[originally published in the Del Ray Sun, Nov. 1-7, 2006]
The Dark is Rising . . .
by Laura Brand-Ballard, LCSW
Ugh. It’s that time of year again. It’s starting to be dark in the morning when it’s time to get up, and every day is a little worse. Sure, the end of Daylight Savings Time will help – for a while – but then it will feel like bedtime even before dinner. There’s a reason that old memory trick works: the clock “springs forward” in the spring, and “falls back” in the fall. It works because you always want to “fall back” in bed, this time of the year. In college, we all knew that no matter how sleep-deprived we might get near midterms in the spring semester, we definitely needed that extra hour a lot more in the fall.
Happily, there are plenty of things to look forward to in the fall, too – Halloween, and Jack-o’-lanterns, and candles in the windows, and the flaming color of the leaves turning, and that brisk nip in the air that makes you want to kick your heels up and breathe in the scent of bonfires. Homecoming, and trick-or-treating, and eventually, the excitement of snow and midwinter celebrations: Christmas, Hanukkah, Kwanzaa, Winter Solstice. But there’s no getting around it – most of us viscerally feel the loss of the sun, as the Earth rotates us around to its cooler side.
Now, anyone who owns furry pets can tell you that it’s a natural mammalian tendency to want to snuggle up together and sleep when it’s dark. My dogs, who are up at the crack of dawn - 6 a.m. in the summer, well before I’m up - nowadays peer at me at 7 a.m. from their curled-up cozy spots and then close their eyes to ignore me until the sun comes up, whenever that might be. I’ve even heard a theory of evolutionary biology that mammals are biologically wired to sleep when it’s dark because if we weren’t, we’re so stupid we would wander around getting eaten at night, when the predators are out. (Can’t you just imagine it? “Hey, Ug, c’mon, wake up! Let’s go for a walk in the moonlight. I know, let’s check out where we saw that saber-toothed tiger sleeping the other day!” Not a branch of humanity likely to live long.)
Sometimes, though, that sense of wanting a little more sleep is a warning sign of something a lot bigger than our natural desire to sleep when it’s dark. Sometimes it’s just the first step into SAD, or “seasonal affective disorder,” a mental illness afflicting millions of Americans (though, I would guess, a larger percentage who live in the Dakotas, Minnesota, and Maine than those in Florida and Texas).
Though many talk about SAD as its own illness, the diagnostic manual published by the American Psychiatric Association (DSM-IV-TR) classifies this as an aspect of the larger category of depression. “Affective” means having to do with mood and emotions. So the proper clinical name for SAD is “Major Depressive Disorder, Recurrent, With Seasonal Pattern.” This classification is important, because it helps separate out a serious disorder from mere discomfort and from other serious disorders. If you’re wondering if you may have SAD (that is just so much easier to type and say than “MDDRWSP”!), ask yourself:
1. Does this happen every year (or most years)? It isn’t SAD unless it happens over and over again. You may still be suffering from a major depressive episode, but the season isn’t causing it unless you’ve had it before, or unless you’ve just moved a lot farther north than you’ve ever lived before. It doesn’t count, though, if something bad happens every winter, for example, if you’re a farm worker who is laid off every winter or if severe asthma keeps you inside for months when it’s cold.
2. Has it lasted every winter and gotten better every year in the spring? If you’re okay by Christmas or fine by Valentine’s, it’s not SAD. Likewise, if it isn’t getting better in the spring, it may be Major Depressive Disorder with only a coincidental or mild seasonal influence.
3. Do you find your eating and/or sleeping habits change markedly between winter and summer? If you are sleeping 18 hours a night in the winter and 6 hours per night in the summer, that’s a bad SAD sign. Actually, insomnia in the winter may also be a sign of SAD. Likewise, either eating more than usual or having little or no appetite can both be signs of depression and thus of SAD.
4. Do you notice five or more of the following symptoms every winter? Depressed mood; lack of interest or pleasure in most of your usual activities; a general slowing down or its opposite, agitation, of your body movements, enough to be noticeable by others; fatigue or low energy; feelings of guilt or low worth; indecisiveness or difficulty making decisions; or recurrent thoughts of death, which may or may not include thoughts of suicide.
