Science

Get a grip on the dip

Fighting winter woes with light

Short days and long, dark nights lit only by Christmas lights. Many people associate the winter months with cosiness, but for people who suffer from a dip in the winter or full on depression, spring cannot come fast enough. Thankfully, the winter woes can be made bearable. The holy grail? Light.
By Leonie Sinnema / Translation by Traci White and Sarah van Steenderen

Eight per cent of the Dutch population suffers from the winter blues, and for three per cent of people, the side effects are so severe as to be classified as winter depression.

Symptoms of both forms include sleeping a lot and craving sweet and carb-rich foods.

The symptoms of winter depression return each year.

Disruption to the biological clock is a likely cause of winter woes.

For two-thirds of people who suffer from winter depression, there is an effective treatment: light therapy. After a week of treatment, the symptoms are gone for the rest of the winter.

Although the Greek physician Hippocrates asserted that there was a connection between melancholy and seasonal changes, and ship’s doctor Frederick Cook in 1898 spoke of a link existing between light and mood, it was not until 1984 that winter depression was treated as a seasonal form of depression.

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‘BEEP BEEP, BEEP BEEP.‘ You are shaken out of sleep by your alarm clock and sleepily open your eyes. The room is cold and dark. It is really way too early to wake up, you tell yourself. Satisfied with your own reasoning, you turn over and fall back to sleep. An hour later, you are jolted awake once more. You feel exhausted and far from ready to face the day. For more than one in ten Dutch people, this is a daily occurrence during the winter months.

Craving sweet and carb-rich foods
Needing more sleep
Feeling unsociable
Tiredness
Apathy
Less energy
Sombreness
Loss of interests
Symptoms return each winter

Recognise any of the aforementioned symptoms in yourself? That could mean that you are among the eight per cent of Dutch people who suffer from a dip during the winter. Three per cent of Dutch people experience these symptoms every year. They are so severe that they prevent them from functioning normally. These people are dealing with winter depression.

‘The name really says it all’, says psychologist Ybe Meesters, who has been researching the phenomenon for nearly 13 years at the RUG. ‘Winter depression is a form of depression which occurs in the autumn and winter. In the spring and summer, it goes away, only to return the following winter.’

Sleeping and eating

Some characteristics of winter depression, such as tiredness, apathy and no desire to leave the house, overlap with normal depression. Additionally, winter depression also comes with needing more sleep. ‘They can sleep up to four to six hours longer than they do in the summer, but they still don’t feel well rested’, says Meesters.

Another trait is being hungrier, especially for calorie-rich foods. ‘The general population craves sweeter foods in the winter. During Sinterklass and Christmas, we eat a lot more sweet things. But for people who suffer from winter depression, that craving is not limited to the holidays’, Meesters explains.

Complaints of winter depression come from all levels of society, although women and people who are night owls are generally more susceptible to depression. But whereas the ratio of men to women who are just depressed is two to one, when it comes to winter depression, there are three to four women who suffer from winter depression for every man.

The symptoms do not occur at the same point for every person. Some people hate the months leading up to the New Year, while others struggle to make it through the months of January and February. In the Netherlands, roughly 60 per cent of people become patients before the end of the year and the other 40 per cent thereafter. In the United States, funnily enough, those numbers are flipped. Researchers have no explanation for it. And if it snows? That is when Meesters and his colleagues can breathe a sigh of relief. ‘Snow makes people want to go outside, so when that happens, we get fewer patients.’

Causes

Science has not yet been able to explain what exactly causes the winter blues. The Greek physician Hippocrates hypothesised that a link existed between the winter season and depressed feelings several centuries BC (Before Christ). The American ship’s doctor and explorer Frederick Cook (1865-1940) noticed in 1898 that the crew of the Belgica, a ship which had been stranded in the dark, were much more cheerful upon returning after some time by an open fire.

