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During winter months at Fort Wainwright in Alaska, the sun comes up around 10 a.m. and sets a little bit before 3 p.m. Along with the frigid weather, the extended darkness creates an increased risk of depression and other mental health problems.
That’s why at installations like Fort Wainwright, military officials are acutely aware of the risks of Seasonal Affective Disorder, also known as SAD, which is the medical term for a seasonally triggered change in behavior that can affect anyone but especially at higher latitudes where the days are shortest.
SAD can be hard to recognize because its onset is as slow as the changing seasons.
“One of the most challenging things about identifying Seasonal Affective Disorder is that the onset can be very subtle,” said Army Capt. Julie Dederer, a psychologist at Bassett Army Community Hospital at Fort Wainwright near Fairbanks, Alaska.
“This can cause delays in patients identifying that something is wrong, and in accurately identifying it for treatment once the patient does seek treatment for it.”
The problem becomes most acute around this time of year, near the winter solstice, or the northern hemisphere’s shortest day of the year, which usually falls on Dec. 21.
Anyone can be affected each year regardless of latitude.
“SAD can occur regardless of geographic location, especially if people have a history of mental health issues or depression,” said U.S. Public Health Service Officer Lt. Hana Kim, the assistant department head of the outpatient behavioral health department at the Navy Medicine Readiness and Training Command in Jacksonville, Florida.
There is a relatively high rate of reoccurrence “in that individuals who experience an episode of SAD are significantly more likely to experience another episode the next year,” Dederer said. The good news is that this “provides an opportunity for preventive measures.”
At Fort Wainwright, soldiers can borrow light boxes, which provide broad-spectrum light that mimics daylight. Light boxes are best used in the morning, Kim said.
“For mild to moderate SAD, light box therapy is the first line of therapy,” she said. For more severe cases, antidepressant medications such as selective serotonin reuptake inhibitors, known as SSRIs, might be prescribed.
Lifestyle changes can help
A good deal of treatment for SAD involves behavioral and lifestyle changes.
There are other contributing factors to SAD and its severity, which can include reduced physical activity, poor diet, social isolation, and spending less time on enjoyable activities, Dederer said. To address some of these issues, she recommends:
- Low-fat diets
- Reduced carbohydrates
- Reduced refined sugars
- Dederer also suggested lifestyle changes, including:
- Finding new hobbies to stay active in the winter
- Making deliberate efforts to go outside during the daytime
- Opening blinds to increase sun exposure
- Socializing more with family and friends
Additionally, she suggested getting your vitamin D levels checked during the winter. Low vitamin D is a possible medical factor with SAD, although there is no conclusive scientific evidence to support that. Fort Wainwright provides free vitamin D supplements on-post.
Kim emphasized as important “good sleep hygiene — going to bed at the same time every night, no naps, and no caffeine in the afternoon.”
Additionally, she suggested adopting a “generally healthy lifestyle and exercising, which releases good endorphins in the brain and can help counteract any weight gain caused by overeating, and limiting excess alcohol.”
SAD Education
At Wainwright, the potential for SAD is addressed immediately upon a service member’s arrival, regardless of the time of year.
Wainwright has an outreach component, where behavioral health staff brief every soldier within their first week on base. They discuss challenges in Alaska’s climate and environment, signs of SAD and resources for addressing the condition.
“The hope is that the brief gives soldiers the information to encourage them to be proactive in identifying and preventing SAD symptoms,” Dederer said.
If SAD symptoms are identified in a soldier, the behavioral staff at Bassett “assess the extent to which symptoms might be seasonally driven” and recommend a treatment plan, she added.
SAD and social isolation
“Beware of the challenges in comparing your own needs to those of the people around you,” Dederer said.
“In winter, many people socialize less, which means they interact with their friends less often,” she said.
For instance, “They may believe they are the only one struggling with the ‘winter blues’ and are reluctant to seek help due to stigma. Or they think everyone is experiencing the same thing and there is no reason or benefit to seeking help. Both comparisons can be harmful in preventing someone from seeking help to address their symptoms,” Dederer cautioned.
“The upside is that these interventions are easy to do on your own and accessible to pretty much anyone,” Dederer said.
“The downside however is that the nature of SAD is cyclical —those with SAD have lower energy because of the reduced sunlight exposure, so they spend less time doing activities such as exercising and socializing with friends, and the withdrawal from these activities increases feelings of fatigue and depression, making it harder to put the lifestyle changes in place.”
“The most important thing is to not take it lightly,” Kim said. “Don’t chalk it up to winter blues, especially if you feel this way for more than two weeks.” Since SAD is a subtype of depression, it can lead to more severe depression and suicidal ideation.
“There are good treatment options for SAD, so reach out.”
