Everything to know about Seasonal Affective Disorder for winter in Pittsburgh

Winter has officially arrived in Pittsburgh. With snow blanketing campus and CBS News ranking Pittsburgh the nation’s fourth-cloudiest city, health experts are considering the causes, effects

and treatments of Seasonal Affective Disorder, especially among college students in Pittsburgh.

The National Institute of Mental Health includes in its definition of SAD “significant changes in mood and behavior when the seasons change,” with most symptoms beginning in late fall and early winter and ceasing in the spring and summer.

Jacob Poplawski, a sophomore industrial engineering major, said he started experiencing seasonal depression when he came to Pitt and feels symptoms from around October to February during the season of cloudy and “dreary” days in Pittsburgh. SAD also negatively affects his sleep schedule in college.

“I feel a lot more tired all of the time and then the quality of sleep drops off and then snowballs,” Poplawski said. “But outside of that, it’s sort of normal depression symptoms — not really feeling like doing anything and a lethargic feeling.”

Kathryn Roecklein, a professor of psychology at Pitt and primary investigator of the Roecklein lab, a Pitt lab that studies the disorder, said SAD is not caused solely by the weather. 

“We all go through Pittsburgh winters — that’s not specific,” Roecklein said. “But what is unique is that only about 7% to 15% of us experience depression. So the question then becomes, well, what’s different?”

Roecklein said changes in the environment during the winter months are the leading drivers of SAD, with dawn occurring later and dusk arriving earlier, along with lower light levels in general. She says dawn is important because circadian rhythms track the time of day and seasons by tracking when dawn occurs. 

“In order to sleep well, you need to have your circadian rhythms entrained, or synchronized, with dawn and dusk, and if the environmental light levels are too low, we become desynchronized.”

Roecklein’s lab tracks post-illumination pupil response to study sensitivity to light in determining SAD susceptibility. 

Alison Klevins, a second-year clinical psychology doctoral student who works in Roecklein’s lab, helps in tracking the sensitivity of specific cells in the retina called intrinsically photosensitive retinal ganglion cells. These cells contain melanopsin, which directly projects to circadian systems and has sustained firing in response to blue light. Studying pupil dilation and constriction between those with and without seasonal depression provides the key to understanding SAD.

“You can track the pupil and how it constricts and stays constricted in response to a flash of blue light compared to a flash of red light. If you take the difference of those responses, you can isolate the response of melanopsin,” Klevens said.

Roecklein agreed that the “leading hypothesis” for the cause of seasonal depression is shorter day length, regardless of the region you live in.

Jacob Poplawski, a sophomore industrial engineering major, said he started experiencing  seasonal depression when he came to Pitt and feels symptoms from around October to February during the season of cloudy and “dreary” days in Pittsburgh. SAD also negatively affects his sleep schedule in college.

“I feel a lot more tired all of the time and then the quality of sleep drops off and then snowballs,” Poplawski said. “But outside of that, it’s sort of normal depression symptoms – not really feeling like doing anything and a lethargic feeling.”

To relieve SAD symptoms, Poplawski uses a form of light therapy and also gets outside and exercises frequently.

“I have one of those little bright lights called a daylight lamp, and I typically have it on when I’m sitting at my desk doing work,” Poplawski said. “I’m a Pitt Pathfinder, so I get a lot of steps in when I’m working as well … I also climb a lot around the city, so I make it a point to get out of my apartment and go climb to clear my head.”

Alicia Kaplan, a psychiatrist at the Allegheny Health Center and medical director for the Center for Adult Anxiety and OCD, said it is important to differentiate between SAD and seasonal blues, as a SAD diagnosis has specific criteria.

“It has to interfere with functioning and cause distress … It can often have more atypical symptoms like fatigue, increased appetite, and sometimes increased sleep. Motivation is a big thing — it’s very hard to get things done and focus,” Kaplan said. “To make a pure diagnosis of just seasonal depression and not clinical depression, they have to have had it at least two years in a row during those specific seasons.”

Sarah Souri, a licensed psychotherapist and clinical social worker with a private practice in Wexford, said she often sees symptoms of SAD in her clients. Souri’s work focuses partly on grief and loss, and she said around the holidays, her clients with preexisting mental health issues bring up seasonal depression as well.

“I actually just noticed this week that they’re almost preparing for two to three months of feeling down,” Souri said. “Over the last week and since Christmas, my clients are bringing this up, which is interesting, because I didn’t even think this was much of an issue.”

To ease symptoms, Souri recommends getting vitamin D levels checked. If they’re low, a prescription of vitamin D supplements may help. Souri also emphasized focusing on a healthy lifestyle, including getting exercise, limiting caffeine and sugary foods, and adhering to a healthy sleep schedulefixing your sleep schedule are effective ways to protect from SAD.

“Really pay attention to your sleep-wake schedule and try to get sunlight in the early morning … then avoid bright lights closer to an hour before bed,” Souri said. “Create a nice sleep hygiene for yourself so that you’re winding down and telling your body and brain ‘It’s time to settle.’”

As a psychiatrist, Kaplan often uses medication or cognitive behavioral therapy to help her clients.  

“We’ll look at the stress, thought process and cognitions that go along with suffering from seasonal depression,” Kaplan said. “Sometimes we use serotonin reuptake inhibitors, and sometimes I’ll use bupropion, which is Wellbutrin.” 

Souri advised college students to consider their own needs while “work[ing] with the constraints that you have.”

“Sometimes, college kids don’t have to be up at eight every day for class or for work,” Souri said. “Figure out what works for you and what doesn’t, and think about that when you plan your schedule for next semester so you’re on your own side.”

Though medication is a more frequently chosen treatment, Roecklein suggests light therapy as  a more effective solution to relieving SAD symptoms. 

“There are specific devices that you turn on in the morning and stay in front of them seated, and there’s now light therapy you can use while driving … it’s usually about thirty to forty-five minutes in the morning,” Roecklein said. “Our data suggests that for people with SAD, if they use light therapy, about half of them will recover, compared to people who use antidepressants, where about 40% of them will improve.”

Professional help is also a common solution to easing symptoms of SAD. Klevens noted that the clinical psychology center at Pitt offers psychotherapy services based on the model of cognitive behavioral therapy, admitting both Pitt students and clients of all ages and backgrounds.

“Clients come in with a problem and we develop a goal-oriented treatment plan to improve their lives and relieve symptoms,” Klevens said. “We have resources for brief behavioral therapy for insomnia for anyone with sleep disorders, insomnia, or dysregulated sleep in general.”

Souri also suggested seeking professional help by consulting a psychologist or psychotherapist.

“You can get to some root causes and they will help you with some lifestyle changes,” Souri said. “Then, either your PCP, psychiatrist or medicine manager can help you if you feel like you need to go on medication either temporarily or for a while, to help manage your symptoms until you feel better.”