Yet it was not until 1984 that the illness was properly discovered, somewhat by accident. An American scientist who himself suffered from recurring depressed feelings during the winter discovered that an American research team was studying the effect of light therapy on animals. He offered himself up as a test subject and the first experiment about seasonal depression was born.

For a long time, people thought that a disturbance in melatonin production in the pineal gland was a possible cause for winter depression, but scientific research failed to find sufficient evidence to support that.

It is most likely that the depressions and dips in the winter are caused by a biological reaction to the lack of sunlight. ‘Just as with many other depressions, we don’t know exactly how it works in the brain. There are more things we don’t know than things we do’, says Meesters.

The biological clock’s cells are located in the suprachiasmatic nucleus. Light from outside impacts our biological clock via the retina.

Biological clock

The light deprivation in winter impairs the biological clock’s functioning in people with the winter blues. ‘The biological clock is a rhythmic clump of cells’, says Domien Beersma, professor of chronobiology. ‘Even if we isolate those cells and keep them alive in a separate box they maintain that 24-hour rhythm.’

Pupil reaction predicts chance of recurring depression

The more often you have suffered from depression, the larger the chance of regression. Recent American research has shown that dilation or constriction of the pupils is a good indicator of whether someone will become depressed again. UMCG is also studying the relationship between pupil reactions and depression. This investigation goes a step further than the research from American: they are researching whether pupil reactions can predict which therapy can prevent a relapse. Whether this applies to winter depressions as well is unknown. However, research has shown that people suffering from winter depression show a less sensitive pupil reaction after light therapy in comparison to the pupil reactions in healthy people after light therapy.

The cells are located in the suprachiasmatic nucleus, a cerebral nucleus located at the crossroads of the eyes’ nerve pathways. Two forces work together: the biological clock, which functions on the basis of combined characteristics of the various cells and genetic information, and outside light influence. Together, they determine the time of day during which you prefer to be most active.

Light

People suffering from the winter blues mainly have trouble in the mornings. Thank god, then, for that holy grail: light. UMCG has had a special light clinic to treat winter depression since 1987. People who have been diagnosed by their GP as suffering from depression can go there.

As soon as the symptoms start, patients can report to the UMCG. They then come to the clinic every day for a week, where they sit in front of a light box for 45 minutes every morning. ‘We’ve removed the UV radiation and filtered out the flickering of the light’, says Meesters. Although he and his colleagues researched the most optimal proportion of different light frequencies, they could reach no conclusive answer. ‘Therefore, the light is full-spectrum. That means there is some red and some blue in the light, but we experience it as white.’

For two-thirds of the patients, treatment lasting just one week is enough. They suffer no symptoms for the remainder of the winter. How this works is unclear. ‘It’s kind of like we’re nipping something in the bud, or halting some kind of development’, says Meesters.

Solutions also exist for people who suffer from a mild version of the winter blues: to them, light is also essential. ‘People have a tendency to stay in bed longer, but going outside in the morning would actually be a good idea’, says Meesters. That is because 45 minutes after we wake up, our bodies are most sensitive to light. A regular schedule can also help and people who have trouble getting out of bed in the morning can opt to buy a wake-up light. ‘Vacationing in a sunny country is also a good tip’, Meesters jokes. ‘But that might be a bit expensive.’

Tips to sleep better

To get rid of your winter blues, sleeping better and getting up early are essential. Artificial light from television, computers, or mobile phones disrupts our biological clocks. It is best to avoid blue light at night, difficult though it may be. Setting your computer or mobile phone to night mode might a good alternative. That should be a simple action on your phone, and you can download extensions for your computer via your browser’s web store.

There are various apps that can help you sleep better or wake up more easily. Go To Bed (iOS) helps remind you when it is almost bed time. Sleep Cycle (iOS) measures your sleep cycle and wakes you up at the moment your sleep is lightest. Do you have trouble falling asleep? Try Digipill (iOS). The Sleep Deeply module, which is free, helps you relax and go to sleep.

Nederlands

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