TOM KNAPP | Staff Writer
It's a time to look toward the light.
The shortest day and longest night of the year are just past.
A lot of winter - typically some of the coldest days and biggest snows - lies ahead.
And the bright spots of the holiday season are behind us.
Seasonal affective disorder combines with the post-holiday blues to make January, for many folks, the most depressing time of year.
"Just walk outside," Dr. Susan Jean Atkins, a Lancaster psychologist, urges.
"People are not getting enough sunshine in their eyes. That affects moods. That affects everything," Atkins says.
"More people spend more time indoors now, and they're exposed to different kinds of lighting," she adds. "That plays havoc with our brains."
"The best thing you can do is get sunlight - get out and get as much sunlight as you can," Ken Ruffner, a clinical psychologist with Community Services Group in Lancaster, agrees.
"And get exercise," he adds. "People this time of year feel sluggish - you don't have to have seasonal affective disorder to feel that way. It gets to you when you can't see the sun.
"People feel like they want to hibernate. They shouldn't. Get moving. That will help a little bit."
Seasonal affective disorder - or SAD, an unusually apt acronym - typically strikes in early autumn. The condition can last through spring.
CNN reported in 2011 that 4 percent to 6 percent of Americans suffer from the disorder, most of them women. Theories vary, with some experts saying early January is the worst period for SAD sufferers, while others say late January is harder.
Symptoms, according to Gretchen Gaudioso, a client family advocate and community educator for Mental Health America of Lancaster County, include oversleeping, fatigue, weight gain, hopelessness and lack of interest in things around you.
"Those are the things you have to fight. If you're isolating yourself, make yourself leave the house. If you can't leave the house, reach out to someone. Make a phone call. Send an email," Gaudioso says.
"Instinctually, you don't want to get out of bed, you don't want to talk to anyone because you feel so bad," she says. "Find someone who understands, someone who can push you."
The "post-holiday blahs" make it worse, Gaudioso says.
Ruffner agrees.
"There's all the hoopla gearing up for the holiday. Then it's over and what do you have to look forward to?" he says. "January and February are such grim months."
There's a reason winter celebrations such as Christmas and Hanukkah are filled with lights, Atkins says.
"We're desperate for light. It brings our moods up," she explains.
The letdown is almost inevitable.
"Around the holidays, people tend to be with other people more," Atkins says. "By January and February, the parties are over. People are isolated and alone more. More sedentary. And, because it's colder, people aren't going outside much."
Atkins says civilization developed in sunnier climes near the equator. As people spread toward the poles - and stopped walking everywhere, getting less exercise and spending less time outdoors - seasonal depression arose.
"There's more depression in the extreme northern and southern latitudes than there is around the equator," she notes.
Even so, Ruffner says, the problem wasn't diagnosed until recently.
"Nobody even heard of this until about 30 years ago," he says. "It was about 1984 ... when somebody noticed that this is a recurring problem."
Gaudioso says the problem isn't necessarily getting worse - but more attention is being drawn to the issue.
"It's not that people are suffering from it more," she says. "There's more awareness of depression - you can read about it more often now; people are talking about it more."
Ruffner cautions people against self-diagnosing, though - a little bit of winter depression is normal, he says.
SAD, on the other hand, is persistent and recurs annually.
"For a while SAD was considered a primary diagnosis," he adds. "These days, it's thought of more as a descriptor or specifier for people who have other mood disorders."
That's because SAD tends not to be a stand-alone disorder, Atkins says. It's a seasonal worsening of an existing problem.
"Anybody who has depression, they tend to get much worse as the light begins to diminish," she says. "That begins to happen in the fall.
"Light is the predominant issue, more than anything," she adds. "It's not the cold. We're like plants that way."
"The more sunlight you can get, the better," Ruffner says. "The real cure would be to move closer to the equator."
Some people can treat the problem successfully by sitting in front of a light box - a form of light therapy that simulates the benefits of sunlight and increases levels of melatonin in the brain - for 30 to 60 minutes a day, Ruffner says.
Others need medication, cognitive therapy or counseling, he says.
"It can be very debilitating," Ruffner says. "A person's appetite might be affected, sleep might be affected. They're not getting any pleasure out of things. They're feeling hopeless and helpless and worthless.
"If they're really feeling depressed and they don't have someone to talk to about it, it's probably not a bad idea to get some type of professional help."
There are various strategies for combating the languor that comes along with the winter blues, Atkins says.
"Light is at the top of the list," she says. "People have to expose their retinas to more light. Outdoor light is best.
"People's moods can be boosted simply by looking outside. Open the door and look outside for a few seconds. There are measurable results even with that."
Exercise also helps - anything to get the blood pumping. Atkins suggests combining strategies by exercising outside, even if it's chilly.
"What's really helpful is to get out in the morning - every morning - and walk for a half-hour to an hour. That's the most effective."
The biggest foe here, she warns, is the lassitude that accompanies SAD.
"All the things you don't want to do when you're depressed are the things you need to do," Atkins says. "When people start feeling depressed, they lose their motivation. They don't want to do anything, even things they like to do."
So make yourself do them, she says. In particular, get out and do them with other people.
"You might not feel like you want to be with people, but we need social contact. We need social support," she explains. "Be with positive people, not people who are bringing you down. ... Find people who are uplifting to be with."
Ultimately, Atkins says, people suffering from SAD must act counter to their instincts.
"People don't feel like being challenged when they're depressed, but that's exactly what they need to do," she says. "If you don't feel like getting up, get up. If you don't feel like seeing people, call someone and go out."
Physical touch also is important, she says. "Cuddle up with a dog or cat, or your significant other," she advises. "Give children hugs."
If other options are lacking, Atkins says, schedule a therapeutic massage.
Also, she says, make time to be quiet and contemplative.
"Curl up at the fire with a good book. Look for those cozy kinds of experiences," she says. "Use the time to rest. Let the field lay fallow for a while ... and find your creative energy for the spring."
Stress-management techniques include meditation, yoga and journaling, Atkins says.
Pleasurable activities - music, games, whatever makes someone laugh - and good nutrition are likewise vital.
And do challenging things, she adds - whether it's a daily crossword puzzle or learning a new language.
"Even if it's just making one goal a day, that's something," Gaudioso says. "And make sure you're proud of yourself for it."
