Our modern lifestyle blurs the distinction between day and night, exposing us to the bright lights of TV and computer screens at night and, with long hours spent indoors, depriving us of exposure to bright outdoor light during the daytime. Many Americans, who tend to spend roughly 90% of their time indoors, may be suffering from an environmentally induced year-round form of the winter blues.
It is not known how many people with diabetes experience the winter blues, but depression — a broader category that encompasses SAD — is significantly more common among people with diabetes than in the general population. It’s not exactly clear why this is the case, and theories abound. Diabetic retinopathy may play a role by reducing the light signal sent to the brain. Both diabetes and depression may see their likelihood increased by a common factor like a sedentary lifestyle. Whatever the cause or combination of causes, people with diabetes have reason to take extra precautions to recognize, prevent, and fight the winter blues.
The good news is that there are effective methods to combat the winter blues and SAD — as well as other, nonseasonal forms of depression. Decades of scientific research have revealed practical steps that can help and that nearly any person can put to use.
Since people with diabetes may experience symptoms similar to those of depression when their blood glucose levels are out of target range or are fluctuating greatly, this is a good area to examine first. Pay attention to whether your low moods, cravings, or feelings of irritability are accompanied by out-of-range blood glucose levels, whether they resolve when blood glucose levels return to normal, and whether they last minutes or hours versus weeks or months. You may also want to talk to your doctor about whether another medical problem, such as thyroid disease, may be contributing to your mood difficulties.
It is also wise to look into whether your symptoms constitute SAD — which requires professional help—or just the winter blues, a milder condition that is likely to respond to self-help measures. A useful self-assessment tool can be found at www.cet.org. (Click here for more winter blues resources.) It is worth noting, however, that people with SAD or full-blown depression are also likely to benefit from self-help recommendations when used in combination with professional treatment.
Let the sun shine
For some people, chasing away the winter blues is as simple as spending more time outdoors. Getting light early in the morning generally provides the best results, but exposure to natural sunlight at any time of day — even on a cloudy, rainy, or snowy day — is likely to provide some benefit. You need not, and should not, look directly at the sun. Consult your doctor before spending more time outdoors if you take a drug or have a medical condition that causes heightened photosensitivity. It helps to emphasize the difference between night and day by dimming room lights and avoiding TV and computer screens before bedtime and by sleeping in a darkened room.
If exposure to natural daylight doesn’t provide enough relief, there are two illumination devices you might want to consider. The first is a light box, a specially constructed desktop device that uses a bank of fluorescent lights to deliver a calibrated amount of light at the correct height, angle, distance, and intensity to provide the maximum benefit. Properly administered, bright light therapy from a light box is a powerful intervention that can alleviate both seasonal and nonseasonal depression, potentially providing as much benefit as antidepressant medicines but usually with fewer and less troublesome side effects.