As the days get shorter and winter closes in, many people feel like hibernating. We start sleeping more, eating more and avoiding social contact. The effects can be particularly oppressive for people with depression, many of whom feel escalating dread.
Here are eight ways to keep the black dog at bay after you turn back the clocks.
Winter depression is often spurred by waking up in darkness rather than light, which affects your body clock in a way that is sometimes called “depressogenic.” For people who are prone to the winter blues, trying light therapy helps.
Exposure to bright light, especially upon waking up, has three major positive effects that can relieve depression.
It keeps the circadian clock in check, preventing it from drifting later than your desired, or workday, sleep period. It’s an energizer that gives a morning boost, whether you’re depressed or just sluggish. And it has direct antidepressant properties, stimulating the same neurotransmitters as antidepressant medications.
Special types of lights are required; it’s not enough to flick on your bedside lamp. A visit to a therapist who specializes in this treatment is also recommended, although light boxes can be purchased without a prescription.
Even if your depression doesn’t have a seasonal pattern, research shows that light therapy can help: it has been found useful for treating bipolar depression, depression during pregnancy and chronic depression.
Depression can worsen fears of social rejection, causing you to avoid social occasions. But social support is one of the most important factors for recovery from depression and for avoiding relapse. So try to go out even when you don’t feel like it: make a commitment to do a certain number of social activities each week and stick to it.
Once you’ve forced yourself to get out, the dread of socializing typically eases and you’ll often find that you’re having a surprisingly good time. Remind yourself of this the next time you feel the urge to stay home. And be aware that depression can cause you to be oversensitive to social slights that may not have been intended. If you think someone has rejected you in some way (for example, a colleague failing to say hello to you in the hall), try to consider alternative explanations for the incident (she was preoccupied with concerns over her imminent meeting with a boss) and avoid overreacting or ruminating on depressing thoughts.
If you find yourself unable to enjoy social situations that used to give you pleasure, you may need to seek additional help. This is a symptom of depression called anhedonia, which often requires medication or other professional treatment to lift.
Like socializing, exercise is something that depressed people often dread and seek to avoid; however, it will dramatically improve your mood if you can get yourself do it. Regular aerobic workouts can markedly lift depressed mood in about 33% of patients. But if they don’t keep it up, they quickly crash.
To motivate yourself, choose an activity that you enjoy (or at least, hate less than other exercises) and schedule it at regular times, so that it becomes a routine. Exercising repeatedly at the same time each day or days of the week helps create a habit, and the more you repeat that habit, the harder it becomes to let yourself deviate from it.
Remind yourself before each workout that you will feel great once you get going — and afterward — and that there is no reason for feeling dread or avoiding exercise. The more you mentally reconfirm the direct link between exercise and rise in mood, the less credence you’ll lend the dread over time.
If you do yoga or any other form of meditation, you know that focusing on breathing is a critical part of the practice. It’s also useful for fighting depression. Why? One reason is that taking slow, deep, relaxing breaths stimulates the vagus nerve, which is responsible for counteracting the stress response.
The vagus is a “very complex and widespread nerve that not only lowers heart rate and can lead to more relaxation but also has branches that go to the face and voice box. Low vagal activity is the reason depressed people seem so emotionally flat. When vagus nerve activity increases, that flat affect lifts.
Under stress, the heart beats faster and blood pressure rises. The vagus nerve sends the opposite message. And because depression is often initiated or exacerbated by stress, anything that tamps down the stress response can help. In fact, one therapy for treatment-resistant depression is the use of a device that electrically stimulates the vagus nerve.
But you don’t have to go that far to seek stimulation. You can stimulate the vagus by breathing, if you make your expirations longer like in yoga. If you exhale for twice as long as you inhale, you will be enhancing vagal activity. Another way to stimulate the vagus is by breathing in deeply and then exhaling forcefully while holding your nose and mouth closed, until your ears “pop.” Obviously, don’t hold your breath this way for too long or push too hard.
When anxiety runs high, remembering to slow down and breathe deeply can help prevent it from pushing you over the brink and into depression.
Massage isn’t just a fun luxury. It can be as effective in treating depression as talk therapy. During massage, levels of the stress hormone cortisol, which is often high in depressed people, fall while levels of the neurotransmitter serotonin — the same brain chemical increased by antidepressant medications — rise.
There are many studies on depression and massage showing that there is not only a decrease in symptoms of depression but also underlying changes that are happening physiologically and biochemically.
Research hasn’t found one particular type of massage to be more mood lifting than others, but one key factor matters. You don’t get these effects unless there’s at least moderate pressure. Light stroking is actually aversive and operates in the opposite direction. It increases heart and stress hormones.
Here’s good news for coffee drinkers: a recent analysis of data from the massive Nurses’ Health Study found that women who drank more than four cups of coffee a day had a 20% lower risk of depression than women who drank less. The research did not include men but there’s little reason to suspect a wildly different effect in them.
Such research can’t prove that caffeine or coffee causes a better mood; it only shows an association. But since many people say they find coffee to be a mood lifter, and since, overall, there’s more evidence of benefit than harm, having an extra cup might be just what the doctor ordered.
There are two supplements available in health-food stores that studies suggest have at least some positive effects on depression: S-adenosyl-L-methionine, or SAM-e, and omega-3 fatty acids, particularly eicosapentaenoic acid (EPA).
Omega-3s are also abundant in oily fish, so simply adding more salmon and sardines to your diet could help banish winter blues. SAM-e is not found in foods, but identifying high-quality supplements that contain the right amount of key ingredients in the appropriate form can be tricky; ask your doctor for guidance. Both supplements appear to be safe, with few reported negative side effects.
Seeking professional mental health care can help you navigate an array of tactics to beat depression. If you’re already in treatment, now’s a good time to talk with your therapist or doctor about a seasonal slip in mood and how to prevent it from becoming something worse. Perhaps medications will need to be adjusted or talk therapy stepped up; for severe cases of depression, your therapist may recommend other options.
But whatever you do, don’t simply suffer. Depression is more treatable now than ever before, and with the cold and dark fast approaching in many parts of the country, the time to stop it is now.