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Coping with the ‘winter blues’ when you have MS

By Samantha Domingo and Amy MB Sullivan

The winter season can mean relief for some people with MS who are highly affected by heat in the warmer months; for others, it can mean facing the dreaded ‘winter blues.’ As the days get shorter, people may find themselves feeling sad – usually these feelings resolve as the seasons change. However, for others these feelings can turn into seasonal depression, also referred to as Seasonal Affective Disorder.

SAD is a mood condition in which individuals experience a change or increase in depressive symptoms during a specific season, though it is mostly predominant during the winter time when the days are shorter because of decreased daylight. Because of this, SAD is more common in the Northern Hemisphere of the United States. It is estimated that between 4-6 percent of people in the United States suffer from SAD; however, another 14 percent suffer from a lesser form of seasonal mood changes. Though it is not a defined as a specific disorder in the Diagnostic and Statistical Manual of Mental Disorders V by the American Psychiatric Association, it is described as a classifier for major depression.

People who experience SAD may notice an increase in irritability or depressed mood. They may also notice increased fatigue and daytime sleepiness. In addition, they may find themselves craving more carbohydrate-dense foods. Some of the symptoms – regardless of season – can overlap with some symptoms of MS.

Other symptoms of SAD include:
  • Sadness (subjective report of depressed mood most of the day, tearfulness)
  • Anger, irritability, worry and discouragement
  • Interest (diminished interest in pleasurable activities)
  • Energy (fatigue or loss of energy)
  • Concentration (diminished ability to concentrate or indecisiveness)
  • Withdrawal from social activities
  • A “leaden” sensation in the limbs
Although the etiology of SAD is not entirely understood, it is thought that the decrease in daylight, often experienced in northern latitudes during the winter months, may have an effect on a person’s circadian rhythm – also known as our internal clock – which can lead to feelings of depression and changes in sleep patterns. In addition, reduced sunlight can have an effect on the production of serotonin, a neurotransmitter that has a role in mood. Lastly, changes in daylight can affect the production and regulation of melatonin, another neurotransmitter that helps regulate sleep patterns and can have an impact on mood.

The good news is that SAD, like many other forms of depression, is a highly treatable condition. If you think you or someone you know may be experiencing SAD symptoms, it is important to contact a healthcare professional for proper evaluation and treatment. Additionally, you may want to try the following to help improve symptoms:
  • Exercise – remaining active can help improve mood, fatigue, and sleep. Even if you are unable to go outside, practicing yoga, stretching, and some walking in the house can help.
  • Eat a balanced and healthy diet – you may be tempted to load up on starchy comfort foods, but make sure you are eating an appropriate amount of nutrients and food rich in vitamins and minerals. Foods like strawberries and almonds have been linked to improvements in SAD symptoms.
  • Exposure to light – opening up blinds and curtains and sitting for some time each day can be highly beneficial. If you are able, spend some time outside in natural light.
  • Light therapy – research shows that about 60-80 percent of individuals with SAD experience symptom improvement with light therapy. Light therapy consists of exposure to artificial light in the form of a light therapy box. Most people need between 30 and 90 minutes (10,000lux) of light therapy per day.
  • Avoid alcohol use – this can affect your mood and disrupt your sleep patterns.
  • Stay connected with your social circle – even if you can’t leave the house due to the weather, you can call a friend, of have others come visit you if they are able.
  • If you have thoughts of suicide, call the toll-free National Suicide Prevention Lifeline at 800-273-TALK (273-8255)
Other treatments for SAD may involve, Cognitive-Behavioral therapy, and in some cases, medications to help with mood. These treatments have been shown in research to be effective in treating SAD. It is important to act early and seek professional help when needed. As with many other medical conditions, prevention is vital.