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SAD in the South? It's true, southerners can experience winter depression

January 21, 2018 34 Comments

[by Tamara Sellman RPSGT CCSH for Advanced Cardiovascular Sleep Disorders Center]

Since Alabama isn't considered a Northern state, then it seems unlikely that people that live here would succumb to a mood disorder related to seasonal light.

However, as the map above suggests, almost all of the United States falls inside the northern latitudes most affected by seasonal affective disorder, or SAD.

What is SAD?

This mood disorder occurs as the result of changes in seasonal natural light. While most people imagine it's only the Americans in Alaska or Maine who are likely to suffer from SAD, the fact is that anyone in any of the states can experience dips in mood during the fall and winter months. 

SAD is considered a cross between a mood disorder and a sleep disorder, as well. This is due to the fact that people with lower moods during the darker seasons tend to have problems with their sleep. They either sleep too much and feel unrefreshed, or their sleep cycles are disrupted by these changes in light so that they sleep at the wrong times for their personal rhythms and struggle, as a result, with insomnia and circadian disruptions such as advanced sleep phase disorder, in which they go to sleep far earlier than normal. 

SAD is frequently linked with "winter blues," but the two are considered different problems. While both have a seasonal connection, SAD tends to start well before the holidays and linger all the way into spring, whereas "winter blues" tends to occur as the result of stressors linked to the holidays, illness, or other mental health concerns. 

Researchers tend to think of SAD as more of a disruption of one's "biological clock." This relates to circadian rhythms, which depend upon light cues during the day and night to help keep our sleep-wake patterns in balance.

The loss of sunlight (even just an hour's worth) during the winter has also been shown to reduce one's levels of serotonin. This brain chemical that affects mood is influenced by levels of melatonin also generated by the brain, which are charge of regulating sleep-wake cycles. 

How to know if you have SAD

The most common symptoms of SAD include: 

  • Unexplained anxiety
  • Dips in mood ("the blues")
  • Lack of energy during the day, or feeling tired all the time
  • The urge to oversleep
  • Unexplained sleeplessness or insomnia
  • Increased appetite, especially for high carbohydrate foods
  • Voluntary social isolation
  • Grumpy, irritable behavior
  • Less interest in activities you normally enjoy
  • Weight gain
  • Problems with focus and concentration
  • Loss of libido

Most people with SAD start to experience symptoms as early as September, and they can continue into late May, depending upon the climate and latitude. 

If you think you have SAD, you're not alone. Some researchers estimate that between five and 10 million Americans suffer every year. More women than men suffer from SAD, and it typically begins in young adults between the ages of 20 and 30. More than half of those diagnosed with SAD have family members who also suffer.

Can we blame SAD on this year's frigid winter weather?

No, SAD has an effect on people because of limitations to available natural light. Cold weather can still bring bright sunshine between storms. In fact, cloud cover with incoming and warmer rain is just as likely to steal light and leave us in a lower mood as a "bomb cyclone." 

However, cold and snowy weather can have an impact on our sleep health. 

Heart problems

Cold weather raises the risk for heart attack because the heart must work harder to regulate your body temperature, and this leads to a higher pulse rate and higher blood pressure. When the heart works harder, this can result in the release of stress hormones in the body, which can make it very difficult to fall asleep.

Comfort concerns

While it's healthy to sleep in a cooler room at night, a downright cold room will force your body to shiver to generate warmth. Layer on the blankets rather than turn up the heat (see Dry air, below).

Dry air

When we turn up the heat during the winter, it tends to reduce the relative humidity in our homes and workplaces. Meanwhile, outside, the air may be equally dry as well as cold. This dry air generally depletes the moisture in the body. You'll feel it in your eyes, your skin, and your mucous membranes.

Without additional moist air provided through a humidifier, or through added liquids like water to prevent dehydration, you'll find you become more congested at night, making it hard to sleep. This is due to dried out sinus and nasal passages. Itchy skin can make sleeping uncomfortable as well, and your eyes may be crusty, swollen, or irritated even after sleeping. 

How to defend against SAD

Here are some ways you can head off a case of seasonal depression.


Pleasing aromas and fragrances can definitely improve your mood. Lavender, orange, rosemary, cinnamon, and vanilla are good choices for aromatherapy.

Light therapy 

You can start by simply opening up your blinds or curtains when the sun comes out to let the sunlight in.

The use of phototherapy lamps, light boxes, goggles, and visors has helped many in the Northern climates tackle winter blues during their extremely long, dark winters. Aim for a 10,000-lux light therapy product, using it between 10 and 20 minutes every morning.

Another option could be one of the new dawn simulator lamps that are programmed to gradually release synthesized "morning light" from your nightstand and can help if you struggle to get out of bed in the morning. 

Listen to uplifting music

Music can go a long way to motivate, energize, and bring pleasure on dark days. Pick bright, happy tunes and songs that remind you of spring or summer.

Play some music, if you know how. Even singing can elevate mood.

Eat like it's summer

Pick light, bright foods that transport you to summertime. Berries, raw crunchy vegetables, and lots of citrus and herbs can improve your sense of well being and defend against cravings for unhealthy sweets and starches.

Get a massage

Even a half-hour of gentle massage helps to improve circulation, loosen muscles that are tired or stiff (arthritis happens!), and leave you smiling.

A regular massage can do wonders for your sleep as well if done in the evening. Besides leading to relaxation overall, it can help prevent problems with restless legs or racing thoughts at bedtime.

Take vitamin D 

Our bodies need sunlight to manufacture vitamin D; without it, we can become deficient. How are your vitamin D levels? Ask your doctor to check them, and consider taking a supplement. Vitamin D, in adequate levels, can help not only to improve mood, but it allows the body to absorb more calcium and phosphate, which are good for muscles, teeth, and bones.

Exercise in the morning

One of the best ways to reset your circadian rhythms is through physical exercise in the morning... ideally in natural light. Even if you have to stay indoors, the endorphins the body produces during exercise are excellent for fighting off mood dips and can help keep your circadian rhythms in balance.

Visit your doctor 

If you just can't shake your seasonal depression, talk to your doctor about medications and non-pharmaceutical therapies that can help lift you out of your funk.

Just because you're a Southerner doesn't mean you can't be SAD

While this mood/sleep disorder is more common up North, it can't be ruled out immediately for those of us in Alabama. Because it's less uncommon, it may be easier to overlook it as the root cause of one's symptoms of depression and problem sleep. Therein lies the challenge: SAD is treatable, but only if you recognize it and seek to confirm a diagnosis.

Don't shortchange yourself the opportunity to overcome mood and sleep problems that are related to circadian disruption. There's no reason to suffer through the dark seasons, no matter where you live. 

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