Dr. Tara Kraft, CHI St. Alexius Health


Leaves are covering the ground, temperatures are falling and days are becoming shorter.

For many North Dakotans, the eager anticipation of the first sparkling snowfall and the holiday season intermingles with a familiar apprehension about how long the cold will last. This concern is often followed by increases in anxiety and depressed mood that can overtake the initial excitement of the season.

North Dakotans are known for their hearty and steadfast nature through the long winter season, and although we fare quite well in temperatures far below zero with snow banks as high as a vehicle, we are more vulnerable than our neighbors in warmer climates to symptoms of Seasonal Affective Disorder (SAD).

Most scientists agree that sensitivity to decreased daylight hours contributes to important changes in brain and body chemistry that lead to the core symptoms of SAD. SAD's prevalence varies with latitude, affecting only 1.4 percent of Florida residents but closer to 10 percent of residents in northern states. Furthermore, women are two to nine times more likely than men to suffer from SAD, which means that North Dakota women are at particularly high risk. With such a significant gender gap, it is imperative women educate themselves on the warning signs of SAD, utilize preventative strategies as much as possible and know when to seek professional help for symptoms.

Signs and symptoms

Symptoms of SAD are similar to those of major depression and can include the following:

Feeling depressed or irritable

Loss of interest or pleasure in activities that used to be enjoyable

Significant weight loss or gain

Sleep disturbance (insomnia or hypersomnia)

Feeling sluggish and heavy or agitated

Lack of energy

Feeling worthless, hopeless or guilty

Difficulty concentrating or making decisions

In severe cases, suicidal thoughts

Many people experience some of these symptoms for short periods of time, particularly in the midst of stressful situations; however, professional help for symptoms should be sought if they persist on a regular basis for two weeks or more and begin to significantly impact functioning at home, work or in relationships.

Treatment options

Three primary treatment strategies have been found to be most effective in reducing and eliminating symptoms of SAD, including light therapy, cognitive behavioral therapy (CBT) and medication management of symptoms. All of these treatments have been shown to be effective alone, although the best results are often found by using more than one treatment. It is always best to consult with your primary doctor or a trained mental health professional regarding the best treatment package for you.

Light therapy: Because SAD is associated with sensitivity to decreased daylight hours, exposure to light at similar luminosity as daytime sunlight (measured in "lux") during the winter months can be beneficial. Doctors recommend spending approximately 30 minutes per day sitting near a lamp at 10,000 lux during the early morning hours for the best results. Results are typically seen in two to four weeks of daily use.

Cognitive Behavioral Therapy (CBT): CBT is a type of psychotherapy aimed at addressing both the behavioral symptoms and unhelpful thinking patterns that accompany SAD. CBT involves meeting weekly with a trained mental health professional to learn skills and strategies to reduce and eliminate symptoms. Length of therapy varies, although results have been seen in as little as 6-12 sessions with regular practice of skills between sessions.

Medication: A group of medications called selective serotonin reuptake inhibitors (SSRIs), which are commonly used to treat major depression, have been shown to be effective in treating SAD.

Prevention strategies

SAD cannot always be prevented, but these strategies have been shown to help:

Get outside. The cold keeps us indoors significantly more during the winter months, which deprives our bodies of the sunlight we need to maintain good health. Invest in warm winter gear and spend as much time outdoors as possible.

Exercise. Aerobic exercise has been found to be as effective as standard treatments for SAD in some preliminary research studies. Scientists recommend at least 30-45 minutes of aerobic exercise three to five times per week for best results.

Stay active. "Hibernation" and withdrawal from social activities and hobbies during winter months can make seasonal depression worse. Plan social events, find a winter hobby and don't forget to engage in fun, rejuvenating activities.

Remember self-care. Eat well and get adequate rest. Be mindful of daily stress and schedule time for rest and relaxation.

As a mental health professional and proud North Dakotan, I challenge all of us to watch out for one another and educate our friends and families on the warning signs of SAD. With the right tools, winter can continue to be an exciting, adventurous season rather than a time to dread. If you or someone you know is suffering with SAD, make an appointment with your doctor or a local psychologist today. We are here to help!

Dr. Tara Kraft works in adult and adolescent psychology at Archway Mental Health Services, CHI St. Alexius Health. She enjoys writing and educating on issues related to psychological health and well-being.