Find A Physician

Return to Winter's Shorter Days Trigger Depression in Some Overview

More on Winter's Shorter Days Trigger Depression in Some

Newsroom

Return to Winter's Shorter Days Trigger Depression in Some Overview

More on Winter's Shorter Days Trigger Depression in Some

Research and Clinical Trials

Return to Winter's Shorter Days Trigger Depression in Some Overview

More on Winter's Shorter Days Trigger Depression in Some

Clinical Services

Return to Winter's Shorter Days Trigger Depression in Some Overview

More on Winter's Shorter Days Trigger Depression in Some

Winter's Shorter Days Trigger Depression in Some

New York (Jan 24, 2011)

Snow on trees at sunset

"Every mile is two in winter," wrote poet George Herbert more than 300 years ago, capturing the oppression and gloom many of us feel under winter's heavy cold gray skies. The winter months have a more profound effect, and produce a true and deep depression – termed winter depression, winter blues, or seasonal affective disorder (S.A.D.) – in people whose internal clocks fail to adjust to the season's abbreviated hours of daylight.

text from article

People who develop winter depression appear to be doubly vulnerable to both depressive illness and to light exposure deficiency, said Michael Terman, Ph.D., a psychologist and Director of the Center for Light Treatment and Biological Rhythms at NewYork-Presbyterian's Columbia University Medical Center campus. "Our circadian timing system and all of the many endpoints of the circadian clock – body temperature, hormone rhythms, alertness, sleep-wake – are indirectly anchored to the time of sunrise." When sunrise shifts later in winter, the shortened day can trigger the onset of winter depression in susceptible people.

Michael Terman, Ph.D.
Michael Terman, Ph.D.

"People with S.A.D. develop symptoms that resemble hibernating behavior – they feel tired, overeat, and oversleep," said Richard Friedman, M.D., a psychiatrist and Director of the Psychopharmacology Clinic at NewYork-Presbyterian's Weill Cornell Medical Center campus. S.A.D. suffers are regularly depressed in winter, but their symptoms start to abate around the equinox and they feel fine in summer, he said.

Before the advent of the eight-hour workday fewer people likely experienced winter depression. People arose when it was light and slept when it was dark. "The average nine to five work schedule forces us to maintain consistent sleep-wake cycles year-round," Dr. Terman said, "and, yet, our innate rhythms are shifting later during the fall and winter months." Waking up in darkness allows our circadian systems to drift later than our wake-up times, and can be hazardous for those susceptible to S.A.D., he added.

text from article

A random sample population study of New York City residents conducted by researchers at NewYork-Presbyterian/Columbia suggested that winter depression affects a significant number of people in the region. Respondents were asked how their energy, alertness, mood, social interactions, sleep duration, and appetite varied throughout the year. They concluded that about 6 percent of metropolitan area residents – and an equal number of men and women – suffer clinically significant winter depression, and many more suffer "subsyndromal winter depression," Dr. Terman said, and are very much slowed down and glum in the winter months. Those less affected can carry on, but, "it's a miserable five months of the year for them," he added.

Richard A. Friedman, M.D.
Richard A. Friedman,
M.D.

Dr. Terman treats winter depression with chronotherapy – an approach aimed at resetting patients' internal clocks. The primary and most effective treatment is light therapy – daily, early-morning (generally 30-minutes long) exposure to a specialized lamp that emits light equivalent to full daylight intensity. "Light treatment elicits an amazingly fast antidepressant response in many people with seasonal affective disorder," Dr. Terman reports.

Patients with S.A.D. may also respond to an alternative, and less well-understood, treatment, Dr. Terman has discovered. High levels of negatively ionized air, produced by a small bedside unit used at night, improve symptoms in almost half of S.A.D. patients, studies have shown. "At this point we don't know why it works, but it may be that inhaling ionized air enhances our blood oxygenation. So it may be similar to active aerobic exercising, which oxygenates your blood and has an antidepressant effect."

Some people with S.A.D. do not respond to chronotherapy or find the daily routine too much of a commitment. "Light therapy is the simplest treatment approach, but it's harder than taking a pill, so it's not for everybody," Dr. Friedman said. Other effective treatments include the SSRI (selective serotonin reuptake inhibitor) antidepressants Zoloft and Paxil, and Wellbutrin, an antidepressant that enhances dopamine and norepineprine function." Cognitive behavioral therapy, which targets the negative thoughts and cognitive distortion of depression is also effective," he said.

But, "you can get a brief reprieve from winter depression by escaping to the sunny tropics for a few days," said Dr. Friedman, "because the amount of light that comes out of the sky is remarkable. Unfortunately, though, that's not feasible for everyone these days, and the benefit is likely to be short-lived."

Contributing faculty for this article:

Michael Terman, Ph.D. is the Director of the Center for Light Treatment and Biological Rhythms at NewYork-Presbyterian/Columbia University Medical Center and a Professor of Clinical Psychology in Psychiatry at Columbia University College of Physicians and Surgeons.

Richard A. Friedman, M.D. is the Director of the Psychopharmacology Clinic at NewYork-Presbyterian/Weill Cornell Medical Center and a Professor of Clinical Psychiatry at Weill Cornell Medical College.

  • Bookmark
  • Print

    Find a Doctor

Click the button above or call
1 877 NYP WELL


eNewsletters


Clinical Services


Top of page