Beating the Winter Blues

Photo by Fractured Studios (Flickr)

We all suffer from the “winter blues” every once in a while, but many people suffer from a more severe form of the winter depression called Seasonal Affective Disorder, or SAD. The acronym fits, doesn't it? As a nurse, you might notice a change in your regular patients' moods during the winter months. Some might come into your care a little more tired and a little less enthused about life. Don't make the mistake of assuming they are stuck in a winter funk. Take the time to assess whether your patients are suffering from SAD or just the winter blues.

• Beat the Winter Blues - NIH News in Health discusses the winter blues, SAD, and some ways to beat both.
• Beating Winter's Woes - WebMD also offers some advice on diagnosing and beating the winter blues.

SAD is relatively easy to diagnose because its symptoms mirror that of depression. If you notice that a patient is emotionally down or disengaged, perhaps feeling hopeless or worthless, or even lashing out with excessive irritability, your patient might be suffering from SAD. Other signs to look for are a loss of interest in the things your patient normally enjoys, weight gain, and complaints of excessive fatigue or sleeping.

If your patient is suffering from any of these symptoms during the fall and winter months, particularly if you practice in the cold climates, your patient might have a winter blues disorder beyond what most of us experience when it gets cold and dark sooner. This is when we, as nurses, need to put up the red flag and discuss the possibility of SAD with the patient's attending physician and the patient him or herself.

• Seasonal Affective Disorder - The U.S. Department of Veterans Affairs discusses seasonal affective disorder in this informative article.
• SAD (Seasonal Affective Disorder) - Healthfinder.gov provides many helpful links to resources for those looking for more information on SAD.

Whether winter blues or SAD is diagnosed, any patient suffering from a winter funk should take some extra steps to ensure that he or she stays healthy and happy during the colder months. We tend to focus on diet and exercise during the spring and summer months because we want to look our best in our swimsuits and shorts. We also tend to be more active in the spring and summer because the weather is nicer and it's more tempting to go outside and “play.”

We need to keep this philosophy going through the fall and winter, even if it is cold outside and we just want to sit on the couch and eat holiday goodies. We need to maintain a healthy diet and exercise regime in the fall and winter, as well. This isn't as difficult to do as it might seem, and the number one way you can help your patients stay healthy and happy during colder weather is to be encouraging.

There are plenty of healthy cold-weather recipes out there, offering those who love a hearty bowl of stew or chili to warm them up on a cold winter's night the option of still eating the food. Encourage your patient's to use healthy substitutions to fat-laden winter recipes to ensure they continue to eat a good diet all year round.

• Making Comfort Foods Healthier - Clemson University's Cooperative Extension offers some helpful hints on how to enjoy winter comfort food without the weight gain.
• Healthy Winter Comfort Food - Australian website “Taste” offers some creative recipes sure to satisfy any winter food craving from several different magazines.

And who says winter sports can't be fun, too? We still need to get out into the daylight and get some exercise during the fall and winter months. Engaging in winter sports, such as ice skating, sledding, skiing, or just building a snowman with your kids is a great way to stay active in colder weather. There are also plenty of reasonable outdoor wear companies offering waterproof and warm exercise clothing to keep us active when it's cold and rainy or snowy.

• Stay Active Through the Winter - New Hampshire offers some cold weather activity suggestions sure to get you moving.
• Winter Activities - Massachusetts also tells us how to get, and keep, moving in colder weather.

Why is getting outside so important, even in the wintertime? Because light is a natural anti-depressant. In fact, one of the primary treatments for SAD is light therapy, where patients are required to sit in front of a light box for an average diagnosed time of 30 minutes a day. Light also keeps our internal body clock accurately keeping time. We react to light naturally; dark tells us it's time to go to sleep, and light tells us it's time to wake up. During the fall and winter when light is in shorter supply, we need to take advantage of it to keep us happy and our internal clocks functioning properly.

Aside from diet, exercise, and light therapy, if you are faced with patient who is suffering from SAD, it might be time to recommend some Cognitive Behavioral Therapy. In certain cases, CBT is required along with diet, exercise, and light therapy to treat patients suffering from severe cases of SAD. Anti-depressants are also effective in treating this seasonal disorder.

• Seasonal Affective Disorder (SAD) and Light Therapy - Drew University explains how light therapy works when treating SAD in this article.
• New Treatments for Seasonal Affective Disorder - The Harvard Mental Health Letter discusses some new treatments found to effectively aid patients suffering from SAD.

We all suffer from winter blues. When they become disabling, however, they are far more serious than the holiday downs. As healthcare practitioners, we should keep in mind how the winter months might pose additional health problems for our patients. We should keep in mind and encourage our patients to understand that even though the winter blues dissipate in the fall, they might still require treatment. Let's all beat the winter blues by staying healthy and active during the winter months!

• Winter Blues / Seasonal Affective Disorder - Villanova University's Counseling Center gives the questions we should all ask to determine if the blues are simply blues or a case of SAD.
• Is it the Winter Blues or Seasonal Affective Disorder? - West Virginia University details the difference between the two conditions in this article.

Julia Tortorice