“In the midst of winter, I found there was, within me, an invincible summer.”
-Albert Camus
As the days grow shorter and colder during the winter months, many find themselves feeling down. Initially, symptoms like lack of energy and drive are common, but in many these evolve to blatant apathy, lack of enjoyment,and/ or overt tearfulness and feelings of hopelessness. Often dismissed as “winter blues,” research suggests there are scientific reasons we might suffer from greater depressive symptoms in winter months. Fortunately, evidence suggests that a combined approach of mindfulness techniques and psychotherapy, such as Dialectical Behavior Therapy (DBT), can provide real relief for those with this predilection.
Understanding the Winter Blues
The winter blues are characterized by symptoms similar to depression, however, they emerge during the fall and winter months when daylight hours decrease. It is not uncommon for people to experience episodic, mild sadness, sluggishness, and weight gain during winter. These feelings tend to resolve in spring and summer. However, 10-20% of people experience a more severe form of seasonal depression. SAD symptoms have a meaningful impact on quality of life and are serious enough to interfere with functioning.
Although we do not know the exact cause of SAD, most experts believe it is caused by disruptions in the circadian rhythm, the body’s internal clock that regulates the sleep/wake cycle. Our internal clock responds to external light and dark to regulate the sleep wake cycle, and this may influence the level of certain chemicals in the brain. Some of these chemicals, called neurotransmitters, mediate mood, emotions, affect, and energy level. For example, shorter days stimulate the brain to release more melatonin and less dopamine and norepinephrine, leading to greater feelings of lethargy, poor focus, low motivation and mood instability. Less sunlight signals the brain to produce lower levels of serotonin, a neurotransmitter that promotes feelings of pleasure and wellbeing. Although not everyone is sensitive to these seasonal changes, certain individuals are particularly vulnerable and develop SAD.
The Role of Mindfulness in Managing Winter Blues
The term mindfulness means to bring awareness to the present moment with openness, curiosity, and without judgment. Practicing mindfulness allows you to pay attention to thoughts, emotions, and bodily sensations without allowing them to color your mood and perceptions. Although it feels almost impossible to experience our emotions without being swayed by them in our fast modern world, mindfulness techniques can be used to address the symptoms of SAD. Particularly in New York City (NYC), mindfulness is a powerful tool to prevent you from over-identifying with the barrage of external stimulation and internally generated self defeating emotions. Instead of becoming engaged with negative thoughts, The therapists at The Midtown Practice can teach you mindfulness strategies in person or virtually.
Mindfulness strategies can also mitigate winter blues by cultivating self-compassion. When we feel distressed or down, the natural human instinct is often to become self critical and ashamed. Mindfulness teaches you to see these hard moments as an opportunity to feel kindness and compassion with yourself. Reassurance and patience will help you build resilience and recover from difficult moods more quickly than self criticism and doubt.
How Dialectical Behavior Therapy (DBT) Can Help
DBT is a type of psychotherapy that teaches emotional regulation skills. It is often used to treat individuals suffering from psychiatric conditions marked by negative emotions such as sadness, anxiety, anger, and irritability. The aim of DBT is to give individuals the tools to respond and regulate their emotions and teach them to recognize and modulate even the most intense feelings.
At The Midtown Practice, DBT therapists teach patients coping skills to manage SAD. They work individually and in groups to help patients manage difficult emotions, and make choices aligned with their goals and values instead of their passing negative emotions. Patients learn to strike a balance between acceptance and change, validate negative feelings, and move towards positive change.
How We Combine Mindfulness with Psychotherapy and DBT for Real Results
Integrating mindfulness practices into DBT sessions maximizes the benefits of both approaches. Most DBT therapists open DBT groups and individual sessions using mindfulness strategies. In SAD, these involve learning to engage in cold weather activities, socializing more, creating a cozy space to engage all your senses, and using mindfulness visualization techniques. The latter encourages individuals to see themselves enveloped in a warming and comforting light, which can help patients feel safe and at ease.
As an example, consider the following case study which illustrates how DBT and Mindfulness techniques can help with SAD.
Dan grew up in Florida, but since he was young he had dreams of moving to the Northeast. When he was accepted to a prestigious graduate program in Boston, he was practically giddy with excitement. When he arrived in the fall, he was elated. Graduate school was everything he had wished for and more. He made a ton of friends who shared his similar interests, and was fully engaged academically. He even began to date a new romantic partner. Together they explored the area, attended sport events, and welcomed the fall by participating in a New England tradition, leaf peeping. The fall weather suited him well, and he was delighted to witness the beautiful foliage.
As fall progressed, he began feeling sluggish and noticed he was less excited to attend classes. At first he could push through, but by the end of November, he found it nearly impossible to get out of bed. He fell behind in school, and became less excited to spend time with his peers. His partner tried to help, but Dan lost the drive to reassure her that his mood was nothing personal. Once December came, he barely left the apartment. He began feeling as though winter would never end and that his sadness was permanent.
His girlfriend called his mother, who became worried about Dan. She called the school who referred him to a therapist who specialized in DBT. The therapist diagnosed Dan with SAD, and explained to him the nature of the disorder, and taught him tools to work through his difficult emotions. He learned about cognitive distortions, thinking patterns that can mire one’s perceptions and beliefs about a situation. Through mindfulness techniques he observed himself ruminating that winter would never end, and he would never be himself again. With DBT techniques, he learned to reframe his thinking to be more accurate, clear, and helpful. When he was feeling low, he learned to use DBT and mindfulness strategies such as brisk walking while focusing intently on his feet touching the ground, indulging the senses through smelling fragrant tea or cocoa, wearing cozy textures, or bundling up to go outside to distract himself during low points.
Additional Support and Lifestyle Changes
While DBT and mindfulness form a powerful combination, overcoming SAD can further be addressed by optimizing nutrition, increasing physical activity, and social connection. Interventions such as Vitamin D supplements, light therapy, sticking to sleep routines, making time for hobbies, and joining winter-themed clubs provide additional relief.
If you think you are suffering from SAD, the therapists at the Midtown Practice can assess your symptoms and formalize a diagnosis. Next, we will help you identify and manage your feelings, so you can make choices based on your goals and values, instead of your temporary emotional state. We will introduce you to lifestyle modifications and explore pharmacotherapy when helpful. SAD can feel like an untreatable condition, but in the right hands, you can learn that it is manageable, and begin living a full life in all four seasons.
