Now that winter is here, how are you feeling? Are you irritable? Depressed? Eating too many sweets? Oversleeping? Dreaming of escaping to a sunny island in the Caribbean?

You could chalk up these feeling to cabin fever. But it may be more than that: It could be that the short days and long nights of our northern winters are making you SAD.

If you notice a pattern of the "blues" beginning around Labor Day and not lifting until way past Easter you may have SAD, "Seasonal Affective Disorder" (or the Winter Blues), a treatable form of depression.

If you are like most SAD sufferers, this time of the year is far from joyful. Winter means dread knowing what lies ahead for you, which could include:

• Depression
• Changes in appetite/weight
• Sleep problems (too much or too little sleep)
• Lack of energy
• Body aches or pains
• Memory loss
• Inability to make decisions
• Problems concentrating
• Feelings of worthlessness
• Lack of interest or enjoyment in activities
• Extreme cases of SAD sufferers may even have suicidal thoughts.

If you experience some or all of symptoms during the winter, you are not alone: 10 million Americans suffer from full-blown SAD and 25 million more have milder symptoms. In New England, over 20% of the population will suffer mild to serious depression over the winter. (Compare that with only 2% of the population of Florida who will have SAD in the winter!).

While 83% of SAD sufferers are women, men and children are not immune from SAD. Children and teenagers, however, may exhibit different symptoms than adults, becoming more irritable with the onset of winter, with frequent crying spells, anxiety, fatigue and lower grades.

While the exact reason why some people get SAD while others are immune remains a mystery, the fact remains that the shorter winter days - and less sunlight - has impact on those that suffer SAD. One hypothesis is that the body's natural rhythms rely on the intensity of sunlight to provide adjusting cues (which originate in the retina in the back of the eye) to regulate our mood, energy, sleep and appetite. In the summer, we wake up with the sun and go to bed when the sun sets (or close to it), so our body's internal rhythms are in sync with the sun.

In the winter, we have to force ourselves to wake up while it's still dark, and we are still awake many hours after the sun has set, which creates havoc for people who are sensitive to the decreased light exposure. With the majority of the population, the decreasing sunlight in the fall is not troublesome. But for those with SAD these changes are profound enough to cause major disruption to their lives.

Winter is not necessarily the only cause of SAD; anyone deprived of regular sunlight exposure - such as those working in windowless offices or factory buildings - can suffer from SAD symptoms. And even in the summer, a series of rainy overcast days can trigger SAD symptoms.

While many people have SAD, most suffer in silence because they do not realize that SAD -- unlike other depressive illnesses -- can be treated successfully without drugs using a bright light therapy.

Aside from escaping our dreary northern winters for a warmer climate (impractical for those of us with jobs and children!) using a light box in the morning is the most effective treatment for SAD, according to clinical studies (published in the Archives of General Psychiatry). Bright light therapy is no longer in the experimental phase, but is considered a mainstream type of psychiatric treatment for SAD; more insurance companies (such as Aetna and United HealthCare) now reimburse for all or part of the cost of a light therapy box.

Light therapy boxes, which are now available in smaller sizes and more convenient to use on your desk or night table, are a florescent full-spectrum light source (minus the harmful UV rays) that delivers an intensity of about 10,000 lux of light (about the light intensity of a spring morning.in comparison, the average room light is about 300 lux). The light intensity of these devices trick the brain into thinking spring has arrived, thereby elevating mood and energy levels.

Treatment with a light box is quick and painless - just about 1/2 hour in the morning when you wake up. Light therapy can easily be scheduled into your home or office routines, such as using the light box while checking e-mail, reading a newspaper, preparing breakfast for your kids, or making phone calls. With daily use of the light box, symptoms of SAD improve within 2 to 5 days. Treatment should continue the entire fall/winter season until mid-spring when the days become longer. Light boxes can even be used during the summer months during long stretches of overcast or rainy days.

Light boxes can be used with little or no side effects to most people. (One warning: tanning beds are NOT considered light therapy devices because they are high in ultra-violet rays which harm both your eyes and your skin.) Most reputable light boxes cost anywhere from $250 to $500. If you feel you have SAD you may want to consider light therapy; light boxes can be purchased without a prescription but a diagnosis by a qualified health professional is recommended, and may be required by your health insurance company for a partial or full reimbursement.

For more information on Seasonal Affective Disorder, visit the following web sites:
   • Dawn's Early Light to Twilight's Last Gleaming . . .
   • Norman Rosenthal, author of Winter Blues
   • Seasonal Affective Disorder
   • Seasonal Affective Disorder from FamilyDoctor.org

ARE YOU SAD? TEN TIPS ON WHAT TO DO:

1. Go outside several times a day. Glance up at the sky (but NOT the sun!) to get the full effect of the daylight into your retina. Try not using sun glasses so often during the winter.

2. Exercise regularly. Skip the indoor gym and take your exercise outside if it's a nice sunny day and not too cold. Take up snowshoeing or cross country skiing. For the less vigorous, simply walk your dog, take your kids sledding or build a snowman - anything to get you out of the house!

3. Try not to hibernate for the winter. Make a goal of three activities with friends and neighbors every month. Fire up your wood stove, light some candles and invite your neighbors and their kids over for hot cocoa. Check your local calendar of events for winter festivals or interesting music venues and gather up your family or call a friend to join you. If your schedule allows, get yourself out of the house by volunteering in a soup kitchen or nursing home.

4. Share your feelings. If you are overwhelmed by your seasonal depression, talk about it with family and friends. Or talk to a counselor.

5. Use vitamin supplements everyday. Get a good multi-vitamin at your health food store. East a balanced diet and to avoid carbohydrates, which can make you feel more sluggish.

6. Get enough sleep. Try to sleep at least 8 hours a day. Establish a regular pattern of going to sleep at a regular time, say, 10 p.m., and waking up at 6 a.m.

7. Consider purchasing a light therapy device, which has been well-documented by the National Institute of Mental Health and leading researchers to help SAD. Once you have one, use it faithfully everyday in the morning for one-half hour.

8. Take a home decorating tip from the Swedes (who are in almost complete darkness all day this time of year): Use bright lights, minimal curtains, and light colored walls and furnishings in your home and workplace to brighten your environment. If you are renovating or adding on to your house, make sure you include some south-facing windows to brighten up your rooms.

9. Stay warm. Although it has not been scientifically proven, many SAD sufferers report that warmth, in conjunction with light, help ease the symptoms of SAD. Turn up the thermostat, wrap yourself up in a wool blanket, sit by the fire, bundle yourself up when going outside.

10. Buy some flowers or force bulbs. You need a daily reminder that spring is just around the corner!

Most importantly, take your SAD seriously. While it may be difficult -- particularly if you have children at home -- to take time to care for yourself during these winter months - it is important you are actively take time to make these changes to overcome your seasonal depression. You may have to tweak your daily routine to fit exercise, spending time outdoors, and sitting in front of a light box. But, together, all these small changes will add up to one thing: You may finally tolerate - or even get to love - a season you used to dread!

About the author: Marcia Passos Duffy is a former SAD sufferer who uses a light box every day to help her weather the New England winters. She is also the publisher of The Heart of New England online magazine. Subscribe to her free weekly newsletter by visiting www.TheHeartofNewEngland.com or by sending a blank e-mail to heartofnewengland-subscribe@yahoogroups.com

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