Staying pink in blue season

(Want to read the Christmas Carol without our annoying blather?)

Dickens juxtaposed the miserable Scrooge and London's gloomy climate to the good will of the Christmas spirit. Nowadays, the Christmas spirit contrasts with the blues sparked by the holidays in many people.

It's no coincidence that seasonal affective disorder, or SAD, peaks around Christmas, when the sun lingers too long below the Northern-Hemisphere horizon. The holidays also spark a milder, but more common problem, the winter blues.

Did Scrooge suffer these maladies? Probably not -- he was ornery as a hooked muskellunge all year long. But the sharp writing of Dickens certainly conjures winter woes.

The holiday blues make you sad. SAD makes you miserable. What are these conditions? Can you shield yourself from them?

Blue at Christmas present
oliday blues, sometimes called winter doldrums or winter blues, is a sadness, but not a depression, that strikes in the fall. The symptoms include "feeling down, having less energy, putting on a few pounds, and having difficulty getting up in the morning throughout the dark, short days of winter," according to the Society for Light Treatment and Biological Rhythms.

These blues may have roots in the holiday season itself, says Lynn Rehm, professor of psychology at the University of Houston, and a specialist in winter blues and depression. "Holidays for the most part, for most people, are happy and enjoyable, but even things that are happy and enjoyable can be stressful. It's a time when people accelerate their activities. ... sometimes overdo it in various ways, overparty, overspend, all of which can be stressful."

It's not just the quantity of activity, but also the symbolism, that can hurt, he says. "The holidays are also something of a milestone for people. We think about where we are in life, look back at the year, make evaluations, and for many people that can be stressful."

During holidays, he adds, we reunite with family, for better or worse. "We have this cultural model of what Christmas, the holidays, are supposed to be like." The ideal was described by Scrooge's nephew in A Christmas Carol. Christmas time, he said,

Most of Christmas past
n the ideal, a big, extended family assembles and finds the company enjoyable, Rehm says. Even disregarding the fact that many families are sundered by geography or divorce, they may never have gotten along ideally. Expectations, as Rehm suggests, can cause stress. "We look at what the holiday ought to be like, see ourselves and our lives as falling short."

Winter blue, or just SAD?
ar more severe than winter blues is seasonal affective disorder. Since the 1980s, SAD has emerged as a legitimate diagnosis -- a type of depression -- with specific symptoms and treatments.

SAD's symptoms may resemble the winter blues, but they are severe enough to interfere with normal functioning, says the light-treatment society. "They often feel chronically depressed and fatigued, and want to withdraw from the world and to avoid social contacts. They become less productive at work and complain that their quality of life has gone. In the extreme, they may increase their sleep by as much as four hours or more per day, have greatly increased appetite -- sometimes accompanied by irresistible cravings for sweet and starchy foods -- and gain a substantial amount of weight."

The symptoms, especially weight gain, increased sleep, and reductions in sexual drive and activity, resemble the seasonal changes experienced in many mammals. Do these seasonal changes and SAD have similar biological roots?

Although the exact cause of SAD is unknown, it is related to the body's clock -- the circadian rhythms that distinguish daytime and nighttime metabolism. A key element in this timing is the suprachiasmatic nucleus (SCN) of the hypothalamus, which is linked by neurons to the eyes, and thus can determine day length and season of year.

SCN neurons increase firing around dawn and slow around dusk, starting a long chain of events that allows animals to adapt to changing day length by, for example, hibernating. At night, more melatonin is produced; this hormone affects the pineal gland, affecting wakefulness, body temperature and other key factors. Some sort of screwup in this mechanism gets the blame for SAD -- while also pointing toward its treatment.

Bright idea
AD, like other depressions, can be treated with anti-depressants. But in light of its cause, short days, it can also be treated with light. The trick of using bright light was recognized long ago in Denmark, Rehm says. "It's been 'discovered' by American psychiatrists and psychologists in the last 20 years, but a student from Denmark said it's always been commonly recognized... The traditional treatment has been sun lamps, so they had this form of treatment 30 to 40 years ago."

Up to two hours' of exposure daily to high-intensity lights, preferably in the morning, seem to reset the circadian clock, an odd treatment that helps many SAD sufferers. Although there are seldom side effects, experts say the treatment should only be started after a diagnosis by a mental-health professional.

For some final thoughts on feeling miserable during the holidays, let's check with an expert -- Ebeneezer Scrooge. Far be it from us to diagnose him as suffering either holiday blues or seasonal affective disorder. But the fella was down, seriously down.

(Did he hear Blue Christmas once too often?) You can too.

Got some brilliant ideas for avoiding that psycho-spiritual morass!

Terry Devitt, editor; Pamela Jackson, project assistant; S.V. Medaris, designer/illustrator; David Tenenbaum, feature writer; Amy Toburen, content development executive

©2001, University of Wisconsin, Board of Regents.