With Dr. Rankin

I can recall last winter Paige telling me that I seemed “off”. Indeed I was struggling to stay motivated with pretty much everything. I grew increasingly disgruntled and was a real drag to be around. I didn’t recognize it as seasonal depression. After asking around, a doctor friend of mine suggested that it was and gave me some great advice on how to get out of the funk I was in. I love riding bicycles because it gets me outside in the elements and the harsh winter had taken that away. Recently I visited with Dr. Josh Rankin to talk about seasonal depression. Take a second to learn about a common struggle for so many people this time of year.

OCA: What is seasonal depression?
JR: Seasonal affective disorder (SAD) is a type of depression that usually comes and goes with changes in the seasons. Most often, it starts in late fall and continues through the winter, but some people exhibit symptoms in a reverse fashion where they are more affected in the summer. It is different than Major Depression in that it does come and go, whereas Major Depression usually lasts 6 months or more with less variability in symptoms.

OCA: What are some symptoms of seasonal depression?
JR: Most patients I see for SAD say that they just don’t feel themselves. Sort of like when you say you felt “off”. Most people tell me they don’t feel “depressed” but feel like they just can’t get going. They lose interest in things they enjoy, may have some difficulty sleeping, and may have changes in their appetite/weight. Irritability and mood swings are common also.

OCA: How common is it to struggle with seasonal depression?
JR: I think most people I know struggle with it to varying degrees. Most people just call it the “winter blues”, and their symptoms are generally mild and don’t need any medical treatment. But every year, I see about 4 or 5 patients a month during December through February that I diagnose with SAD.

OCA: What causes it?
JR: The exact cause is not known, but several theories exist. One is based on the fact that most people with SAD are worse in the winter and that the further away from the equator patients are, the worse SAD can be. This theory proposes that the less sunlight we are exposed to leads to lower levels of serotonin (a neurotransmitter involved in mood regulation). This lack of sunlight also decreases the amount of Vitamin D our body makes, so it is also theorized that this decrease in Vitamin D may contribute to SAD.

OCA: How can I tell if I have it?
JR: Well, SAD is diagnosed based on a patient’s reported symptoms. If you have the symptoms mentioned above, and you notice that these symptoms start during a specific time of the year and otherwise remit, then it’s likely you have SAD. If you have it and it’s creating significant problems at home or work, then it’s worth at least talking to a doctor or therapist about it.

OCA: How is it treated?
JR: I try to keep patients off prescription medications for SAD if I can because these medications are not without side effects. Plus, some of these medications take 6 weeks to work effectively, so by the time they take effect you may be improving anyway. I first tell patients to stay/work in a well-lit room (preferably sunlight) during the daylight hours of the day. Getting outside for at least 30 minutes a day is also recommended (i.e. bundle up and leave the trainer/treadmill idle in the garage!). But in some people, SAD can be severe enough to affect relationships and work performance to a significant degree. If this is the case and the usual measures aren’t helping, I will usually recommend either counseling or antidepressant medications or sometimes both.

OCA: Can it be prevented?
JR: I am a firm believer in Vitamins (even though I struggle to remember to take them myself). I try to take a vitamin D supplement (usually 1000 IU) every day from October through mid-March because during this time, my rides/runs are rarely during the daylight hours during the week, and I believe keeping this level up helps keep my mood stable. And even though it’s easier to skip those cold workouts, I try to force myself to get out there as regular exercise has been shown to help all forms of depression.

OCA: Are athletic types more/less prone to struggle with seasonal depression?
JR: Overall, I think active people are less likely to have SAD (and a multitude of other ailments) to the degree it requires medical treatment, but they are by no means immune. Factors such as a family history of depression or other mood disorders are a risk factor for SAD, and there’s not a lot you can do about your genetics. So, sometimes even the most active athletes among us can suffer from SAD.

OCA: Don’t let seasonal depression (SAD) get you down. Go see your doctor and get some advice. Trust me, your significant other & friends will be glad you did! A big thank you to Josh for sharing his knowledge & experience. 

To see my previous post with Dr. Rankin click here.

Looking for a doctor who understands the athletes’ lifestyle? Check him out, click here.

Dr. Joshua Rankin
FirstCare Family Doctors – Tontitown, a MANA Clinic
171 N. Maestri Rd.
Springdale, AR 72762
479-361-1020