SHORTER DAYS CAN LEAD TO WINTER OF DISCONTENT

Merry ... oh, whatever.

Someone who says this might not be Ebeneezer Scrooge or the Grinch, but someone grappling with the winter blues, or what is sometimes called seasonal affective disorder.

"Actually, the winter blues is a type of seasonal affective disorder," said Dr. Thad Lake, medical director of psychiatry at Southeast Missouri Hospital. "The symptoms (of the two) are usually similar. It has a seasonal pattern -- same time of year, every year."

Winter blues is considered a milder form and may not have all the symptoms of a clinical depression.

Possible symptoms include: a depressed mood, change in sleeping, change in appetite, loss of interest in usual activities, poor energy, poor concentration, hopeless or guilty feelings, suicidal feelings and change in activity level. A clinically depressed person has at least five of these symptoms, but someone with winter blues may have fewer symptoms.

With winter blues, the symptoms "are more of an associational thing," Lake said. "If the only thing is you've gained some weight, that's probably not something to be too concerned about."

The stronger form of winter blues is seasonal affective disorder (SAD), in which people may have the same symptoms but to a greater degree, resembling a full clinical depression: Life becomes as gray as the cloud cover that blocks the sun so often in November and December, day-to-day problems that other people go through easily seem as uncrossable as the Sahara, making decisions becomes as difficult as solving a nuclear physics problem.

In the extreme cases, thoughts become: What would it matter if I were dead?

There have been several studies to see how many people suffer from SAD. Figures vary from 1 to 10 percent, depending on how far north or south the study is located. Lake said around 5 percent suffer from SAD, and that there are no firm numbers on how many get the winter blues. The psychiatric unit at Southeast does see a rise in the caseload during the holidays, he said, but not necessarily because of any kind of winter blues. This time of year, the holidays from Thanksgiving through New Year's, is simply more stressful than other times of the year -- cooking, organizing family gatherings, trying to get Pokemon gifts, and so on.

Why some people get the blues in the winter is still a mystery. There are several theories -- the less light available in shorter winter days causes changes in the brain and hormone levels, or it causes the body's internal clock to run out of sync, or it changes the levels of the neurotransmitters seratonin and dopamine in the brain.

Whether lack of light is even the cause is up in the air.

"Really the only reason we can say that maybe that's a cause is people respond to bright light therapy," Lake said. "It's kind of circular reasoning."

Look at it this way -- aspirin cures a headache, but is it a lack of aspirin that causes the headache?

Light therapy, or phototherapy, does seem to help milder cases of the blues.

One can find SAD-related lights on sale on the Internet and some catalogs, but it isn't necessary to go to all that expense.

Simply reading in front of two 150-watt bulbs 20 minutes in the morning can help, Lake said, citing some case studies.

"Now that's small studies -- we're not for sure that that works," Lake said. "But they suggest that this is a reasonable thing to try."

There have been bigger studies using bigger lights, he said, but those are the kind of lights most people don't have access to.

One note here: A tanning bed is not the same thing as light therapy; besides, you're not supposed to open your eyes unprotected in a tanning bed because the ultraviolet rays that tan the skin can also damage the retina.

Other things that may help include opening up the drapes to let light in and taking a walk outside on your lunch hour.

"With any type of depression, we always recommend people increase their activities," Lake said. "If they can, get out and walk. It's good for your general health. Anything that's good for your general health can help."

As for the more severe winter blues, "if you're feeling miserable and you feel that life's not worth living and you're having suicidal thoughts, then you really need to get professional help."

"The more severe forms tend to be better and should be treated with conventional treatments, the same things we'd use for any clinical depression," Lake said. That includes antidepressant medications and psychotherapy.

Light may still help those people, he said, but that would only be in addition to the other treatments.

If you are concerned about you or someone you know with the winter blues, you can call the Community Counseling Center at 334-1100 for a referral.