Winter depression
Updated onJulia Dobmeier is currently completing her master's degree in clinical psychology. Since the beginning of her studies, she has been particularly interested in the treatment and research of mental illnesses. In doing so, they are particularly motivated by the idea of enabling those affected to enjoy a higher quality of life by conveying knowledge in a way that is easy to understand.
More about the experts All content is checked by medical journalists.When the days get shorter and darker, some people fall into winter depression: They are dejected and listless, have a strong need for sleep and cravings for sweets. Winter depression is a seasonal depression. Year after year it begins in the autumn months and then disappears again in spring. Read everything you need to know about winter depression here.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. F53F39F92F33F34
Winter depression - description
Winter depression is one of the seasonally occurring disorders of the emotional life (SAD = seasonal affective disorder or seasonally dependent depression). As the name suggests, it occurs in the dark season: Winter depression begins in the autumn months and usually ends in spring. During this time, those affected complain of a lack of energy and excessive sadness. They have a pronounced need for sleep and usually have a greater appetite than usual, especially for sweets.
SAD occur much less often at other times of the year (e.g. in summer). Some patients with SAD are also not depressed, but manic. This means that they are inappropriately euphoric, tend to lack distance and overestimate themselves.
Seasonal disorders of the emotional life (SAD) such as winter depression are assigned to the group of "recurrent depressive disorders".
Not all winter depression is winter depression
Of course, people also get classic depression in winter. Only about every tenth depression that occurs in winter is actually true winter depression.
It is estimated that around one to three percent of adults in Europe suffer from SAD, and around nine percent in Germany.
Women are more often affected by winter depression than men. Children and adolescents can also get sick. In southern countries, winter depression is less common. They are more common in the more northern latitudes, where winters are longer and darker.
Winter blues
A more harmless - because clearly weaker - form is the winter blues. Those affected by the blues drag themselves through the dark days without drive and in a bad mood, but they are not really depressed. This milder form is also called sub-syndromal SAD (s-SAD) among experts.
Winter depression: symptoms
The symptoms of winter depression differ in some respects from those of classic depression. People with winter depression are extremely tired and even addicted to sleep (hypersomnia). In the morning, in particular, they find it difficult to get out of bed.
Another typical symptom of winter depression is an increased appetite and cravings for carbohydrates, especially sweets. Therefore, those affected regularly put on weight in winter.
A greater need for sleep and a desire for sweets are not uncommon in winter. Treatment is only necessary when these needs degenerate and become a burden.
Other symptoms of winter depression are:
- Lack of energy
- general listlessness
- Imbalance
- gloomy mood
- Irritability
- Listlessness
- Neglect of social contacts and oneself
Winter depression: causes and risk factors
According to experts, if someone regularly becomes depressed in the dark season, this is mainly due to the changed lighting conditions in winter: Depression in the dark season can be the result of a change in hormone production due to light.
Little light, a lot of melatonin
When it gets dark in the evening and less light falls into the eye, this is a signal for the pineal gland deep inside the brain. It releases the hormone melatonin - people get tired. Since the light intensity is lower overall in winter, more melatonin is released during the day.
In patients with winter depression, the flow of information from the visual cells in the eye to the brain is disturbed. Those affected have visual cells that are less sensitive to light than other people. If light is in short supply in winter, your brain will be stimulated to produce the sleep hormone more than is usual in winter. This could be an explanation for the severe tiredness and the depressive symptoms.
A lot of melatonin, little serotonin
It is very likely that the neurotransmitter serotonin is also involved in the development of winter depression. The body converts serotonin to produce melatonin - the serotonin level drops. This has an impact on the mind, because serotonin is considered the happiness hormone. Among other things, it lifts the mood. Antidepressant drugs that increase the level of serotonin in the brain (SSRIs = serotonin reuptake inhibitors) can therefore improve winter depression.
If the brain lacks serotonin, it tries to compensate for the deficiency: An irrepressible desire for sweets overcomes many people with winter depression. Sugar and some of the ingredients in chocolate help to make more serotonin available to the brain cells.
