Tag depression

In the early 1980s, a researcher at the National Institute of Mental Health (NIMH) named Norman E. Rosenthal noticed that he would grow depressed, each year without fail, at the onset of winter. A sober, scientific individual – he set out to systematically describe and report on this odd, familiar depression that seemed to ebb and flow with the seasons. And although industry experts were initially skeptical of the condition’s existence, Dr. Rosenthal’s work struck a personal chord with many other researchers – many of whom privately struggled with precisely what Rosenthal described, not just their patients – prompting further research into the subject.

The condition, now known as Seasonal Affective Disorder, and appropriately-abbreviated “SAD,” is a well-known feature of life in colder climates. It’s known among clinicians as one of the most common factors implicated in major depressive disorder, which means that SAD is not a separate disorder but a specific type of depression – one characterized by a recurring, seasonal pattern, with symptoms lasting about 4 to 5 months per year, and receding upon the changing seasons. Most people who experience SAD have also experienced at least one other episode of major depression in their lives, and the two are closely related.

It’s best thought of in terms of susceptibility and triggers. Specific individuals are born with different brain chemistry, making them naturally prone to depressive moods. And SAD statistics overlap precisely with those of other forms of depression. It occurs more commonly in women than men and occurs more often in people with pre-existing mental health conditions – especially bipolar type-II, ADHD, and eating disorders. It also seems to have a genetic component, as SAD is more common in people who have relatives with mental illnesses.

But climate remains the best, most-obvious predictive feature. In Florida, about 1.5% of the population reports seasonal mood changes. While in Alaska, a full 10% of the population reports struggling with SAD.

But like depression as a whole, we don’t fully understand the disorder. Research suggests that the culprit is dysfunction within two chemical systems – serotonin and melatonin. The former chemical is responsible for mood regulation, and our body relies on sunlight to create the precursor molecules, or building blocks, of serotonin. The latter is a hormone produced inside the body which regulates our circadian rhythm – again, a function of how much sunlight we get. So, the prevailing theory is that decreased sunlight reduces serotonin and boosts melatonin production, throwing our daily rhythms out of whack. As a result, affected individuals cannot adjust to the dramatic seasonal changes in the length of their day – sleeping longer, eating the wrong food at the wrong times, and falling into a self-perpetuating cycle of insomnia.

But where does this leave us? Fortunately, as with other forms of depression, treatments are available for SAD. In a separate post, I’ll cover some of the typical ways we address depression, as well as SAD-specific tips for beating the Winter Blues.

Exercise is often beneficial to those suffering from mild to moderate depression. Studies suggest that physical activity is, in almost all cases, an essential intervention for treating the disorder. Even modest amounts of aerobic exercise provide a protective, preventative effect against depression and anxiety.

While the psychological mechanisms behind major depressive disorder are not yet fully understood, some studies suggest that it results from impaired neuroplasticity – a term referring to the brain’s ability to create new synaptic connections in response to experience. It’s a sensible conclusion. It seems that the more severe forms of depression tend to coincide with increasingly-reduced synaptic density in the brain. As in, the greater your depression – the fewer electrical impulses your brain can create. But the same studies suggest that exercise can even increase neuroplasticity, above baseline, in healthy subjects, which has researchers seriously considering that physical activity itself might stimulate the growth of new neural pathways.

In cases of mild depression – exercise is one of the sharper tools at our disposal. But I want to emphasize: mild depression.

Despite being one of the most common mental disorders in the United States, depression is complicated and poorly understood. It often involves environmental stressors outside any person’s realm of control, and the severity of symptoms varies greatly – frequently exceeding the reach of holistic treatments. As many as 19 million people – that’s 7.8% of all U.S. adults – have had at least one major depressive episode in their lives. And if you were to ask all these people how they beat their depression? Pills would be the most likely answer. During 2015-2018, 13.2% of all adults in the U.S. used antidepressant medication.

Are they overprescribed? Absolutely. Many disorders resemble depression, or have depression as a significant symptom, thereby escaping treatment. Also, antidepressants are only a form of symptom management – they do not address the myriad environmental causes of imbalanced brain chemistry. But they’re the primary treatment, simply because we haven’t developed anything more effective at pulling people out of major depression in the short term.

Exercise is not a magic bullet. If a person has major depressive disorder to the point that their day-to-day functioning severely diminishes, it won’t have the same effect. Exercise simply doesn’t help push a person out of a major episode. Since depression is both a symptom and a cause of reduced physical activity among adults in the Western world, many people who struggle with depression tend to lose their motivation as time goes by. So, quality exercise becomes more and more challenging to achieve. “Just work out” is often well-aimed, but inconsiderate advice.

And that’s the Catch-22. The best tool at our disposal for fighting a motivation-sapping disorder requires motivation. This is why medication is usually the first thing prescribed by doctors, and not exercise. It tends to produce more robust results, and quickly, requiring no effort from the depressed individual other than following the instructions.

If you’re feeling minor depression with just a few, but not all, of the usual symptoms – you should use exercise first, in conjunction with other non-medicative measures, as a means of improving mood and well-being. At the very least, the side effects are far more manageable in this case.

An exercise routine can be like a parachute during these minor depressive episodes. It can save you, sure. But the longer you wait to pull the cord, the less it slows your fall. And if you wait too long, it won’t help much at all.