So SAD. Illuminate me.

December 19, 2007 2:42 PM

I've been aware of a tendency toward winter blues for many years, but this winter is really kicking my ass already. I think I'm ready to look into a little treatment, and I'd like some advice. Yep, I've read all of the previous AskMes on this.

Has anyone found getting a "real" diagnosis of SAD from their doctor to be particularly helpful? (Or particularly unhelpful?) I get that the tendency is to say that of course one should see a doctor if one thinks one has a medical condition, but I am not suffering from severe depression, I'm not looking for an SSRI prescription, or even a therapist. Really, I'm quite certain that this is just Not Enough Light = Cranky and Exhausted.

I'm pretty sure that some light therapy will do the trick. I do wonder if insurance might partially cover the cost of a light-box? Anyone have any experience with this? It was mentioned in previous threads w/out follow-up.

Getting outside for more light and fresh air would be great...except that the resultant pain from my Raynaud's makes that prospect a bit...depressing.

Sorry to say that I can't go someplace warm for a few weeks, though man oh man, I wish I could.

Anything else to consider adding to my treatment regimen?

posted by desuetude to health (19 comments total)

How is your diet? Having a balanced and healthy diet really affects one's psyche. Exercise is also a good mood booster.
posted by MaryDellamorte at 3:21 PM on December 19, 2007

I'm eating better than ever - loads of fresh fruits and veggies and everything wholesome, and I'm sleeping regularly and exercising too. I'm in great shape. But this winter's kicking my ass already too - much much more so than in other years. The only thing that's helped me so far is maximizing time in the sun (such as there is sunlight.) I actually thing something is different this winter myself. Good luck on your quest, and thanks for asking this question.
posted by Dee Xtrovert at 3:42 PM on December 19, 2007

I'm making a very big effort to be living my life in well-lit places, like bringing more lamps into my office.
When it gets really really bad, you might try a tanning bed for 10 minutes. Yes, yes, I CAN HAS SKIN CNACER, but I found it to be a jump-start in being able to cope with months and months of the grey tunnel that the Pacific Northwest turns to from November to March. Once was enough for me, ymmv.
posted by lilithim at 3:47 PM on December 19, 2007

Kudos on your healthy eating and lifestyle habits. Most people are quick to just run off and get a pill to fix their problems. Medication should be used as a last resort. I've suffered from depression and anxiety problems since I was a child. I guess after so many years I've just learned to cope with it. I'm depressed most of the time but it's just a part of who I am, I just accept it now.

There's some good treatment information about SAD on wiki.

And here's a link I found about choosing a light box. All insurances vary so the best bet would be to call them up and ask.
posted by MaryDellamorte at 3:54 PM on December 19, 2007

Did you see this in the NYTimes?

It links to a nonprofit Center for Environmental Therapeutics that has a info and a questionnaire on their Web site.
posted by buka at 3:56 PM on December 19, 2007

My diet's pretty great, MaryDellamorte. No processed food, plenty of veggies and whole grains.

buka, yep, I saw the article and took the tests. Unsurprisingly, it indicates that I seem to be depressed and am a night person who should be doing lightbox therapy at 8 am. Which would actually be convenient for me, which made me feel a little better. Man, am I cranky.

lilithim, I considered the tanning bed option, but I am the color of cinnamon-flecked milk. Are you using full-spectrums at your office or just lots of regular lamps?
posted by desuetude at 4:26 PM on December 19, 2007

I would recommend fish oil capsules and/or cod liver oil for vitamin D. I had the same problem when I first moved north to Oregon. The long, grey winter season seemed like an endless parade of bleary. Along with a good diet, I take a capful of cod liver oil in water every morning. I'm doing much better with the rain, even enjoying it. I don't like taking capsules especially and never felt like fish oil capsules did anything. I don't know if there's a difference in cod liver oil but I think it does somehow help out. I don't seem to be craving the sun much if at all. Of course I miss it, but having it be grey outside doesn't seem to affect me much any more.

I do ride my bike every day so get outside almost every day for at least half an hour rain or shine.
My two cents worth. Your mileage may vary.
posted by diode at 4:33 PM on December 19, 2007

I swear by St John's Wort. I ignore any data and refuse to read any studies that may indicate a placebo effect, so as not to spoil said effect.
posted by kuujjuarapik at 7:07 PM on December 19, 2007

My psychiatrist just recommended I get a light box. I thought it was interesting - since I'm on medication for bipolar disorder - that he did not suggest upping my meds. That's good, since I don't want to increase my dosage unless it's absolutely necessary.

I've been shopping around. I haven't checked into insurance yet, but I'm not hopeful. At this point though, I'm willing to pay out of pocket. I'll let you know what I come up with. I have Oxford - do you mind telling me what insurance you have? You can email me if you like.

Out of curiosity, are you of Northern European descent?

Good for you Foetry Guy, for fighting the system! Don't let the man grind you down!

