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Finding the light: living with winter depression

Joy Piper
Freelance Writer
Correspondence Secretary
SAD Association

It was 16 January 1991. I was 36 years old, happily married, with two lovely daughters aged 6 and 10. I drove into our driveway that evening feeling suddenly detached and empty, a leaden lump in my chest. I wasn't sad or tearful. I just felt very flat.
By morning it was obvious that something was very wrong. Weeks of disturbed nights followed. I lay awake in the early hours. During the daytime all I wanted to do was sit and stare. Normally chatty and sociable, now I couldn't find the energy to hold a proper conversation. I just about coped with the basics of running the home. All my thoughts and movements were in slow motion. I was conscious of life going on around me but couldn't connect with it.
Friends assumed that I had suffered a breakdown. When I finally went to my doctor in late February, feeling that there was no point to going on in life, I was immediately prescribed a standard sedative antidepressant.
However, instinct told me this was not "normal" depression. Even at my lowest ebb, if the sun came out I was outside as soon as possible, eagerly bathing my face in its light. I felt a primitive compelling hunger for bright light, like an acute thirst for water on a hot summer's day.
From early March, I felt a strange, irritating buzz inside. Then my head cleared and instead of wandering around at a snail's pace I began to think, speak and act with renewed energy. By summer I had settled down. Almost as soon as I started the antidepressants I was weaning off them, with my doctor's sympathetic guidance.
Vague memories stirred of an article I had read in Reader's Digest some years before, about wintertime depression relieved by sitting in front of special lights. My father had suffered from weather-related depression for years before his retirement to the south coast enabled him to lead a more flexible, relaxed and outdoor lifestyle. I began to wonder if my depression was the same. Then I saw the address of the SAD Association in a magazine and wrote to them. The information they sent seemed to confirm my suspicions.
However, I knew my symptoms overlapped with those of other forms of depression and illness. Aware of the dangers of self-diagnosis, I asked my doctor to refer me to the seasonal affective disorder (SAD) unit at the Maudsley Hospital in South London.
A preliminary interview there indicated I might indeed have SAD. After four consecutive years of normal summers, hyperactive springs and autumns and incapacitating lethargic winters, and having put on three stone in weight through wintertime bingeing on carbohydrates, I was finally admitted to the Maudsley Hospital in mid-February 1995. I was confined to my room for three hours every morning and evening, during which I was exposed to full-spectrum light at treatment level for SAD. The difference in me after three days was sudden and dramatic. The psychology student who interviewed me on Tuesday evening and then on Wednesday afternoon could hardly believe the overnight change in me. Neither could I!
My depression evaluation at discharge was the complete reverse of what it had been on admission, after just one week with no medication or treatment except the lights. I was diagnosed as 95%+ certainty that I had SAD.
I immediately ordered a lightbox. Someone from the Maudsley kept in touch by phone to monitor and guide me during my first few weeks back home. Light treatment takes time to get right. It's not as easy as it sounds.
After a few seasons experimenting I worked out a regime that worked for me. Life was near normal, as long as I was disciplined and consistent with my light therapy. It was best if I started this at the beginning of September, a month before symptoms usually began, with half an hour every morning. My daily treatment times increased to two hours both morning and afternoon by the depth of winter. Mid-to-late February had generally been the time I began naturally emerging from SAD, so it seemed sensible to start decreasing my light treatment times then, as the days began noticeably to lengthen. If it was a sunny spring, I could safely cease light therapy by April but still kept my lightbox available for top-ups in dull weather.
Looking back I now realise I have always changed to some extent with the seasons. Along with a probable genetic predisposition, three coinciding factors may partially account for my sudden precipitation into SAD:

  • In autumn 1990 a gloomy lid of cloud due to ­persistent high pressure sat over the southeast (where I lived) for several consecutive weeks. Light levels were therefore consistently extremely low for some time.
  • I was continually wearing reactolite lenses at the time. These further reduced light levels entering my eye. Some opticians now advise against ­wearing these indoors.
  • Our house faced east/west with no south-facing open-aspect windows. Light levels indoors in ­winter were therefore considerably reduced.

SAD turned my life upside down and, as depression often does, threw up some unsettling personal issues. Psychotherapy enabled me to identify these, deal with them and move on.
Since our recent move to the south Dorset coast where natural light levels are high, my SAD has noticeably improved. A walk by the sea on a sunny winter's day is both preferable to sitting in front of a lightbox and as, if not more, effective. Our south-facing garden room with large, triple-aspect windows helps me benefit from sunshine when it's too cold to be outdoors for long. It's a slower pace of life here and although SAD is not caused by stress, this can aggravate its symptoms. Another possible factor in my improvement may be the menopause.
I still use my lightbox regularly, but much less than before. It's early days, a lot depends on the weather, but I now live in hope of some remission, although I'm aware I'll always need good light levels to function normally.
A comprehensive information pack priced £5 UK (£10 overseas, including Ireland) is available from the SAD Association (see Resources). Understanding Seasonal Affective Disorder, a booklet from MIND, is available from www.mind.org.uk/information/booklets/understanding/index.htm

Resources
SAD Association
PO Box 989
Steyning
BN44 3HG
W:www.sada.org.uk
Winter blues
W:www.normanrosenthal.com/winter_blues.html
American Academy of Family Physicians
W:www.aafp.org
BUPA SAD pages
W:http://hcd2.bupa.co.uk/fact_sheets/html/sad.html
Surgery Door
W:www.surgerydoor.co.uk
Affective Disorders
W:www.affective disorders.co.uk
Patient UK
W:www.patient.co.uk
NHS Direct
W:www.nhsdirect. nhs.uk/en