Adjusted bio clock
The human body follows a biological rhythm. Above all, the sleep-wake rhythm is regulated by the incidence of light in the eye. In people with winter depression, the bio clock is apparently adjusted: the body only releases melatonin late, and production continues at a higher level in the morning hours.
Winter depression: diagnosis
Only a psychiatric specialist is able to differentiate a slight winter blues from a winter depression or a classic depression. Therefore, you should not hesitate to consult such a doctor if you are in a gloomy mood in the cold season.
anamnese
First, the doctor will talk to you in detail to take your medical history (anamnesis). To do this, he asks you exactly about your complaints (type, severity, duration, etc.). He can use special questionnaires to help him better assess the depressive symptoms. The symptoms mentioned above, which recur every year in the dark season, are decisive for the diagnosis of winter depression. The depressive symptoms appear within several winter seasons and subside completely within 90 days.
Other aspects of the anamnesis interview are any underlying illnesses and the use of medication (some preparations can trigger or worsen depression).
Investigations
The anamnesis is followed by a physical examination (taking internal and neurological aspects into account), blood tests, ultrasound (sonography) and, in rare cases, magnetic resonance imaging (MRI) of the head. In this way, the doctor can rule out other possible causes for the symptoms. This can be, for example, a lack of vitamin B12, dementia or an underactive thyroid (hypothyroidism). Various medications can also trigger or worsen depression.
Winter depression: treatment
light therapy
The most important therapy option for patients with winter depression is light therapy, which artificially lengthens the day. To do this, the patient sits in front of a light device with around 2,500 lux for two weeks every day before sunrise and after sunset for a maximum of one hour. Alternatively, a stronger light source with 10,000 lux can be used. Then 30 minutes of light therapy a day is sufficient.
With the help of light therapy, the patient's mood can improve after just a few days.
For comparison: a bright sunny day can shine with up to 100,000 lux.
Medication
Medicinal treatment is also necessary, especially in the case of severe winter depression. Medicines are given that are also used for other forms of depression, especially selective serotonin reuptake inhibitors (SSRIs).
The intake of St. John's wort has also proven itself in winter depression. Because of possible interactions with various other medications, the use should be discussed with the attending physician. In addition, St. John's wort should not be used in combination with light therapy, because the medicinal plant makes the skin more sensitive to light, so that radiation can more easily damage the skin.
Psychotherapeutic support
In addition to light and tablets, psychotherapy can also help. Cognitive behavioral therapy, for example, has proven itself to treat winter depression.
What you can do yourself
During the cloudy months, the body needs as much natural daylight as it can get. This applies not only to people with winter depression, but to everyone. So move around a lot outdoors even in the winter months, for example through:
- To go biking
- jog
- Cross-country skiing or downhill skiing
- Nordic walking
- long walks
Exercising in the fresh air should activate the circulation as early as possible in the day. So go outside in the first hours of the morning. But the winter sun isn't shining right now? That doesn't matter, because even an overcast sky is significantly brighter than any ordinary artificial light source.
A well-structured daily program is advisable - it can also have a positive effect on winter depression.
Winter depression: disease course and prognosis
Most patients with winter depression have a good prognosis, as consistent treatment usually helps. In spring the improvement is announced with an increase in performance and activity, in summer those affected are symptom-free.
After the winter depression has subsided in March to May, there is seldom a fluctuation with a very lofty mood. The transitions to a manic-depressive illness (bipolar disorder) are fluid here. A specialist in psychiatry can differentiate between the various clinical pictures.
If there have already been several seasonal depressive episodes (SAD), the risk is relatively high that the mood will collapse again next fall. The return of winter depression can be effectively prevented with long-term antidepressant therapy (prophylaxis).
Winter depression: prevention
A winter depression can be prevented: Even in the winter months, exercise a lot outdoors to soak up the daylight. You can also start preventive light therapy in autumn if you have suffered from winter depression in previous years. Depending on the severity of the winter depression - as with other types of depression - the preventive intake of antidepressants may also be useful. These are then taken in low doses all year round.
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