When the winter blues meets COVID-19 Quarantine Lockdown

I think most people are familiar with the phenomenon of the “winter blues”, whether they often experience it, or find themselves just a bit over the cold and rain by the end of winter, that dreary grey really can start to get the better of you.

Growing up in Perth did not prepare me for what a winter in the Pacific Northwest (PNW) would be like. I had heard it rained….. a lot, and I was warned that if I didn’t take the opportunity to get outside if the sun came out in late January then there was something wrong with me. But it was really, really wet. Perhaps I was mislead by the fact we had a beautiful “fall” with lots of sun?

This winter in the PNW was so wet in fact that all the locals were struggling as well. It rained 28 out of 31 days in January, with a total of 234 mm of rain (source https://www.seattleweatherblog.com/rain-stats/rainfall-2020/). Perth’s average annual rainfall is 807 mm per year (source https://en.climate-data.org/oceania/australia/western-australia/perth-582/). The rain continued throughout most of February and only in March did we start to see a few sunny days. In fact, sometime early in March we had our first two consecutive sunny days since November!

It’s important to note that the rain in the PNW is usually quite different from at home in Australia. It is light to moderate drizzle all throughout the day, the kind where you can get away with a rain jacket, but after a while it is just miserable and the ground is muddy or covered in puddles from the non-stop rain. Whereas at home (in Perth anyway) it will often rain heavier, for a shorter period, often as distinct rand bands/fronts cross the coast. The clouds here in the PNW sit low, confining you like a low ceiling to the point you feel slouchy, cramped and almost trapped (I didn’t notice this until one day where it was sunny and all of a sudden I felt like a weight had been lifted from my shoulders and I felt like I could stand up straight and tall).

View from our balcony on a typical winter day, low cloud, rain, maybe even fog

Sometimes you get teased by a Swiss cheese effect where you can see a tiny spot of blue sky through layers of thick cloud, it is often short lived, showing you just how much cloud is hanging over your head.

Fog and layers of clouds hanging around Orcas Island

The upside to all the rain is snow, and 2020 started off well with decent snow fall. Mt Baker has the world record for the most snowfall in the world, a staggering 29 metres fell in the 1998-1999 season! It had a snow base of approximately 4.5 – 5m for most of February this year. Steven’s Pass was also having a great year with a snow base of a few metres. I would check the forecast and then head out on powder days, usually one weekday plus a weekend (maybe a second weekday if the forecast was really good – it’s a 5 hour round trip drive so it’s quite tiring and I tried not to do it too often).

Beautiful view of Mt Shuksan from the Mt Baker ski area (this was early in the season - it got a lot more snow over January!)

Even the pure excitement of the fluffy powder wasn’t necessarily enough to off-set the overarching winter blues.

A major factor my boyfriend and I noticed was how early the sun was setting prior to the winter solstice – it was dark by 4pm, and “night” by 4:30pm. That reduced “photo-period” really messed us up. My boyfriend even ended up buying Vitamin D tablets to see if they helped with the lousy, lethargic feeling. The video below came to mind, and warning there is swearing in it so maybe don’t watch with sensitive ears around.

I listened to a podcast on “Speaking of Psychology” with guest Dr. Kelly Rohan, from the University of Vermont, who is an expert in Seasonal Affective Disorder, or “SAD” (seriously they couldn’t come up with a better name or acronym?) and learnt a lot, the information below is from the transcript, or the video of the interview can be found here:

Seasonal Affective Disorder is a form of clinical depression that's recurrent. It's major depressive disorder that happens during certain months of the year. The only thing that makes SAD different from general depression is the seasonal pattern that it follows, where people have major depressive episodes recurring predictably in certain seasons of the year.

The end of daylight savings, which takes place in early November, is a pretty big cue that seems to set off the cascade of symptoms. October tends to be a window where the first early onset symptoms start occurring, then they pick up momentum in November, with a lot more symptoms in December. January and February tend to be the worst months.

We don't know what causes SAD. It’s only been researched as a recognized mental health diagnosis since the mid-1980’s. The leading theory or best educated guess about what causes SAD is the hypothesis that it's a slow running biological clock in response to the later dawns that occur, specifically during the winter months.

It’s important to separate cause from trigger. It's thought that the environmental trigger to developing winter depression is a short photo-period (photoperiod is day length, simply the number of hours and minutes between dawn and dusk, sunrise to sunset). There are some studies that show photoperiod is the strongest, most robust environmental trigger for when the symptoms start in any given year, as well as the strongest predictor of how depressed somebody with SAD feels on a particular day during the winter months. There's some evidence for circadian rhythms getting out of sync during the dark days of winter.

