Depression with a Seasonal Pattern (formerly known as Seasonal Affective Disorder or SAD) is a form of depression that presents at certain times of year and accounts for roughly 10% of all depression cases. The weather and change in seasons can have an emotional and/or physical impact on everyone, but when symptoms start to interfere significantly with mood and daily functioning, it may be worth it to investigate further.

For most people with a Seasonal Pattern of Depression, the onset begins in the fall and tends to get progressively worse throughout winter as the days become shorter and there is less daylight. There is also a small portion of the population who experience decreased mood in the Spring and Summer months. Researchers have found that individuals in more northern cities are more likely to experience seasonal depression than those who live closer to the equator.

What Are Some of the Symptoms?

Many individuals with a seasonal form of depression will describe feeling tired all the time and may crave carbohydrates or report weight gain. Appetite disturbance is also a common symptom, with cravings for starchy or sugary foods. Sleep disturbance in the form of over-sleeping is also reported frequently, along with feelings of hopelessness or guilt. Along with decreased mood, it may also be difficult for individuals to enjoy or engage in daily activities.

What Should I do? Tips for Managing Seasonal Depression

• If you think that you may be experiencing a seasonal form of depression, it may be helpful to talk to your doctor first, in order to rule out any other medical issues or associated conditions. (For example, thyroid problems can often present as symptoms of depression).
  
• Try to spend some time outdoors each day in natural light and try to maximize sun exposure when indoors. (For example, keep curtains open, move furniture close to windows, move your desk close to the window or into the sunlight; trim branches or hedges that may block light from getting in to the house).
  
• Aim to increase physical activity or weight training into your weekly schedule to assist in the increase of healthy chemicals in your brain, along with decreased stress and increased energy. Finding a way to exercise outside a few times a week is also ideal.
  
• Try to incorporate healthy servings of fruit, vegetables, and lean protein into your diet to mitigate the carbohydrate and sugar cravings (that can also deplete energy). Eggs are also high in natural 5-HTP (which works in the brain and central nervous system to increase the production of serotonin (a chemical often associated with symptoms of depression and anxiety).
  
• Purchase a full spectrum light (otherwise known as light therapy, light box therapy, or phototherapy). Sixty to eighty percent of people with seasonal depression report significant improvement with light therapy for up to thirty minutes per day. Full spectrum light bulbs will also create a brighter light in the home during the winter and can be purchased at most hardware stores.
  
• Clinical Counsellors can also assist in the assessment and treatment of all forms of depression. In particular, cognitive behaviour therapy (CBT) can assist individuals in acquiring tools for coping with negative and unhelpful thoughts and actions that often accompany depression.
  

Medications may also be a helpful adjunct for many individuals in treating many forms of depression. Talk to your doctor to find out if medications may be suitable for you.

Herbal remedies may also be helpful but it is important to remember that even herbal remedies or vitamins may also have side effects (especially in combination with other medications). So it is always important to consult with your doctor, naturopath or health care provider when taking any form of medication or herbal remedy.

This article is by Tamara Dalrymple, M.A., PsyD (Candidate), a Registered Clinical Counsellor & Mental Health Specialist.

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Click Here to Read: INVISIBLE WOUNDS - WAYS TO RETRAIN TRAUMATIZED BRAINS

By: Anna Mehler Paperny

Sleep plays a vital role in healthy brain function and emotional well-being. Good quality sleep can also serve as a protective factor towards healthy minds, physiological health, quality of life and even safety. Recent studies have determined that sleep is intricately linked with many aspects of mental health including quality of social relationships, prevalence of depression, and risk taking behavior. 

 Symptoms of psychological distress among men and women in the general population have been associated with ongoing sleep deprivation of less than six hours per night. High stress occupations or alternating shift work are commonly associated with sleep problems. Sleep disorders are connected to a myriad of systemic conditions including hypertension, chronic pain, headaches, obesity, stroke, and diabetes. Poor sleep quality is also associated with increased accidents and poor occupational or academic performance.

