Commentary By Andrew M. Miller, MD

Although the holidays bring good cheer, they are followed by the dark, cold days of winter – a season that’s difficult for many. Physiologically, the body responds to the absence of light and colder temperatures by entering a dormant phase characterized by lower energy and a slowing of body systems. Some people also experience low mood during winter. This condition is referred to as seasonal affective disorder (SAD).

SAD symptoms can usually be managed by spending more daylight time outdoors, exercising, eating well and getting enough sleep. However, it’s important to know that some SAD symptoms are similar to those of chronic clinical depression – a more serious condition requiring consultation with a doctor. Generally, chronic depression is characterized by a solid two weeks or more of low mood and/or any combination of these symptoms:

• No interest in engaging in daily activities, low motivation

• Poor concentration

• Appetite loss

• Poor sleep, restlessness

• Thoughts of harm (see your doctor immediately)

If suffering from one or more of these symptoms, visit your primary care doctor. If depression is suspected, your doctor can refer you to a psychiatrist for evaluation. The psychiatrist will review your medical and genetic history and discuss lifestyle and behaviors to determine the cause of your depression. People sometimes experience depression when dealing with loss or personal challenges. Obesity and depression are often closely linked. In this case, the psychiatrist will ask about eating habits and consider this in recommending treatment.

For most, the best way to treat chronic depression is to engage in therapy – clinically referred to as “cognitive behavioral therapy” – with a psychologist/behaviorist (therapist), generally after an initial diagnostic visit with a psychiatrist. Typically, you will be asked to keep a daily journal of mood and activities for eight to 12 weeks. The therapist will use the journal, along with information gathered in therapy sessions, to develop a treatment plan. In addition to recommending therapy for behavior and lifestyle changes, the psychiatrist may prescribe pharmaceuticals, such as antidepressants. When depression is properly diagnosed and treated, people can return to the quality of life they once enjoyed.

Andrew M. Miller, MD, is a psychiatrist specializing in depression and other mental health issues. He is a guest columnist located at Indiana University Health Saxony Hospital, 13100 E. 136th St., Suite 1200, Fishers. Miller can be reached by calling the office at 678-3030.