Source: Pinterest

There is a nice correlation with latitude and SAD, the further away from the equator you get, the more cases of SAD you find, although it seems to exist at Southern latitudes, but not nearly at the frequency that we observe at Northern latitudes.

The symptoms include feeling persistently down or sad, losing interest or pleasure in things that one would normally enjoy, like hobbies and social activities. A significant change in weight, either weight gain or weight loss, or significant change in appetite, either up or down. Sleep disturbances, which could take the form of insomnia, difficulty falling or staying asleep, or the opposite, called hypersomnia, sleeping too much, which could be at night and or in the form of naps that occur during the day. Feeling pretty persistently tired and fatigued. That seems to be the universal symptom of winter Seasonal Affective Disorder. Difficulty concentrating, clarity of mental focus, holding attention are also symptoms.

Generally clinicians would be looking for at least five of those that are present throughout the day nearly every day, at least two weeks without relenting. The average SAD episode lasts for five months

Pretty much every study that's ever been conducted specifically on Seasonal Affective Disorder has found overwhelmingly more cases amongst women than men. We think that the gender difference in SAD is at least as high as the gender difference in non-seasonal depression, which is two to one to women to every male case of major depression (one study I found in my own research found a ratio of 3:2 women to men – Booker and Hellekson, 1992).

First-line treatments for winter Seasonal Affective Disorder include light therapy, which has been around since the early 1980’s. It was developed specifically as a treatment for winter oppression to try to simulate an early dawn based on the assumption that if we do that, it will jump start a slow running circadian clock and put those circadian rhythms back into a normal phase, more like they are in the summertime. There's lots of research supporting light therapy as a very effective treatment for winter depression, but it isn’t FDA approved in the USA so it’s important to go to a specialist in the field as it can do some real damage if not done properly. Anti-depressant type medications are also used in some cases.

Cognitive Behavioural Therapy (CBT) is a tried and true psychotherapy treatment for non-seasonal depression. It's been around since the 1960’s, and is now more or less accepted that CBT is another effective form of treatment for winter Seasonal Affective Disorder.

Interestingly, in my own research for this article I found a study of a population of Icelanders and their descendants living in Canada and the USA, which found that the prevalence of seasonal affective disorder for them was lower than among the general population along the east coast of the United States – suggesting that the relationship between latitude and SAD is a little more complex than originally thought, and that perhaps there was a genetic adaption in some populations which played a role (Magnússon & Axelsson 1993).

I have been writing and researching this topic over March, and now into early April, as the weather started to clear up I felt like we ran into a new issue; Coronavirus and the travel restrictions, social distancing and stay at home orders.

Now even as the weather improves, our activities are limited. Many people are experiencing rising anxiety levels in relation to the virus, stress of not seeing family and friends (for the social ones, my boyfriend is the ultimate introvert in an “essential role” and so is wishing he could just stay home all day), and the financial pressure for those who have lost their jobs as a result of businesses and industries having to close (and in the USA lack of employment also can equate to loss of health insurance!)

It's so frustrating as my boyfriend and I are only living in this beautiful part of the USA for a short period, and we hate "wasting" weekends at home instead of going out exploring. But, what can you do? These things happen, and it's important to follow the guidelines. It's hard to manage the oscillation in mood between accepting it for what it is and making the best of the situation, with the feeling of missing out, or cabin fever that comes from being stuck at home. Luckily we have a beautiful big back yard and a lovely view to enjoy at home.

There are many resources such as podcasts to help manage anxiety during this period, such as: https://www.apa.org/research/action/speaking-of-psychology/coronavirus-anxiety

It has been a interesting and trying few months, but practicing gratitude and trying not to focus on the negatives is helping. I hope you all can find something, be it a hobby or other, to help keep you mentally and physically well during this period. Look out for each-other!

Amy xx

References:

Booker, J. M., & Hellekson, C. J. (1992). Prevalence of seasonal affective disorder in Alaska. The American Journal of Psychiatry, 149(9), 1176–1182

Kegel. M, et al (2009). The prevalence of seasonal affective disorder (SAD) in Greenland is related to latitude. Nordic Journal of Psychiatry. 63,4, 331-335.

Magnússon A, Axelsson J. (1993). The Prevalence of Seasonal Affective Disorder Is Low Among Descendants of Icelandic Emigrants in Canada. Arch Gen Psychiatry. 50,12, 947–951

Rosen, L. N. et al (1990) Prevalence of seasonal affective disorder at four latitudes. Psychiatry Research, 31,2, 131-144