Kathy Nuzzi is always dressed up. At the grocery store, for a doctor's appointment -- if you see Nuzzi, you see an outfit and full make-up.
"I like dressing," the Emerson resident says. "No matter where I'm going, I'm always dressed up. I didn't do [that] before."
It's been nearly 20 years since the "before," before Nuzzi was diagnosed with seasonal affective disorder (SAD) and began light therapy. Age 45 at the time, she had suffered through the same thing every winter of her adult life.
"I go downhill right after Christmas," says Nuzzi. "I get very depressed. I don't look forward to January, February, March. I kind of just want to hibernate."
Nuzzi considered it part of living in New Jersey until Dr. Susan Zafarlotfi, clinical director at the Institute for Sleep-Wake Disorders, Breath and Lung Institute at Hackensack University Medical Center, diagnosed her and started treatment.
"To some people, I say I use light therapy and they say, 'Ahhh, you're nuts. It's not going to do anything.' But it really does do something," says Nuzzi, who sits the small light next to her make- up mirror and uses it for about 40 minutes a day from October until she feels a lasting high level of spring energy and happiness. "A lot of people think: 'When I retire I'm going to move to Florida or one of the Southern states.' It doesn't have to be that way. You can definitely work with it."
According to Zafarlotfi, the light therapy helps regulate the production of serotonin and the secretion of melatonin. This helps set our circadian rhythms, our internal body clock that regulates our 24-hour cycle. Often, patients first come to Zafarlotfi for insomnia, although she finds many more people are being their own advocates these days and not waiting to get help or dismissing their annual emotional dive as a little case of the "winter blues."
Symptoms of seasonal affective disorder include a pattern of winter depressions (happening repeatedly and at least once in consecutive years), no other non-seasonal depression or psychological problem, periods without depression in spring and summer, fatigue, difficulty focusing, changes in eating, sleep and sex drive.
Like non-seasonal depression it can damage every aspect of your life, which unfortunately can't be put on hold until the calendar turns to April or May. January, February and March can be the worst. The most depressing day of the year is reportedly the third Monday in January.
Yes, that's tomorrow.
Dr. Cliff Arnall of Britain's Cardiff University created a mathematical formula that took into account weather, holiday debt, time since Christmas, monthly salary and reality crushing the motivation and hope ushered in by the new year. The answer to the equation was Blue Monday.
But in the United States that third Monday in January is Martin Luther King Jr. Day. Federal employees or teachers may feel the joy of a day off. For the rest of us, however, not getting the holiday off may add to the problem.
Of course, in reality, February and March can often be the dreariest in this part of the country, and even April when spring weather fails to arrive on our preferred schedule. Each day trekking through the dirtying mounds of snow sinks people a little further into their seasonal sadness.
By Arnall's logic, though, there is good news under these gray skies: Starting Tuesday, things can only get better.
Treatments
Options beyond light therapy for seasonal affective disorder:
Negative ion therapy: This is a relatively new type of therapy but studies have shown that sitting in front of a negative ion generator has the same effect as light therapy.
More light: It's not all about special light boxes. Generally brightening your environment can help as well. Turn on the lights and open the shades.
Diet: Most with SAD crave carbs, often binging and inevitably being left with even less energy and likely overweight, creating many other issues. So limit carbs and avoid foods with pure sugar or white flour, also limit white rice and potatoes. A well-balanced diet high in protein with a variety of fruits and vegetables and limited carbohydrates should help.
Exercise: Getting exercise not only creates more energy and helps with weight issues, studies have shown it helps mood as well.
Herbs, vitamins and supplements: St. John's wort has proven to be a successful anti-depressant. Vitamins D and B may help. Fish oil can help mood and heart.
Winter vacations: Taking a week or two in the middle of January in a sunny climate can do wonders, although the effect may be lost soon after returning, and some type of therapy likely must resume. For some, coming back to the gray actually makes the depression worse.
Watch out for alcohol and marijuana: Both can increase depression.
Stress management: Knowing the time is coming and planning properly throughout the year can be helpful. Also, finding ways to better manage stress during the more difficult winter months is helpful - for instance, using the money spent on going out, socializing or shopping in the summer to hire someone to do some of the least-liked tasks like cleaning or grocery shopping.
Relocate: In extreme cases, relocation to a warmer, sunnier place may be the answer.
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