Living in a winter bummerland

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1:17Jonquilyn Hill:Yep, it's that time of year. Here in D.C., it's dark, the snow on the ground is dirty, and this cold weather will not let up. It feels so... I feel like I get more irritable and generally feel like there's a gray cloud weighing on me. I tend to spend a lot more time alone and lose interest in being social and going out with friends. I don't mind the cold, actually. It's just, it's the darkness and the dampness that are really tough to deal with. When it gets dark at like 4 p.m., like, you don't really want to then, like, go to the gym. The winter and the weather is telling you, like, it's time to go to bed now because you have to get up early and soak up all of the daylight hours that you can.

2:08Jonquilyn Hill:A lot of us feel this way. A poll from the American Psychiatric Association found that nearly half of Americans say their mood takes a dip in the winter. And 5 % experience a really acute version of this, seasonal affective disorder. It was a little difficult at first to differentiate because I have clinical depression and generalized anxiety disorder. So my moods were a little bit low just compared to the next person. I've noticed more than other times of the year a real lack of motivation to do things, even indoor things, but that made me really notice a difference and look into whether or not I was being affected by seasonal affective disorder.

2:57Jonquilyn Hill:I'm John Blanhill, and this week on Explain It To Me from Vox, why winter makes us sad and what we can do about it. To start, I called up Kelly Rowan at the University of Vermont. It was negative six degrees when I woke up this morning. And we have snow from the monster storm that has not melted. We got probably 18 inches that's still on the ground. Kelly studies the winter blues and when it crosses the line to seasonal affective disorder. So seasonal affective disorder is on a continuum where most people at a high latitude are going to have some symptoms. It's just a question of how many and how bad, how interfering are the symptoms.

3:38Seasonal affective disorder is the extreme end where it's clinical depression in certain seasons. Folks who have the winter blues have some of the symptoms, but not a clinical depression tied to the seasons. And then there's the rest of us at a high latitude that have a few symptoms, like maybe we're a little bit more fatigued. Our appetite changes with a preference towards carbohydrate-rich foods. We're moving a little bit slower, maybe socializing a little bit less, but not having significant symptoms that interfere with our life. So the reason most of us can confer around the water cooler at work and talk about seasonal affective disorder is something we can relate to.

4:21People have some symptoms. It's just a question of how many and how bad.

4:26Jonquilyn Hill:What's happening in our brains when the days get shorter? So when the days are shorter, specifically when the sun is rising later in the winter months, our circadian clock is affected by that, by the long nights that we have in the wintertime. Late lies the wintry sun abed, a frosty, fiery, sleepy head. Blinks but an hour or two and then a blood red orange sets again. The circadian clock is the part of our brain that regulates our daily rhythms and things like alertness and our sleep rhythms. So that when we have a longer night, the circadian clock gets kind of out of sync with the light-dark cycle and can make us feel kind of sloggy, especially in the morning when the alarm is going off and it's hard to get out of bed.

5:23Before the stars have left the skies, at morning in the dark I rise, and shivering in my nakedness, by the cold candle bathe and dress. Robert Louis Stevenson, Wintertime. It's because the brain is saying, wait a minute, it's still dark out. It's still time to be asleep. What is this? You want me to get up and get going now? It's a bit confused, this time of year. temperature does play a smaller contribution people who have seasonal depression feel more depressed on cold days but really what's carrying the day overall is day length is the strongest thing in the environment that predicts when the symptoms begin in any given year and how bad they

6:10Jonquilyn Hill:are on any particular day do we know why some people have seasonal affective disorder and some people don't. I mean, is there a reason why some people's bodies are just so much more sensitive to this change than others? Women seem to be more affected than men, and this is true of depression in general. There's a two-to-one gender difference in depression, two depressed women for every depressed man. That seems to be the case in seasonal depression as well. Living at a high latitude, where on the winter solstice, the days are even shorter. Like here where I live, Burlington, Vermont, on the winter solstice, we have just over eight hours of daylight to work with.

6:53So people living here at my latitude are more likely to be affected than folks who are living in southern Florida, for example. Having a family history of depression, not necessarily seasonal depression, but depression runs in families. We don't know exactly what is inherited, but there is assumed to be some genetic component that confers increased risk for depression.

