Susan Van Dongen

By: centraljersey.com
The balmy sunshine of spring and summer seems like an eon away. Add to this, bare trees, frigid temps and stormy winter winds and it’s enough to make a person go for a big plate of macaroni and cheese, with a side dish of chocolate chip cookies, then crawl under the covers.
If this sounds familiar, don’t feel alone. This time of year, we often crave a nice nap, or overdo with comfort foods and sweets, to jumpstart low levels of energy and kick that blah feeling that won’t go away, the "winter blues."
But according to professionals, sometimes "the blahs" go beyond mere winter blues and fall into the very real and stubborn ailment of Seasonal Affective Disorder, or S.A.D.
"Whereas winter blues is characterized by down or low mood, decreased energy, increased appetite and craving sweets, patients with S.A.D. will have all of these symptoms but to a significantly greater degree," says Dr. Edward Bilotti, board-certified psychiatrist, founder and medical director of Aroga Behavioral Health and the TMS Center of Princeton. "Their symptoms will be severe enough to interfere with their ability to function well socially, occupationally and academically.
"They may sleep considerably more hours and have trouble getting up in the morning, experience agitation and anxiety, have difficulty concentrating, and often show many other symptoms of major depression, including social withdrawal and loss of interest in pleasurable activities," he adds.
The underlying mechanism for these seasonal mood syndromes remains unknown, but there are several theories. Professionals believe that dysfunctional circadian rhythms, biological abnormalities like differences in sensitivity to light, and changes in levels of neurotransmitters such as serotonin and melatonin, can all contribute to S.A.D.
"Genetic factors might also play a role," Dr. Bilotti says.
Interestingly, for those on the most sensitive spectrum of S.A.D., symptoms can manifest in September and October, early fall, just as the days are beginning to shorten. For others, full blown symptoms may not emerge until the dead of winter, when days are shortest.
Dr. Bilotti indicates that there is a higher prevalence of S.A.D. in women, adolescents and young adults, and in people living in far northern latitudes, such as the Scandinavian countries. "Iceland is an exception, however, and this may be due to a diet high in fish, which contains omega-3 fatty acids, thought to have a beneficial effect on the brain," he says.
Boosting your intake of omega-3 fatty acids by taking fish oil capsules is just one holistic suggestion to counteract S.A.D. Vitamin-D supplements and B-complex supplements are also helpful to patients with depression, and therefore S.A.D.
"Regular exercise helps with symptoms of depression and helps manage increased appetite and weight gain, and is generally good for your overall health," Dr. Bilotti says, noting to check with your doctor before launching into a new exercise program. "Open the blinds and let the sunlight in as much as possible in your environment, and try to spend some time outdoors during daylight hours."
Indeed, in traditional Chinese medicine, it is suggested to expose as much of the skin as possible to sunlight for as little as 10 minutes a day. Which is great, but not when it’s 27 degrees Fahrenheit with a wind chill factor of 15 degrees. Light is very important to the body, mind and soul, however. and if the dark days limit your exposure, there is also "light therapy" or "phototherapy," utilizing full spectrum lights.
"Using a 10,000 lux, full spectrum light may be very helpful when used properly and under the direction of a professional," Dr. Bilotti says. "But phototherapy has real physiological and psychological effects (even side effects), so I recommend consultation with a professional rather than simply purchasing a light and beginning to use it without proper evaluation and guidance."
One such product, the "HappyLight," is manufactured by Verilux; the lights range in price from about $70 to about $190. BlueMax and UltraLux are two other choices for full spectrum lights, and products range in price from about $70 to about $300.
"Other treatments for S.A.D. include psychotherapy and anti-depressant medications," Dr. Bilotti says. "A relatively new treatment approved by the FDA for depression is Transcranial Magnetic Stimulation (T.M.S.), which doesn’t involve any medications and has no systemic side effects."
He has one more recommendation for S.A.D.: "If finances allow, take a winter trip to a sunny climate." Thumbs up to that.
Dr. Edward Bilotti can be reached through Aroga Behavioral Health and the TMS Center of Princeton, 188 Tamarack Circle, Montgomery (Skillman), 609-279-1339. www.arogaonline.com.