If you’ve answered yes to these four questions, you may have Major Depressive Disorder, Recurrent, with Seasonal Pattern. This is actually good news! I mean, it isn’t good that you suffer this illness, but it is good news that you have a name for it, because the point of diagnosis is to make treatment possible. You absolutely do not have to suffer SAD every year.
The first thing you should do is make an appointment with your family doctor to tell him or her about the problem. Sometimes it creeps up on us as slowly as sunrise creeps later and later. Don’t wait, for goodness’ sake! You’ve had this before. Catch it right now! Quit fooling yourself that this year will be different unless YOU make it different! And in that case, this year will certainly be very different. It will be the first (happy) winter of the rest of your life!
So, see your doctor, and I also strongly recommend that you see a mental health therapist. Your doctor is likely to consider starting a mild antidepressant, and that will probably help a lot. They can take a while to become effective, though, and in any event, research is clear that the combination of medication and talk therapy is more effective – especially in the case of recurrent illnesses – than either alone.
What are you waiting for? Put down the paper! Call your doctor’s office! Ask for a recommendation for a therapist! Make both appointments! Now is no time to let your indecisiveness – part of the illness, remember – slow you down or stall you out!
And between now and the appointment, there are several things you can do to help yourself. First and most important – get all the sun you can. Sure, there’s less of it these days, but that just means that when you look out the window and see it peeking from behind the clouds, you need to go outside to enjoy it right that minute! Take a walk on your lunch hour. Take coffee breaks that are 5-minute walks and don’t involve increasing your caffeine intake (which will just mess up your sleep cycle more in the long run).
Yes, it is also true that you can go on the Internet and locate special lamps with full-spectrum lights. They usually cost around $200, though some therapist offices will rent them to try for a week before you invest, and you also may be able to make your own for more like $60 if you can find full-spectrum light bulbs at your local hardware do-it-yourself store. (Don’t get the sometimes less-expensive “natural daylight” craft lamps; they don’t have the same light power or “lumens.”) Sitting in front of one of these for a half-hour a day will also help. Don’t do this instead of the walk, though – the exercise also changes your body chemistry in very positive ways, even if we’re talking a walk to the end of your driveway and back and even if you end up huffing and puffing. Paying attention to what you eat and keeping it pretty well-balanced helps, too. Nothing makes you feel less like a brisk walk than way too much starch, which of course is what we tend to crave as it gets dark. To quote R.J. the Raccoon from the recent movie “Over the Hedge,” talking about “. . . doughnuts – you wanna talk about storing up fat for the winter, that is the way to do it!”
Getting outside also helps keep you in touch with the rhythms of nature, which although they are going the wrong direction at the moment, always swing back around to spring and summer. Make the most of what sunlight there is, no matter how bundled up you need to get.
Depression, with or without a seasonal component, tends to make us huddle at home alone in the dark. Even if we want to go out, sometimes it just seems like way too much effort, and where the heck would we go? (There’s that indecision again. It’s one of the main supports of the illness.) Plan for this. Agree with friends, spouses, co-workers, or anyone to go do something midday on the weekends. (Get some sun!) Accept invitations that you might have accepted midsummer. Pay attention to your energy level. Staying in tends to sap your energy; going out at least a little tends to build energy. Keep track, so you know when you are underdoing or overdoing.
If you have a really severe case – and I do mean severe! I don’t say this lightly – you might consider the ultimate treatment: the geographical cure. I lived for three years in Western Wisconsin, which some might argue was never meant for human habitation. Settlers over the past couple of hundred years have tended to be from Norway, Sweden, Finland, Iceland – you get the idea. They knew what they were getting into. But I also met one stray who lived in the American Southwest before marrying a Wisconsin native and following her home, and when he told me, “I just can’t face another Wisconsin winter,” I thought it was a good time to talk about what a move would mean for the family.
Happily, Virginia is in a temperate climate. You might get a little relief from heading farther south – Disney World is indeed balmy and warm in February – but most of us make it just fine with the occasional midwinter vacation to someplace warm. If that’s all it takes, then enjoy your winter, and keep a kind place in your heart (and an occasional invitation for coffee) for those of your friends, family, and/or neighbors who may otherwise disappear until spring.
- Laura