IF you’ve noticed your mood slipping as the dark nights draw in, be reassured, you are not alone.

Between the months of October to February, up to one in five individuals will suffer with winter blues to some degree. At its worst, this condition is classified as Seasonal Affective Disorder (SAD) with symptoms as severe as those of depression.

Winter blues and SAD share the same features as depression, including low mood, irritability and tearfulness, and a lack of interest in things which usually are a source of pleasure.

Whereas those with depression typically suffer reduced appetite and difficulty sleeping, persons with SAD may find themselves comfort or even binge eating, as well as sleeping excessively. It is often a struggle to get out of bed in the morning. However as spring arrives, persons with SAD may dramatically improve, sometimes within the space of just a week.

We aren’t exactly sure what causes SAD, but reduced amounts of light have been linked to an increase in the chemical melatonin in the brains of those with the disorder. Excess melatonin makes you sleepy. Similarly lower levels of light may also result in a decreased amount of the chemical serotonin, which is involved in controlling your mood, appetite and sleep pattern. First line antidepressants work to promote the activity of this chemical in the brain.

The dark nights may also make you more prone to unhealthy behaviours such as craving comfort foods which leave you feeling sluggish. You may be more reluctant to get out and exercise. Any weight gain can have you feeling guilty and less in control.

It is important not to ignore these signs. If you know you are going to struggle during the winter months, particularly if this is a recurrent issue, it may help to have a plan beforehand.

As with any mental health illness, the basics always apply. Try to get up and go to bed at the same time each day to regulate your body’s internal clock. During the daylight hours, aim to get as much light exposure as you can, for example sitting near a window, or going out for a walk at lunch time. Although it’s tempting to comfort eat, maintaining a healthy diet will make you feel better in the long run. Regular exercise can help, indeed group sports may provide a lot of pleasure. Evidence suggests that regular exercise also gives you better control over your dietary choices.

Light boxes have become quite popular, although they are not currently available on prescription. They work by exposing you to light, ideally early on in the day, typically for between one to three hours, at intensities several times that of traditional light bulbs. If this therapy is going to work for you, you should notice an improvement fairly rapidly, although you would need to continue it daily during the entire winter. If you are really struggling, there is never any shame in discussing it with your GP, especially as winter can sometimes feel like it lasts half of the year in the UK.

ASK DR ZAK

Question: I’m 26 weeks pregnant and I went to the GP with a sore throat last week. He took a throat swab and a blood test and I’ve been told it is glandular fever. Will it harm my baby? Shereen, 32

Answer: Glandular fever is caused by the Epstein Barr Virus, and does not require any treatment. It is more common in teenagers, but can occur at any age. Sometimes it causes jaundice and mild enlargement of the liver and spleen, hence why sufferers are advised to avoid contact sports at the time. However these organs rapidly return to their normal size. You may be left feeling tired for some time, but the Epstein Barr virus does not pose any risk to your unborn child.

Question: My GP enrolled me on a course to reduce the amount of strong painkillers I’m taking. I feel like I’m being accused of being an addict. Anthony; 45

Answer: We are becoming aware that in the long term, strong painkillers including those made from morphine, sometimes referred to as ‘opiates’, are not that effective in treating chronic pain. However, once persons are on such medications, doses are often increased potentially to dangerous levels. Studies show that these individuals are much more likely to come to harm and even die, compared to persons of the same age, who are not on strong painkillers. The aims of the course are not to point a finger, but to give you a better understanding of pain itself, the risks associated with painkillers, and help with reducing your use of them where possible.

If you have a question for Dr Zak, please email: askdoctorzak@gmail.com

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Dr Uddin’s advice is provided in good faith and in accordance with currently accepted evidence. However, this content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should always seek the advice of a GP, or other qualified health provider, regarding a medical condition.