Sleep also plays a critical role in the growth and development of children and adolescents. Insufficient sleep duration and poor quality sleep can have a direct impact on the psychological and physical health of youth. In adolescents, unhealthy sleep practices have been correlated with poor academic performance, low levels of emotional well-being, and symptoms of depression. Excessive electronic media use at night has also been identified as a risk factor for both sleep disturbance and depression in adolescents.

During the sleep cycle, our bodies work to support healthy brain function and maintain physical health. While we sleep, the brain prepares for the next day and forms new pathways to help us learn and retain information. Studies have shown that sleep deficiency alters activity in some parts of the brain that assist in decision making, problem solving, emotional regulation and coping. 

 Getting enough sleep at the right time helps us function well throughout the day. Deep sleep triggers the body to release hormones that assist in boosting muscle mass, repairing tissue, and forming new cells. Our immune systems rely on sleep to stay healthy and defend against infection.

Amazingly, some people may not realize that they are sleep deficient as they become used to a decreased level of functioning which begins to feel normal. The amount of sleep we need each day will change over the course of our lives.  According to the U.S. National Institute of Health, the following guide is generally recommended:

• Preschool-aged children:   11–12 hours a day
  
• School-aged children:        10-11 hours a day
  
• Adolescents:                         9–10 hours a day
  
• Adults & Elderly:                  7–8 hours a day

Tips for Getting a Good Night Sleep

• Incorporate regular exercise into your weekly schedule (at least 3-4 times per week) but not within a few hours of bed time.
  
• Minimize the use of electronic media at least one to two hours before bed time.
  
• Minimize exposure to bright light one hour before bed time. Regularly expose yourself to natural morning light or very bright (full spectrum) artificial light during morning hours to help regulate circadian rhythms.
  
• Try not to work or do homework in bed so that it does not become a conditioned stimulus for work, anxiety, lying awake, etc.
  
• Use Progressive Relaxation Techniques before bed time to activate the parasympathetic nervous system and induce muscle relaxation. Calm breathing can also be helpful.
  
• Work at defining a wind-down routine that eliminates highly stimulating activity before bed time (Dim the lights, listen to relaxing sounds, have an Epsom salt bath, relax your muscles)
• Evaluate your bedroom and sleep space to establish the conditions you need for sleep. Consider black-out shades, eye shades, “white-noise” machines or humidifiers. Your room should not be too hot and your pillow and mattress should be comfortable.
  
• If you have trouble sleeping, avoid napping, particularly in the afternoon.
  
• Monitor what you eat and drink. Try to avoid cigarettes or caffeine in the evening. Alcohol can also disrupt sleep. Eating big or spicy meals close to bed time can also cause discomfort that can affect sleep.
  
• If you can’t sleep, go in to another room and do something relaxing  (avoiding electronics) until you feel tired.
  

If you have difficulty sleeping on a daily basis it may be helpful to talk to a doctor and also record your sleep pattern in a sleep diary to keep track of strategies and progress.

Article by: Tamara Dalrymple, M.A., PsyD (Candidate).  Registered Clinical Counsellor & Mental Health Specialist, Victoria, B.C.

Web Resources:

Here to Help, Getting a Good Night Sleep http://www.heretohelp.bc.ca/wellness-module/wellness-module-6-getting-a-good-nights-sleep

Tips for Sleep Hygiene ,Anxiety BC www.anxietybc.com/sites/default/files/SleepHygiene.pdf

U.S. Department of Health and Human Services https://www.nhlbi.nih.gov/health/health-topics/topics/sdd/why

The National Sleep Foundation. https://sleepfoundation.org/

References:

• Cunningham, T. J., Wheaton, A. G., & Giles, W. H. (2015). The association between psychological distress and self-reported sleep duration in a population-based sample of women and men. Sleep Disorders.
  