7:18Jonquilyn Hill:Is there a particular point in winter when these feelings hit? Like, the days are getting longer, but I am feeling like, uh, can winter please be over? Please, please, please, now. Yeah, the research on that shows that for people that really have seasonal affective disorder, the clinical depression in the winter months, that January and February are the months that are the worst in terms of the depression symptoms at their peak. Now, they start much earlier than that, very commonly around the time change when we move our clocks back in the fall is a big trigger for a lot of people that begins the cascade of the symptoms, but they tend to be at their peak January, February.

8:03Even though you're right, the winter solstice happens on December 21st, a lot of people are able to make it through December because of the holidays are somewhat invigorating for people, all the social activities, feeling like they can kind of make it through then. But then after the new year, what's left? We've got a good three months of winter left to deal with. That's where it really tends to hit folks.

8:32One of the distinctions between seasonal affective disorder and the winter blues, or maybe just a few mild symptoms, is the duration. Generally, the symptoms begin in the fall, and they persist through January, February, and into March, maybe even April. So again, on average, the episodes last for five months of the year, every year, rinse and repeat, do it again year after year. So it's a lot of time to be struggling with serious symptoms of depression.

9:11Jonquilyn Hill:Five months really is a long time to struggle. But there are things you can do to help bring back the sun. That's up next.

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12:06Jonquilyn Hill:We're back with Explain It To Me. I'm J.Q. and I'm talking with Dr. Kelly Rowan, a professor of psychological science at the University of Vermont. And she says that while we can't change the seasons, there are things we can do. There are three treatments for seasonal depression that are effective. They include light therapy, antidepressant medications, and cognitive behavioral talk therapy. Let's start with light therapy. What is that? How does that work? What does it do? Light therapy is timed daily exposure to bright artificial light. Most commonly, we're using 10 ,000 lux of full spectrum or cool white fluorescent light.

12:53Lux is a measure of light intensity. 10 ,000 lux is the same intensity that comes from the sky at sunrise on a bright, clear day. And we do light therapy first thing in the morning upon waking to try to simulate an early dawn and hopefully jumpstart that sluggish circadian clock back into a more normal phase, functioning more like it is in the summertime for the individual. We do light therapy under supervision. I always say even though you can walk into Costco and walk out with a happy light, doesn't mean that you should. That light therapy is a medical device. It can have some side effects, usually mild things like eye strain, headaches, feeling a little bit wired up.

13:42However, it can have some more serious side effects. things like an increase in thoughts about suicide, the possibility of a dangerously elevated mood state called mania or hypomania. So these are among the reasons why it's important to do light therapy, at least when getting started under the supervision of a mental health provider who can watch out for those side effects, help you address them, and also get the dose just right. Because light therapy is not a one size fits all. There's no generic prescription.

14:20Jonquilyn Hill:You mentioned how antidepressant medications can help just like when you're treating depression year round. There's also cognitive behavioral talk therapy, which you've actually adapted specifically for seasonal affective disorder. Tell me about that. If we break down the term cognitive behavioral therapy. We have cognitive, so we focus on thought patterns in CBT. We actually have people write them down, record their thoughts when they're feeling sad, and then they bring those data into session. And we ask a lot of questions like, what's the evidence for that thought? Is there any other way to see it?

14:58To try to gently reframe some of those negative thoughts so that they're not wreaking as much havoc on mood. And in seasonal affective disorder, we see a lot of negative thoughts like, I hate winter. Winter is awful. I can't function at all during the winter months. And we can work on those kinds of thoughts using CBT as well. And then of course there's the B, the behavior and cognitive behavioral therapy. In winter depression, we see a lot of kind of passive behavior, people ruminating a lot, spending a lot of time on the couch, passively watching television. So instead of doing that, which we know only feeds the depression, we try to get people to identify things that they can do in the winter that will bring a sense of joy and doing some of those things instead of going into what I call hibernation mode.

15:55Seeing people is a big part of the behavioral side of CBT, getting people engaged with their social networks so that they're seeing people and their social activities look more like they do in the summertime than going into this passive hibernation-like state that we know only makes the depression worse.

16:16Jonquilyn Hill:Okay, so another thing I hear about is the benefits of vitamin D supplements, especially if you live in a place that's less than sunny. A listener called us about that. I've lived in Oregon now, transplanted from California for about eight years. And even still, I continue to take my vitamin D. I went to the doctor a couple of weeks ago and got blood work and they said, yep, your vitamin D is low. Make sure to continue to take that. Is that something that can help everyone? It would be wonderful if it were that easy. Here's the problem with the vitamin D explanation. If we drew an imaginary line across the United States from Boston on the East Coast all the way to Northern California on the West Coast, everyone above that line probably is vitamin D deficient in the wintertime.