Medication should be used as a last resort. I've suffered from depression and anxiety problems since I was a child. I guess after so many years I've just learned to cope with it. I'm depressed most of the time but it's just a part of who I am, I just accept it now.

It's a shame you've just accepted this. The brain is an organ, just like any other organ in your body. It doesn't have magical powers. It doesn't contain your "soul". Things can go wrong with it. If you had arthritis, would you just accept it as "part of who you are" or would you get treatment? I'm only saying this because I, like you, felt the same way and suffered unnecessarily for far too long.
posted by Evangeline at 7:17 PM on December 19, 2007 [1 favorite]

Evangeline, I'm in Philly and have Blue Cross PPO. Mostly of Central European descent, with a little UK in the mix.

Dee Xtrovert, it's comforting to know that I'm not the only one feeling extra-bluesy this winter.
posted by desuetude at 7:36 PM on December 19, 2007

I was going to chime in with a recommendation for vitamin D as well. My doctor told me that the american college of family physicians recently recommended that people get their vit D levels tested - he said as he's been testing patients he is surprised by how many people are low in vitamin D. The prescription vitamin D capsules contain a lot more than the OTC supplements.
posted by selfmedicating at 7:37 PM on December 19, 2007

I have found that actually taking a supplement of Vitamin D3 helps. combined with taking enough omega oils, this recipe is as good as antidepressants! I can't recommend it enough.
Also, getting enough bright light (the secret to the SAD lights) helps. I had a doctor prescribe me to go up to the mountains, past the cloud line, into the place where the sun reflects off the snow, weekly for an hour. I didn't make it weekly, but when I did do it, I did feel better! We need bright enough light to reset our circadian rhythms.

Try the vitamin D and omegas.
posted by photos_books_food at 9:23 PM on December 19, 2007

oh, and in response to selfmedicating's statement about docs testing vit.D levels- my naturopath did test me and found that, even though the rest of my levels of minerals and vitamins were fine, my vitamin D was 'pathetically low' (we have a good relationship so she can talk to me like that), and immediately put me on a high dose.
I haven't had an allopath test my vitamins, but a naturopath certainly will.
posted by photos_books_food at 9:25 PM on December 19, 2007

I heart my lightbox! I will never ever try another winter without one.

I never had insurance that would cover it, so I bought my first one from Nu-Light and paid out of pocket, and never regretted a dime. When I left the US, I sold my box on ebay and stupidly stupidly did without for several years until my mom decided she knew best and bought me one off ebay about two months ago. I felt the difference immediately.

I have it on a 24 hour timer to come on about an hour before the alarm goes off, and it helps me wake up in stages. Eventually I'll pay the big bucks for the one with a built in dimmer to simulate sunrise, but for now, my husband is willing to cope with it when he can so clearly see the benefits in my mood.

The main thing you want to look for is at least 10,000 lumens. Lumens drop off with distance, which is why full spectrum bulbs really don't do much. They are too far away from you.

A lightbox is really worth the money. If you can't get it any other way, sell all your unwanted Christmas presents on ebay.
posted by happyturtle at 11:26 PM on December 19, 2007 [1 favorite]

I swear by two things: fish oil capsules (if you freeze them, you can avoid the fish burps) and my dawn simulator. It also helps if you can get 15-30 minutes of natural sunlight in the morning, which is easy to do here in the South with an office window that faces east, but probably not so much for the rest of the world. :P Regardless, the clock and fish oil pretty much completely eliminated my S.A.D., and I was dang near incapacitated from October to March every year.
posted by tigerjade at 6:23 AM on December 20, 2007

just to give you some good news: tomorrow is the shortest day all year, and starting on the 22nd there will be a little more daylight in your day, every day. i can't wait!
posted by kidsleepy at 7:52 AM on December 20, 2007

Okay, I walked the four blocks to the other bus stop this morning, light box is on the way, first dose of Vitamin D and Oily Pills have been swallowed, and I picked up some dark chocolate for good measure.

[taps foot impatiently] So...how long does this take to work? ;)

Thanks for the advice from all. I hope to be checking back in with a more cheerful update in a couple of weeks.
posted by desuetude at 11:28 AM on December 20, 2007

desuetude, I felt the difference from my lightbox almost immediately. Three days, tops. I don't know if that's typical, but I hope it works that fast for you.
posted by happyturtle at 9:26 AM on December 21, 2007

Update. I think it's working.

I'm still fighting a major case of the scatterbrains at work, but it is a lot easier to get out of bed in the morning, and I don't feel so despondent.

(My SO was a bit quizzical the first few days that I hunkered down on the floor cuddled up to the radiator with the lightbox, but he agrees that this is preferable to me dragging the Very Bright Light into the bed. Bonus: spending time that close to the floorboards motivated me to mop the bedroom floor.)

So, is it typical to get tired earlier in the evening as well? My bedtime seems to have shifted up by about an hour. Don't know whether this is a bit of regular winter fatigue or some sort of mental anticipation of those 8 am lights.
posted by desuetude at 2:08 PM on January 7