Whether winter blues or cabin fever, depression in winter months is real in Pittsburgh, nationwide

Jan. 15--When Karen Jardine moved from Virginia to Washington County, more than just her address changed.

It was January 1978 and the Northeast was gripped in what is now called the Great Blizzard with record snowfall and bitter cold temperatures. Pittsburgh had 27 inches of snow on the ground -- surrounding rural areas had more -- and some of it remained for 64 days in a row.

"I never saw so much snow," Ms. Jardine, now 58, recalled.

She was used to sunshine and warmer weather, but she and her husband, Jamie, who moved to Amwell to take a job in a glass plant, began adjusting to life here.

Yet, there was something the young musician just couldn't shake -- not homesickness, exactly, but bouts of depression-like symptoms.

Still, she loved the music scene in Pittsburgh and, before long, was raising three children. But every winter, around February, Ms. Jardine slipped back into the abyss, some days finding it nearly impossible to pass up a bed without curling up in the covers.

"I wanted to sleep more. I was depressed and I turned to comfort food," she remembered. "I never felt like that in my life."

Looking back, Ms. Jardine now thinks she was suffering the initial stages of Seasonal Affective Disorder, or SAD. Similar to so-called cabin fever or the winter blues, the disorder is a type of depression that is related to changing seasons.

Winter-onset SAD is the most common, though sufferers can experience symptoms any time of year.

Those symptoms, which can include low energy, trouble concentrating, feelings of hopelessness and a craving for high-carbohydrate foods, are usually triggered by the shorter daylight hours and decreased sunshine that occur at the same time each year.

The disorder is thought to be caused by disruptions to circadian rhythms -- our biological clock. A drop in serotonin, the brain chemical that affects mood, might play a role in SAD, according to the Mayo Clinic.

The change in season also can increase the level of melatonin in the body, making a person want to sleep more.

To be sure, Pittsburgh can be gray during the winter months, with an average of just three sunny days each in December, January and February. March isn't much better, with an average of four bright days.

Pittsburgh has an average of 59 days of sunny weather each year, according to the National Climatic Data Center -- one more than Seattle. Compare that to Yuma, Ariz., which has 242 sunny days.

While subjective, most climatologists consider a day sunny if 30 percent or less of the sky is cloudy.

"I think Pittsburgh actually has some of the worst changes in the light," said Allegheny Health Network psychiatrist Alicia Kaplan, who sees many new patients suffering from the disorder, especially at this time of year. "I see a lot of worsening psychosocial stress and expectations over the holidays that can aggravate depression, especially if someone has an anxiety disorder."

Psychosocial means the condition relates to a person's psychological development in, and interaction with, a social environment.

Most of Dr. Kaplan's SAD patients are women, which, she said, is to be expected because clinical depression is twice as common in women as in men.

"Definitely women are more sufferers, that's for sure," Dr. Kaplan said.

Nationwide, 3 out of 4 SAD sufferers are women. About 5 percent of the American population suffers from SAD, but that number rises to 10 percent in northern latitudes, according to a study from the University of California at Berkeley.

Registered nurse Deborah Maguire doesn't need a calendar to know that autumn has arrived.

Her symptoms, including a craving for comfort foods such as macaroni and cheese, mashed potatoes and soup, begin every October.

"Once the season changes, it's almost like my energy level totally disappears. I would come home from work and go straight to bed," she said. "It's like being hungry for light."

Ms. Maguire, 59, of Jefferson Hills, began noticing SAD symptoms about 20 years ago. In those days, the largely unrecognized disorder carried a stigma.

"People just thought I was tired," she recalled. "Now that there has been so much more attention brought to it, it has been accepted as a true condition."

Ms. Maguire began seeking professional help for the disorder about 10 years ago, as her symptoms became worse.

Among the treatments that have helped her are dietary charges, exercise and light therapy.

"I eat lots of protein and vegetables, drink a lot of water, and I move," she said. "I walk every night right after work and I try to get outside during lunchtime if the sun is out."

Ms. Maguire doesn't wear sunglasses in cold weather unless she is driving because sunlight must reach the retina of the eye to affect the hypothalamus, a part of the brain that controls circadian rhythms. That doesn't mean people should stare into the sun or bright lights.

"Getting outside and exposure to light is important," Dr. Kaplan said, along with a healthy diet, rest and exercise.

"Schedule a time to meet with friends," Dr. Kaplan suggested. "That social component is important. Schedule something you used to like to do for fun and keep busy. Force yourself to get out there."

Ms. Jardine said she plans activities for each February, which she knows from experience will be her toughest month.

"I plan activities like decoupage," she said. "I know it's coming and I have to make a plan." In addition, she usually plans a vacation in a sunny location near the equator.

She also gets an extra boost from writing music, wearing bright colors and replacing the lights around her -- including fluorescent lights at work -- with bulbs that mimic natural light. She also uses a full-spectrum desktop light each day.

In light-starved Scandinavia, a European energy company installed phototherapy lights in bus shelters, and the town of Rjukan in Norway placed giant mirrors to reflect sunlight onto the town's main square to help combat winter blues.

Closer to home, a Portland, Ore., entrepreneur recognized the importance of sunlight on mood by building a "Lightbar" where people can sip coffee and listen to relaxing music while bathing in light with an intensity of 10,000 lux, the recommended dose for SAD sufferers.

Antidepressant medication, personal light boxes and cognitive behavioral therapy also can be helpful for some severe cases of SAD, Dr. Kaplan said.

She said it's important for those who think they need professional help to get it.

People should seek help, she said, "if they are really having trouble coping and they've talked to loved ones or a friend and they really aren't seeing much of a change or if they are isolating more."

"Sometimes people don't know they can ask their family doctor for a referral," Dr. Kaplan said. "Also, just understand that it's important to be assessed by a mental health professional, and people should know they are not alone."

Janice Crompton: jcrompton@post-gazette.com or 412-263-1159.

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