There has been a bit of a kick back this week against the rather glib idea of Blue Monday, supposedly the most miserable day of the year – but actually a concept made up by a holiday company to sell winter breaks. There are lots of articles pointing out that it isn’t one day – it’s a whole month of being blue – or even a season.

Everyone is SAD

We’ve all heard of Seasonal affective disorder (SAD). The trouble is, it’s also becoming one of those glib phrases we all use – without really knowing what it means.

SAD is a recognised type of depression that comes and goes in a seasonal pattern, beginning as the days start getting much shorter in late October and November, at its most severe during December, January and into February, but then improving and disappearing in the spring.

Though the exact cause of SAD isn’t fully understood, the indications are that it is linked to reduced exposure to sunlight during these shorter winter days, with that lack of sunlight stopping the brain’s hypothalamus working properly; increasing production of melatonin and decreasing production of serotonin; hormones that help regulate appetite, sleep – and mood. It is thought that some people are genetically vulnerable to SAD as cases appear to run in families.

However, there are lots of other things as well as lack of sunlight to get depressed about at this time of year! The weather is pretty horrible – it’s cold and wet and windy outside. Cars don’t start, heating breaks down, roofs leak, pipes burst…. there is a lot to be blue about in the middle of winter – Mondays included.

Money is a huge one. Many of us have that post Christmas come down – but for some it is a crash. More companies go bankrupt in January than any other month – and not just big ones like Carillion. Lots of people overspend on the festivities and then have to face reality. On top of that, tax returns go in this month, so the self employed have to find a huge chunk of money by the end of January as well. Anyone would think that the Taxman does it deliberately!

People are ill in the winter too – and they die. That’s why the NHS struggles to handle things at this time of year – and it’s really depressing to be unwell. Pain is depressing, so those general aches and pains of aging, which feel so much worse in the cold anyway, make you depressed – so all those cancelled non-emergency operations are just adding to the burden of general misery.

It’s all pretty depressing – and there can be plenty of triggers for episodes of depression – but they are not all SAD. The fact is, SAD can be difficult to diagnose because there are many other types of depression that have similar symptoms.

In some ways it doesn’t matter.

If you have any of the following…

a persistent low mood; or

a loss of pleasure or interest in normal everyday activities; or

increasing irritability; or

feelings of despair, guilt and worthlessness; or

a feeling of lethargy (lacking in energy) and sleepiness during the day; or

a need to sleep for longer than normal and finding it hard to get up in the morning; or

cravings for carbohydrates and finding yourself gaining weight

…you are probably suffering from depression and you should consider seeing your GP – especially if you think you’re struggling to cope.

If you are worried about talking to your GP about your mental health, please read this piece on the subject. There really is nothing to worry about. Your GP will carry out an assessment of your mental health with you, asking about your mood, talking about your lifestyle, your eating habits and your sleeping patterns; and they will discuss any seasonal changes in your thoughts and behaviour with you during that assessment.

Of course the problem with SAD is that it may take several years before you can confirm that your symptoms are forming a regular pattern.

A diagnosis of SAD is usually confirmed if…

Your depression occurs at a similar time each year; and

the periods of depression are followed by periods without depression; and

you’ve had symptoms during the same time of year for two or more years in a row.

The National Institute for Health and Care Excellence (NICE) recommends that SAD should be treated in the same way as other types of depression and there are a range of treatments are available.

However, when it comes to SAD the obvious one to try is just getting as much natural sunlight as possible by getting outside whenever you can. There is also light therapy – where a special lamp called a light box is used to simulate exposure to sunlight, although NICE says it’s not clear whether it’s effective. Light boxes aren’t usually available on the NHS, so you’ll need to buy one yourself. Alternatively, if you have the money, of course you could just go on a winter holiday! Perhaps that company that came up with Blue Monday may actually be on to something……

Dr Elin Davies is a Psychiatrist with Psychiatry-UK.