Depression : Don't Suffer with SAD This Winter

John Lundy, Duluth News Tribune, Minn.

-Angela Greenwalt blames Duluth.

"They should give out Prozac at the borders of Duluth," the Harbor Highlands resident said. It's worse in Barnum, Bobbie Mistretta said.

"We live in what they call a moraine," the retiree said. "We get even less sun than in Duluth." Greenwalt and Mistretta are among Northlanders who have begun their annual battle with SAD -- Seasonal Affective Disorder. As the days grow shorter, they're gripped by fatigue and lethargy. They fight back with Vitamin D, exercise, lifestyle changes and specially designed, extremely bright lights.

It's no illusion, said Tom Lewandowski, a psychotherapist at St. Luke's hospital and licensed independent social worker with expertise in SAD. The transition to winter acts as a depressant for many people, and it gets worse as you go north.

"In Florida, the incidence of SAD is about 1.4 percent, whereas in New Hampshire -- which is about the same latitude as Duluth -- it's around 10 percent," Lewandowski said. "It keeps increasing as you go north. It pretty much maxes out when you get to Anchorage and Helsinki (Finland), and it can get as high as 15 percent." Winter blues

Those numbers refer specifically to SAD, a clinical illness that accompanies other forms of depression, Lewandowski said. Many more Northlanders experience some degree of depressive symptoms around this time of year.

"You can have the winter blues, which probably affects 30 to 40 percent of the population," he said. "But usually that is a passing phase, usually at the onset of winter. Then it kind of fades. ... In clinical Seasonal Affective Disorder, that 'Oh no, the season's changing' keeps going and gets more intense." That's how it works for Rachel Bartczak.

"In January and February you go to work and it's dark out and you come home and it's dark out," the Cloquet woman said. "You get through New Year's and there's nothing to look forward to." Bartczak, 30, said she has battled depression since she was in high school.

"When I'm having a really bad day, when I'm feeling slummy, I don't want to get out of bed," she said. "Everything seems to be a chore. Getting dressed is a chore. Taking a shower is a chore." She described stepping into the shower one morning and realizing she didn't know what to do next. "So I went back to bed soaking wet."

The light effect

Bartczak takes on the darkness with artificial light. She uses a prescribed light box in her bathroom while she gets ready for work in the morning. At her job as a legal secretary, she uses a Verilux Happy Light -- not prescribed -- in short bursts to giver her a little extra "pep," she said. She bought it at Walgreens for $30. "I think that it makes a difference," the mother of three children said.

But Marty Sozansky, 65, isn't sure if the therapy light she purchased five or six years ago makes a difference. That's because she uses it as only one part of a full-frontal assault on the winter blahs. She also cuts way down on sugar and alcohol, eats more fruits and vegetables, maintains or increases her exercise and takes 1,000 IU (international units) of Vitamin D daily during the winter.

The battle has gotten harder over the years, she said. "I've lived in Duluth about 15 years, and as I've aged I've had more and more struggles in winter."

Sozansky, an instructor in the Department of Writing Studies at the University of Minnesota Duluth, sits under a non-prescription therapy light every morning during the winter. But she also reads or studies something she enjoys. "That alone seems to start my day better," she said.

Sozansky bought the therapy light for $90 one Saturday morning.

Prescription therapy lights can be considerably more expensive, but they also are covered under many insurance plans. Some research shows they help up to 60 to 75 percent of the people who use them, Lewandowski said. About 30 percent of his patients who use it "have pretty dramatic improvements," he added.

Brain's 'light reader'

The bright light is designed to stimulate a part of the brain that is about the size of a grain of rice, Lewandowski said. The suprachiasmatic nucleus is the "light reader" that takes in light through the eye and translates the information to the pineal gland and the hypothalamus. They are the parts of the brain that regulate the sleep-wake cycle.

"In some animals, that part of the brain indicates when they should go into hibernation," he said. "In other animals, it means store up carbohydrates and eat fats."

But it's not known why the process affects some people more than others, Lewandowski said. It affects more women than men -- by 65 to 35 percent. Among those with SAD, 68 percent have a family history of it, and the families tend to be from northern climates.

Climate is a factor for Mistretta, 64, an Austin, Minn., native who returned to Minnesota after 32 years in Atlanta. She increases her Vitamin D intake in winter and uses a light box. But she is an active person and doesn't like the recommended 30 to 45 minutes of use. "I don't sit for 45 minutes," she said.

m The light Mistretta uses is 10,000 lux, a measure of light intensity. Lewandowski said therapy lights should be in the range of 5,000 to 15,000 lux. By comparison, a standard home light bulb is 300 lux. Direct sunlight can be anywhere from 32,000 to 130,000 lux.

Greenwalt, who grew up on the Iron Range, lived in Kansas City and Las Vegas for most of the 1990s. She found the climate in those sunnier places well-suited to her. Since returning to the Northland in 1998, she has struggled through the winters.

"I kind of have an anti-Duluth body," Greenwalt said.

The 42-year-old administrative assistant uses her light box for up to an hour, takes vitamins and continues to work out at the gym, although she said she almost fell asleep on the elliptical machine the other day. She calls the effect of light therapy subtle. "They really say it works, but it doesn't perform miracles." Mistretta, 64, agrees. There's something that works much better, she said.

"I don't think there's any substitute for a blue sky." ©2011 the Duluth News Tribune (Duluth, Minn.)

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