Cover Story: Time of the Season

Seasonal Affective Disorder can be one of winter's cruelest gifts

Nov 29, 2006 at 2:06 pm

Here in the Midwest, it doesn't take fancy meteorological terms to describe the winter climate. "Sucks" sums it up neatly for most people.

We awake to gray mornings and abhor the bald trees, the dank dark, the clinging chill. We curse the drizzle, even to an illogical extent: "Snow I could handle. At least it's dry!"

But what do we do when our love/hate relationship with the season loses all passion and hope? When fantasies of crawling back into bed until May cease to make us feel any better?

The "winter blues" take many forms, often characterized by a gloomy disposition, an increased need for sleep and difficulty tackling normal daily tasks. But Seasonal Affective Disorder (SAD) can be much more severe and potentially damaging.

According to the Cleveland Clinic (, 4-6 percent of Ohio's population suffers from SAD, which "usually starts in fall or winter and ends in spring or early summer."

Little is known about the connection between SAD and other mental conditions that have been categorized as hereditary or gender-based and though studies show that women are most susceptible, children and men with SAD are growing in numbers.

"I've never been a morning person," says Ed Gollar, an engineer and Mount Adams resident who's sought relief from SAD symptoms dating back to his teenage years. "I realized (early on) that getting out of bed when it was dark outside was especially difficult, particularly in winter. It was only sometime in the last 10 or 15 years that I realized there was a disorder called SAD describing those symptoms."

Gollar points out that although SAD symptoms can occur year round — there's even a form of the disorder refered to as "Summer SAD" — winter is by far the least bearable season for patients.

"I've tried taking medication to help reset my sleep cycle, with very little success," he says. "I think that (antidepressants) have a limited success rate but are certainly worth trying."

Differentiating a "normal" funk from the symptomatic manifestations of SAD can be a daunting task, but according to Walter Smitson, professor of psychiatry at the University of Cincinnati, making that distinction is crucial in managing emotional health.

"There's a big difference (between the two forms of depression)," Smitson says. "SAD is much more problematic, and you see things like people who are unable to get out of bed (and have) more absenteeism and less productivity at work. It can ruin their relationships and careers. There are different steps for those people to follow."

For some sufferers, there are available treatment options for SAD that don't warrant a professional diagnosis or require prescription medication, but each has advantages and drawbacks. Some cases even call for mood-stabilizing drugs like Paxil and Prozac.

Smitson says that most SAD symptoms can be relieved with sun exposure and exercise and that medication is considered a last resort within the medical community.

Though the exact causes of SAD are unknown, two popular theories guide trends in diagnosis and treatment. The first approach points to decreased exposure to sunlight as the culprit.

A lack of sufficient sun is said to alter one's circadian cycle and upset sleep schedules, hormone production and mood regulation. Depression has been linked to both high levels of melatonin (a hormone produced during sleep) and lack of exercise.

Smitson says people should resist the urge to sleep through the precious few hours of sun available in the winter.

"If you're diagnosed with SAD, your treatment may be as simple as sitting under a light box for a few minutes each day," he says. "Sufferers should take every opportunity to walk in the winter sunlight."

The other medically noteworthy approach to explaining SAD suggests that the brain's natural chemicals that control emotional balance are fundamentally disproportionate in people with SAD. The aforementioned light therapy, which boosts these levels and is thought to correct both types of imbalances, is commonly recommended.

Light therapy is administered using a white fluorescent lamp — equipped with a screen to protect the user from potentially harmful ultraviolet rays — emitting a recommended intensity of at least 10,000 Lux (the international unit of illumination). The Sunbox Company ( provides an online database with information about SAD and contact information for national light box manufacturers and distributors.

Research shows a low occurrence of mild side effects resulting from light therapy. As is the case with most medical treatment, though, it's the exorbitant cost of the equipment that thwarts patients.

These special devices range in price from $150 to $400 per lamp and, as many testimonials acknowledge, don't always produce sufficient results to justify the purchase. Health insurance policies that include coverage for mental illness can help offset the cost, but widespread stigma that categorize mental health treatment as indulgence rather than necessity ensure that inclusive insurance plans remain the exception rather than the rule.

"I believe businesses or insurance companies have a responsibility to help treat anyone with a mental problem," Gollar says. "But insurance coverage for mental disorders is very poor, which is at least partially due to the fact that mental problems you can't always see from the outside aren't considered on the same plane as (visible) physical problems. It's funny, but no one thinks less of you as a person if you catch a cold or get cancer."

Sheila Sims, Community Resource Director for the Mental Health Association of Southwest Ohio, says there are no support groups specifically for Seasonal Affective Disorder in the Tristate.

"I would recommend (to someone seeking help) that they first see a professional to find out more about their condition and needs," Sims says.

Regardless of the diagnosis, she says that attending a general depression support group can often alleviate feelings of depression no matter what the source. She recommends that anyone interested in starting a local SAD support group contact the Mental Health Association at 513-721-2910. ©