Symptoms of SAD generally manifest in late fall, when the days become shorter and colder, and people enjoy less natural sunlight. Symptoms include, but are not limited to, feelings of sadness, hopelessness and helplessness, lack of energy, loss of sexual interest and usual pleasurable activities, irritability and restlessness, cravings for carbohydrates and overeating (which can lead to weight gain and compound negative and depressive feelings), trouble concentrating, difficulty sleeping and/or insomnia and at the extreme end—thoughts of death or suicide. Symptoms of SAD are usually most intense during the darkest months of the year, so it stands to reason that the farther a person lives from the equator, the higher the incidence of SAD occurs.
These sleep-related symptoms are of particular interest to me, and are usually the catalyst for a person with SAD to come see me for a consultation and treatment. A person with SAD who suffers from sleep problems may go to sleep early and stay in bed for nine or ten hours, but not experience refreshing sleep. Because of a lack of restful sleep, people with SAD are often drowsy and have trouble concentrating and working during the day.
The relationship between sleep and depression is a bit of a “chicken or the egg” relationship. Which came first? SAD-related depression, or the sleeping problems? It depends. For some, symptoms of SAD occur first—for others, sleep problems appear first. Depression may cause the sleep problems, and sleep problems may cause or worsen the other SAD symptoms.
There is a common link between people with depression and insomnia. Studies have shown that people with insomnia have a ten-fold risk of developing depression compared with people who sleep well. Further, developing depression is highest among those with both sleep onset and sleep maintenance insomnia.
People with depression may also experience insomnia symptoms, including difficulty falling asleep, difficulty staying asleep, experiencing restful sleep and daytime sleepiness. People who suffer from depression are also five times more likely to have a breathing-related sleep disorder than non-depressed people, according to a study at the Stanford University School of Medicine. The 2003 study by Stanford researcher Maurice Ohayon, MD, PhD, found that people with depression were found to be five times more likely to suffer from obstructive sleep apnea (OSA), the most common form of sleep disordered breathing. This was one of the first studies to make the connection between depression and sleep disorders. More current research has confirmed the connection.
So, if you believe you are experiencing SAD-related depression and/or sleep disorders, please see a psychiatrist or sleep specialist about it. There are treatments such as morning light therapy that can offer some relief, so you don’t have to suffer unnecessarily through the winter blues. Call me—I’m happy to help.