17:09The reason we don't think that vitamin D is causally related to seasonal affective disorder is because everybody north of Boston should have seasonal affective disorder in the wintertime if it were really about a vitamin D deficiency. So my advice would be if it's something you're concerned about, get tested and use the supplementation if your doctor recommends that. But I would not expect seasonal affective disorder to be fully reversed by that.

17:40Jonquilyn Hill:Is there anything people can do, like in, say, September or October to get ahead of all of this? Like, what can we do throughout the year to prepare our bodies for this time? Yeah, I think for anybody who struggles with the winter, whether it's somebody with seasonal affective disorder or somebody with the winter blues or a few symptoms, there are some things you can do. Do what you would usually do. If it was go to the gym and see people, do that. Don't get stuck in the pattern of going home, getting under a blanket on the couch just because it's dark out. That's the first step down the slippery slope to falling into a depression or experiencing a lot of symptoms.

18:25So I would encourage people to stay in their routine, stay active with your groups, keep your social contacts going, schedule activities and do them with your social networks, and then watch out for those negative thoughts. Look for your natural antidepressants and try to use those as much as you can to fight at this time of year.

18:53Jonquilyn Hill:Up next, what if the key to beating the winter blues? is to embrace them.

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20:52Jonquilyn Hill:I'm J.Q., this is Explain It To Me, and this is Keri Lebowitz. I am now a winter person, although I would say that I'm a reformed winter hater. Keri is a health psychologist and the author of How To Winter, Harness Your Mindset To Thrive On Cold, Dark, or Difficult Days. So during undergrad, I became really interested in the science of well-being and studying human flourishing and how we can help people thrive. And I learned about the work of this professor, Jor Vitterso, who just happens to be this world expert on human happiness, who lives and teaches at the northernmost university in the world, the University of Tromsø in northern Norway.

21:36And then I sort of started thinking about, isn't it kind of funny or weird or surprising that this professor who is a world expert on happiness lives in a place that is so far north that the sun doesn't rise for two months each winter.

21:52Jonquilyn Hill:Whoa, okay. No direct sunlight for two months. That is a lot. What did you learn? So in the end, I ended up moving to northern Norway for a year to do this research. And so Yohar and I conducted a research study on what we call wintertime mindset. So what people think about when they think about the winter. And what we found is that people in Tromso relate to winter differently. So they're really not focused on the downsides of winter, the unpleasantries of winter, the discomforts of winter. Broadly speaking, they're oriented to the season's opportunities. So the darkness and the cold is seen as a time of year to be cozy, to slow down to rest.

22:36The winter light is really seen as special and magical and beautiful, which the winter light there is very special and unique. But really, they tend to orient towards the things that they like about the season instead of just sort of seeing it as a time of year to endure.

22:54Jonquilyn Hill:Yeah, you know, I've seen pictures of that time of year in Norway. And even though the sun doesn't rise. It's like this gorgeous, like blue light. What was it like to experience that? It is so magical. So the polar night, right, is this time of year where the sun doesn't rise directly above the horizon. And when you hear that the sun doesn't rise for two months, maybe like me, you're picturing total pitch blackness. But that's not what they get in Tromso. So first of all, they get a few hours of what's known as civil twilight each day. So this is the same as that time right before the sun rises or just after it sets when the sun is still below the horizon.

23:35And so you have the sky that's pink and purple and deeply blue and yellow. You're getting these magnificent sunrise and sunset colors. But instead of getting them for 15 or 20 or 30 minutes like we do in most places on Earth, you can get them for two or three or four hours as the sun is skirting below the horizon for a couple of hours each winter day. And then before and after that period, you have the blue hours. You look outside and it's somewhere between like a navy, a royal or a pale blue, depending on what time of day. And it's really like something I have not experienced anywhere else on Earth.

24:19And I think that people in Tromso really revel in and appreciate this extra special light that they get during the darkest days of the year.

24:33Winter in Tromso is uniquely magical, right? So you usually have a lot of snow, so you can ski and snowshoe and snowmobile. It's one of the best places in the world to see the northern lights. So you have the aurora borealis often dancing in the sky. The winter is the time of year that the whales come to the nearby fjords to feed. So you have whales. So there's all these things that, you know, it's giving Disney's Frozen, right? It's giving Anna and Elsa, right? It's extremely magical. But that said, it still is a nighttime level of darkness for about 18 hours a day, right? It still is cold and blustery and wet and snowy.