese text dating back to around 300 BC. – describes how the seasons affect all living things. It advised in winter to “go to bed early and get up with the sunrise,” keeping “desires and mental activity in peace and restraint, as if keeping a happy secret.”

Today, scientists are rediscovering how closely our biology is tied to the seasons. According to Dr Katie Weiss, Provost's Research Fellow at the University of Edinburgh, the biggest development over the past decade “has been the realization that seasonal changes in human mood are probably endogenous – that they are part of our physiology.”

Large scale resources such as UK Biobank transformed this field of research, allowing scientists to track seasonal patterns among hundreds of thousands of people over many years—something that was previously impossible.

However, where to draw the line between normal winter lethargy and clinical depression is not easy. Sadness is considered a subtype of major depression or bipolar disorder, defined by a predictable seasonal pattern: symptoms typically begin in the fall or winter and resolve in the spring. In addition to the typical signs of depression, people often sleep longer, feel sluggish, and want to eat more, especially carbohydrates.

The reasons for these changes are still being studied, but they are almost certainly related to decreased daylight. Light is a key regulator of our internal body or circadian clock, influencing the timing of hormone release, alertness and mood. Without enough daylight – especially when combined with too much artificial light in the evenings – these rhythms can become out of sync with the outside world.

The Amish in the United States, who spend more time outdoors and less time exposed to artificial light at night, have one of the lowest rates of sadness among the Caucasian population. Photograph: Evelyn Hockstein/Reuters

Some people may be more sensitive to this shift than others. Weiss and her colleagues are studying seasonal effects in bipolar disorderwhere manic episodes often peak in the spring and depression is more common in the darker months. “We suspect that people with bipolar disorder may be very sensitive to light and seasonal cues, and this triggers their symptoms,” Wise said.

Even among those who don't have clinical depression, many people experience a more mild seasonal mood swing known as subsyndromal sadness or the “winter blues.” In the UK, around one in five people suffer from the condition, although only around 2% suffer from full SAD.

However, seasonal biology goes far beyond mood. Researchers have found fluctuations in expression more than 4000 protein-coding genes in white blood cells and fat, as well as changes in the cellular composition of the blood itself throughout the year.

Weiss and her colleagues recently analyzed four years of UK Biobank sleep data from half a million people. “We found that in winter people tended to sleep longer and suffer from insomnia – their sleep was not as good as in summer,” said Wise, who will present the findings at the British Sleep Society conference in Brighton next week.

As natural as these seasonal changes may be, society still expects people to carry on as usual. Few of us can hibernate, no matter how tempting it may sound. The most effective antidote to the winter slump is light. Bright light therapy remains the gold standard treatment for SAD, although timing and dosage are critical (see below). For those who cannot perform daily sessions in front of a light box, natural sunlight is a powerful substitute.

“Early morning light is particularly effective at resetting the circadian clock.” Photograph: Rebecca Cole/The Guardian.

Studies of Amish communities in the United States, which spend more time outdoors and less time exposed to bright artificial light at night, show some of the lowest SBP rates reported among Caucasian populations. In contrast, the prevalence in New York City is about 4.7%.

Exposure to bright natural light early in the day helps synchronize the circadian clock and suppress the production of melatonin, a nighttime hormone that can make you sleepy. Light also has a direct warning effect: one study found that an hour of blue light increased reaction time more than the equivalent of two cups of coffee.

But light is not everything. Cognitive behavioral therapy adapted for patients with sadness may be as effective as light therapyhelping people rethink their relationship with winter rather than just managing symptoms.

Winter will come anyway. By changing our attitude, we can bring back some joy from the dark months.

How to beat the winter blues

  • Look for the morning sun: Even on gray days, get outside as early as possible. Daylight resets your circadian clock, increases alertness, and suppresses melatonin production. The early morning light is especially bright.

  • Try a light box: Light levels are measured in lux. A typical Sad lamp emits about 10,000 lux of light—20 to 40 times brighter than typical office lighting and roughly equivalent to outdoor light on a cloudy summer day. Sit in front of it for 20-30 minutes immediately after waking up.

  • Check your sleep pattern: Maintain regular bedtimes and waketimes, avoid screens late at night, and keep evening lighting warm and dim. This will help prevent your internal rhythms from shifting.

  • Go outside correctly: Even on a cloudy day In January, the light outside is about 10 times brighter than indoors. Try to devote at least an hour a day to this, ideally combining it with something pleasant: a walk, a cup of coffee in the park or relaxing with friends.

  • Plan your winter fun: Reframe thoughts such as “I hate winter” to “winter is harder, but I can plan for it.” Adopt cozy rituals such as candles, hot chocolate or warm baths, and plan social or outdoor activities such as cold water dips or winter hikes.

  • Know when to ask for help: If problems with mood, sleep, or motivation persist for several weeks or are interfering with daily life, see a therapist or mental health professional. Sadness is treatable.

    UK charity Intelligence available on 0300 123 3393 and Children's line on 0800 1111. In the US call or text. Mental Health of America by calling 988 or chatting at 988lifeline.org. In Australia, support is available at Beyond Blue by phone 1300 22 4636, Life line 13 11 14 and in Male line by phone 1300 789 978

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