• Lemola, S., Perkinson-gloor, N., Brand, S., Dewald-kaufmann, J., & Grob, A. (2015). Adolescents' electronic media use at night, sleep disturbance, and depressive symptoms in the smartphone age. Journal of Youth and Adolescence, 44(2), 405-418.
  
• Lin, W., & Yi, C. (2015). Unhealthy sleep practices, conduct problems, and daytime functioning during adolescence. Journal of Youth and Adolescence, 44(2), 431-446.
  
• Kent, R. G., Uchino, B. N., Cribbet, M. R., Bowen, K., & Smith, T. W. (2015). Social relationships and sleep quality. Annals of Behavioral Medicine, 49(6), 912-917.
  
• Lauderdale, D. S., Chen, J., Kurina, L. M., Waite, L. J., & Thisted, R. A. (2016). Sleep duration and health among older adults: Associations vary by how sleep is measured. Journal of Epidemiology and Community Health, 70(4), 361.
  
• Melo, M. C. A., M.S., Medeiros, F. d. C., PhD., de Bruin, V.,Meireles Sales, Santana, J. A. P., M.D., Lima, A. B., M.D., & Daher, E. D. F., PhD. (2016). Sleep quality among psychiatry residents. Canadian Journal of Psychiatry, 61(1), 44-49.
  
• Moore, M. (2012). Looking for a good night's sleep. The Lancet, 380(9839), 322-3.
  
• Puterbaugh, D. T. (2011). Searching for a good night's sleep: What mental health counselors can do about the epidemic of poor sleep. Journal of Mental Health Counseling, 33(4), 312-326.
  
• Segura-jiménez, V., Carbonell-baeza, A., Keating, X. D., Ruiz, J. R., & Castro-piñero, J. (2015). Association of sleep patterns with psychological positive health and health complaints in children and adolescents. Quality of Life Research, 24(4), 885-895.
  
• Winsler, A., Deutsch, A., Vorona, R. D., Payne, P. A., & Szklo-coxe, M. (2015). Sleepless in fairfax: The difference one more hour of sleep can make for teen hopelessness, suicidal ideation, and substance use. Journal of Youth and Adolescence, 44(2), 362-378.

During an episode of depression, most people tend to reduce or discontinue activities or social connections that usually contribute to keeping their mood healthy and balanced.  Physiologically, the frontal lobe of the brain is also not activated in the way that it normally would be and as a result, individuals often become more vulnerable to unhelpful thinking patterns or self-defeating thoughts.

A depressed mood can lead to inactivity but inactivity also contributes to depression.  Add in a vulnerability to increased negative thought patterns and this can create a vicious cycle and in many cases, a downward spiral.  Setting goals to increase activity level is a powerful first step in managing depression.

The key is to start generating some sort of activity patterns again, even if motivation is low.  In the early stages of recovery, it is common to not "feel like" doing much or receive much enjoyment from engaging in activity.  Eventually, as individuals continue to increase activity level and learn tools to manage unhelpful thought patterns, the ability to enjoy activities returns gradually, often along with some form of motivation.  

In the early stages of resuming activity, it is important to set small goals and upon achieving them, acknowledge these successes.  In the depressive mindset it is common to minimize achievements or expect much more in terms of accomplishment, often resulting in feelings of failure.  But completing small activity goals is a very important first step in the recovery process.  Giving oneself permission to set manageable goals is also an important part of this.  Manageable goals are defined differently depending on the individual.  For some people, a manageable goal may entail opening one piece of mail, a five minute walk, or phoning one friend.

In terms of re-activating a healthy lifestyle, setting small goals related to exercise, self care, social involvement and day-to-day tasks is a powerful part of the process.  And it takes time....

Article by: Tamara Dalrymple, M.A., PsyD (Candidate). Registered Clinical Counsellor & Mental Health Specialist, Victoria, B.C.

Resources:

• Patterson, Randy. The Changeways Clinic Core Program: Practical Strategies for Personal Change.
  
• Provincial Health Services Authority. Self Care Depression Program.