Opinion

Here come the clouds again | Dr. Pepe

Dr. Harry Pepe is a physician practicing with PartnerMD, a Bothell medical practice specializing in concierge-style primary care and executive physicals. - Contributed photo
Dr. Harry Pepe is a physician practicing with PartnerMD, a Bothell medical practice specializing in concierge-style primary care and executive physicals.
— image credit: Contributed photo

While the clouds, rain and shorter days of fall and winter in the Northwest bring welcome relief from the summer heat, they can also bring an unwelcome visitor to otherwise healthy folks: the “winter blues.”

Seasonal Affective Disorder (SAD) is due, in part, to the shorter daylight hours of October through March. Interestingly, there is also a much less common springtime version. SAD is marked by depressive symptoms that arise in the fall and winter, including anxiety, decreased energy, hopelessness/depression, decreased interest in normal activities, such as hobbies, irritability, oversleeping, appetite changes, especially a craving for high-carbohydrate foods, weight gain, difficulty concentrating and processing information and social withdrawal.

SAD can be difficult to diagnose for two key reasons. First, it's normal for everyone to have up-and-down days, so patients may not recognize there is concern. It's important to recognize if you feel depressed for days or are not able to eat or pursue normal activities. Secondly, other types of depression or mental health conditions have similar symptoms.

Physicians will often evaluate patients, in conjunction with a physical exam, to check for underlying issues that could be linked to depression and conduct medical tests to rule out underlying conditions.

Criteria that could suggest SAD include: experiencing symptoms during the same months for at least two consecutive years, a period of depression followed by periods without depression, and/or a lack of underlying medical causes or other explanations.

Treatment and prevention of SAD can be achieved through several low-cost, readily available options, including light therapy, vitamin supplements, or prescription or over-the-counter medications.

Reduced sunlight during the winter months can be supplemented with light therapy, which uses a specialized light as a substitute for sunlight. The added exposure can cause a change in brain chemicals that are linked to mood. Light therapy is easy, affordable, seems to have few side effects, and may be as effective as prescription antidepressant medication. Getting outside on bright days is a good, and free, way to see if added sunlight elevates your mood.

Sunlight also provides us with vitamin D. Low levels of vitamin D are frequently found in patients with depression. While there is no good evidence that vitamin D supplementation reverses depression, taking a supplement to raise low vitamin D levels before the onset of the late fall/winter season may help alleviate or prevent SAD.

If symptoms are severe, patients can also be prescribed antidepressants. Some doctors suggest starting the antidepressant regimen before symptoms appear and to continue taking the medicine beyond the time that symptoms typically go away.

The “winter blues” are more than an extended case of the “Mondays.” SAD is a valid medical concern. If you think you could be suffering from the disorder, visit a doctor or mental health provider to see if they think an evaluation is in order.

 

Dr. Harry Pepe is a physician practicing with PartnerMD, a Bothell medical practice specializing in concierge-style primary care and executive physicals. Pepe has broad experience in family and urgent care, and his special interests include disease prevention and building relationships with patients who take an active role in managing their overall health. He is a cycling and hiking enthusiast and resides in Kenmore. To learn more, call 425-780-4800 or email bothellinfo@partnermd.com.

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