“It’s all about the dark,” said Barbara Goodman. “It gets dark so early and you wake up when it’s dark.”
Goodman not only has Seasonal Affective Disorder, she also treats it as the owner and director of Goodman’s Behavioral Health, a part of Encompass Health and Wellness in Reedsburg.
“Back when I first had it, I just knew I hated winter,” she said. “Does everybody hate winter like this?”
SAD is a subject people don’t really know about, she said.
“Seasonal Affective Disorder is essentially the experience of depression symptoms that are brought on by shorter days and are more common in the winter months,” said Jack Nitschke, clinical psychologist at the Wisconsin Psychiatric Institute and Clinic and associate professor of psychiatry and psychology at the University of Wisconsin Madison.
He said oftentimes, people with SAD will do just fine throughout the spring and summer, but in wintertime, especially in northern latitudes like Wisconsin, they’ll be experiencing more symptoms of depression.
These symptoms can include a sad or depressed mood, a loss of interest, not getting pleasure out of things that are usually enjoyable, sleeping all the time or having trouble sleeping, overeating or losing appetite, having a lower self-esteem or experiencing trouble concentrating, he said.
When clients who are suffering from this condition come into Goodman’s office, she said many are pretty much paralyzed. They say they’re not getting up or going to work on time.
SAD can affect any age group, but typically starts when a person is between ages 18 and 30, according to the American Psychiatric Association.
When students come into the office of Karen Evenson, the mental health counselor at the University of Wisconsin Baraboo/Sauk County, she said she often asks them if they’ve noticed a seasonal component to their mood swings or mood changes as part of her assessment.
“Because of our culture and our lives, we often have to keep going and keep busy, and can’t indulge some of those natural changes that come along with seasonal change,” she said.
She said students showing signs of SAD might be having a hard time concentrating on studying, not getting work done, procrastinating, sleeping a lot, trying to get relief by using substances or not wanting to be with friends.
She said using a light box, which mimics sunlight, can be beneficial for SAD sufferers.
“That’s something they can use in the early morning hours like when the sun would usually rise in the summer,” she said.
She said this exposure stimulates the pineal gland, which produces melatonin that helps maintain circadian rhythm. When we’re deprived of light, serotonin and melatonin start to deplete, she said.
The light boxes come in different sizes and styles. She said getting a prescription for a box can help defray the cost, but is not needed to obtain one. The boxes can be purchased at places like Walmart and Walgreens.
She said she collaborates with students to figure out what they can do to reduce stress, whether that’s cutting down on work hours, tweaking their schedules or adjusting their priorities.
Increasing their awareness of what could make things easier and make them feel better are the kinds of things she works with them on, she said.
She said she has the easy job as the therapist and clients have the harder job.
People get to decide for themselves if they’ll implement the plan, she said.
“They have to apply these things to their lives and basically have self discipline to make the changes,” she said.
Older population risks
It’s difficult in the winter months for the elderly population to get out and get around, so you see a decline in their mood and energy levels, said Sara Goldbeck, director of social services at Wisconsin Dells Health Services.
If it’s a quieter time of the year with less family visits, Scott Arneson, executive director at Wisconsin Dells Health Services, said they want to step it up for their residents to make sure they have social interactions, which bring more excitement to their lives.
“Whether it’s an outing to Walmart or bingo, any kind of activity or entertainment, just like in our lives at home, can affect how you feel about the day and where you’re at,” he said.
The facility puts on activities for residents seven days a week like karaoke, live music, exercise groups, trivia, movie outings and shopping trips, Goldbeck said. They also celebrate birthdays at monthly parties throughout the year.
“This is their home, so you make it home for them,” she said.
The youngest risk
When children shows irritability or aggression, depression issues are not normally the first thing that jumps to someone’s mind.
“Often times, kids aren’t well-versed in why they’re behaving the way they do,” Evenson said.
Children don’t always have the management skills to control, prevent or disable irritability and aggression,said Monica Bork, a pre-kindergarten to eighth-grade school counselor at New Lisbon School.
She said irritableness and depression peak in winter.
“Is that because we’ve been in school so many months or is it due to SAD?” she questioned. “I think that for some students, it is SAD.”
Students who start the school year off really motivated, sometimes lose their direction midyear, she said. If they end the year strong, it signifies that it could be SAD or something like it that had them down in the winter.
If she thinks a student needs additional support, she contacts parents to refer students to see their family healthcare provider or a counselor since she isn’t allowed to make diagnoses as a school counselor.
In her office, she utilizes solution-focused counseling with students that are exhibiting signs of SAD. One exercise is having students create strength shields. They put their strengths and the good things in their lives down on paper in an effort to get them to see beyond the dark hole they’re falling into, she said.
“It gets them to connect to something else that’s out around them, so they don’t feel so alone,” she said.
Since talking doesn’t always work with children, she said she tries to make it more tangible and concrete for them.
For younger ages, she uses play therapy. She has a basket of toys in her office and a basketball hoop.
“They’ll talk better if they’re doing something,” she said.
Going outside for even just 15 minutes, which exposes students to the natural light, is a treat at this time of the year, she said. When students are cooped up two or three days in a row due to high wind chill, she said she thinks it has a negative effect on them.
For SAD sufferers like Goodman, when March hits, the end is in sight, she said.
“We’re on the right time of the year for things to be improving,” Evenson said.
People who are suffering from SAD are probably starting to feel a little bit better as days get longer and temperatures rise again, she said. That tends to diminish some of their symptoms.
“Everything that I do, I still can feel that SAD underneath,” Goodman said. “But if you already have a plan in place, you can move forward. You can feel it, but it’s not paralyzing you.”
The best solution
“The very best anti-depressant out there is exercise,” Nitschke said.
When people exercise, endorphins are released, which are chemicals in the body that make people feel good, he said. Keeping people going with exercise routines through the winter and making sure they’re getting as much activity in the winter as the summer can hold off symptoms of depression that might be associated with SAD.
“The idea in the winter months is not to come home at five o’clock, sit on the couch and watch television all evening,” he said. It’s to get up, get involved and do things, which he said is called behavioral activation.
Both Goodman and Nitschke emphasized the importance of making plans for the winter before it hits.
In September, Nitschke talks to patients with SAD about which activities they can maintain in the winter and which ones they need to find replacements for.
“If you have somebody who does a lot of biking in the summer, it’s about finding other forms of exercise or biking they can do in the winter like spinning class,” he said.
“You have to figure out your own cocktail (for success),” Goodman said. “What’s my plan here, what am I going to do – and be committed to it.”
Some patients’ routines include starting a prescribed anti-depressant in September and going off of it in spring, both Nitschke and Goodman said.
“By the time winter hits, their medication is already stabilized,” Goodman said. She said she also believes in the benefits of D3 vitamins, massage therapy, cranial sacral therapy, oils and reiki.
“It is all about total care of your body,” she said.
While it’s important to make transitions while still feeling good, you have to keep doing it all along and develop a routine, so it just seems normal, she said.
This year, Goodman started skiing again, which she said has greatly improved her mood.
“When I was younger, I skied all the time,” she said. “That’s probably why it wasn’t as bad back then.”