Colds, dry skin and eyes, lack of exercise, and seasonal affective disorder (SAD) are all common health issues that winter brings. Many people feel a little "off" as the cold weather drags on. Often, their bodies are just responding to the darker and colder days. Circadian rhythms can be thrown off by the winter season. This shift, along with other factors, may affect your mental health.

Cold weather has been linked to a variety of mental illnesses, including despair and anxiety. All of the major mental illnesses have their maxima in the winter, suggesting that mental illnesses are more strongly linked to seasonal cycles than previously thought. The depressing winter months are thought to be harsher, especially for those who suffer from the seasonal affective disorder (SAD).

What is seasonal depression or SAD?

SAD is a kind of depression linked to seasonal variations, with symptoms appearing and disappearing around the same period each year (November to March), which coincides with the winter months for many of us. This seasonal depression worsens in the winter and then subsides in the spring. The "winter blues," a mild version of SAD, may strike certain people. It's natural to be depressed in the winter. It's conceivable that you'll be confined to your home and that it will become dark early.

SAD is most common in people who live at least 30 degrees latitude north or south. The amount of winter daylight you receive changes the farther you are from the equator. SAD, like other forms of depression, is treatable and can be controlled with medication. Seasonal depression is one of the common types of depression which we encounter in clinical settings during winter.

Epidemiology and gender distribution

A milder form of winter blues may affect as many 10 to 20 percent of people, according to the World Health Organization. SAD affects about 1% to 2% of the population, particularly women and young people, and can cause lasting damage if undiagnosed. In the U.S, SAD typically occurs in the winter months; in India, it's more common in the summer. SAD is most common during the winter months in temperate areas, such as the United States, and is linked to decreasing sunshine exposure. However, in the warmer areas of India, the opposite is true: seasonal affective disorder is more frequent during the summer months.

About 5% of adults in the United States suffer from SAD. It generally starts while a person is in their early twenties. Researchers aren't sure why women are more affected by SAD than men. Women make up over 75% of people who suffer from the seasonal affective disorder.

More than 10 million people in India suffer from comparable or identical symptoms of Seasonal Affective Disorder, which is frequently self-diagnosable (SAD). Its milder form generally goes away after a few months.

SAD affects a wide range of people; it is more common in younger people and women. You are at higher risk if you have another mood disorder, such as major depressive disorder or bipolar disorder or if you live at high latitudes (farther north of the equator), such as Alaska or New England.

Comorbid mental illness with seasonal depression

People with SAD may also have other mental health problems, such as depression, bipolar disorder, or post-traumatic stress disorder (PTSD), according to the National Institute of Mental Health (NIMH). People with Seasonal Affective Disorder are more likely to develop physical and behavioral changes during the winter months.

Causes of seasonal depression

Researchers are unsure of the specific aetiology of seasonal sadness. People who are prone to the illness may be triggered by a lack of sunshine. According to the theories, some of the causes of seasonal depression include:

·        Changes in the biological rhythms: When someone has less exposure to sunlight, their biological clock shifts. This internal clock regulates mood, sleep, and hormones. When it changes, people may have trouble regulating their moods.

·        Chemical imbalance in the brain: People at risk of SAD may already have less serotonin activity in their brains. Serotonin levels can fall further, leading to mood changes. Since sunlight helps regulate serotonin, the lack of winter sun can make the situation worse.

·        Deficiency in vitamin D: Serotonin also gets a boost from vitamin D, which is produced when we get more sunlight in the winter months.

·        Change in melatonin levels: People who have been exposed to low levels of sunlight during the winter may experience an overproduction of melatonin in their system.

Clinical features of SAD

SAD is a type of depression, rather than a separate disorder. People who have summer SAD may experience agitation and restlessness, decreased appetite, weight loss, episodes of violent behaviour, loss of interest in usual activities, including withdrawing from social activities. SAD symptoms include anxiety, sorrow, irritability, social disengagement, exhaustion, and a loss of focus.

How to diagnose the SAD?

·        Symptoms of major depression that occur during specific seasons for at least two consecutive years.

·        Depressive episodes happen more frequently during a specific season than during the rest of the year.

·        The depression should last two week and be accompanied by mood disturbances and other neurovegetative symptoms.

Things to do to combat SAD

It's especially vital to look for oneself throughout the winter. SAD may be fought by sticking to a healthy daily routine. Here are a few things you can do to combat SAD.

·        Get sunlight whenever possible: Serotonin levels are raised by going outside or allowing the sunshine in via a window, which helps to regulate your mood. Even when there is cloud cover, sunshine is the best source of light for light treatment.

·        Maintain regular exercise and daily routine: Endorphins, a hormone that provides you a natural high, are released when you exercise. Endorphins are the chemicals that maintain you in a happy, energized and relaxed state.

·        Adequate rest: To keep your mind and body in check, you should sleep for seven to eight hours each night. Sleep is the most effective approach to restore and refresh the mind. Sleep is also the most effective treatment for any type of sadness, anxiety, or other mental illness.

·        Adequate diet: SAD symptoms can make you crave sugary foods and simple carbohydrates, such as pasta and white bread. Oatmeal, whole grain bread, brown rice, and bananas can boost your feel-good serotonin levels. Food rich in omega-3 fats can also improve your mood and may even boost the effectiveness of the antidepressant medication.

·        Take the right steps: Too much stress can exacerbate or even trigger depression. Figure out the things in your life that stress you out, and make a plan to avoid them. Make time for leisure activities that bring you joy, such as painting, playing the piano, or working on your car.

·        Say 'NO' to temporary reliefs: Say no to alcohol and smoking. Say 'YES' to exercise and dance away your worries. Eat a healthy diet. Stay positive: There is always a solution for every clear and positive mind.

Treatment of SAD

SAD can be effectively treated with light therapy, antidepressants, or talk therapy. Light therapy involves sitting in front of a box that emits a very bright light. It usually requires 20 minutes or more per day, typically first thing in the morning. Some people may begin light therapy in the early fall to prevent symptoms. Talk therapy, particularly cognitive behavior therapy, can be effective in treating SAD. Selected serotonin reuptake inhibitors are the most common antidepressants used to treat SAD.

You may need a combination of treatments to treat the seasonal affective disorder. Phototherapy, using a special lamp, can treat SAD. Vitamin D supplement may help improve symptoms. Sometimes, providers recommend medication for depression, either alone or with light therapy.