For many people who live in the Pacific Northwest, the fall season, with its colorful leaves and cooler temperatures, signals new beginnings and holidays on the horizon.

However, for those who suffer from seasonal depression, autumn and the eventual onset of winter mark the beginning of a struggle because the progressive loss of daylight brings on a low mood and changes in sleeping and eating patterns. More than a simple desire to hibernate, seasonal depression can take a toll on one’s ability to enjoy life.

Light deprivation is believed to be a contributing factor to seasonal depression, as reduced amount of natural daylight (typical of Seattle winters) can affect brain chemicals that regulate sleep patterns and mood.

Norman E. Rosenthal, MD, a researcher and doctor who has struggled with seasonal depression himself, has also written a popular book on the subject, “Winter Blues” (now in its fourth edition). According to Dr. Rosenthal, seasonal depression can show up to a lesser or greater degree in different people. For some, their outlook may get a bit gloomy, and it may be harder to get up in the morning.

Others, however, can have serious symptoms, which may include:

  • Feelings of being “leaden” so that activities that felt easy before can seem like more of an effort.
  • Changes in appetite, especially a craving for foods that are high in carbohydrates.
  • Difficulty waking up in the morning or sleeping more than usual.
  • Irritability and a desire to withdraw from others.
  • Trouble concentrating or not being able to think as clearly.

If you think you may be suffering from seasonal depression, you should seek the help of your primary care physician, especially if you experience any of the following: you feel down and depressed more than half the days of the week for at least two weeks; you have difficulty getting to work on a regular basis; you are irritable or have withdrawn to the extent that your relationships are impacted; or you are having thoughts that life is not worth living.

Your physician may suggest light therapy. One form of light therapy involves use of a dawn simulator, which sets the lamps in the bedroom to illuminate gradually, mimicking the onset of dawn. Another form of light therapy involves a light box. Light boxes deliver light that is intense enough to mimic a walk in summer sunlight. Your doctor can provide guidelines for appropriate timing and dosages of light therapy.

I also recommend several other helpful interventions for seasonal depression, including exercise and a healthy diet. If done outdoors, exercise can also expose you to sunlight. You might also consider cognitive behavioral therapy, or CBT. Your primary care physician can refer you to a psychologist or psychotherapist, who can evaluate your depression and work with you on a plan to help improve your mood.

Although the Seattle area can be cloudy in the wintertime, any amount of natural sunlight can help alleviate the winter blues. Fortunately, there are many public parks to choose from. A favorite is Volunteer Park in Capitol Hill, which has a conservatory, so you can spend part of the time outdoors in an arboretum and part indoors, surrounded by plants and flowers.

Boosting your self-care during the winter months is important. You might visit a spa for a massage or a dose of warmth in the sauna or hot tub. Places like Banya 5 in downtown Seattle or The Hothouse in the Capitol Hill area can help you relax and rejuvenate. Another pleasurable activity is to visit our farmers markets, many of which stay open year-round. The Ballard and Capitol Hill farmers markets both provide a fun, outdoor arena where you can choose vegetables in season.

While the fall and winter months can be prime time to enjoy the indoors, don’t forget to get outside, even if it takes some extra effort. Most of all, reach out if you are struggling, as you are not alone and there is help available.

Jodi Rubinstein, LICSW is a behavioral medicine provider at PacMed’s Beacon Hill clinic. Pacific Medical Centers is a private, not-for-profit, multi-specialty health care network with 150 primary and specialty care providers. Its ten locations are in the Puget Sound neighborhoods of Beacon Hill, Canyon Park, Federal Way, First Hill, Lakewood, Lynnwood, Northgate, Puyallup, Renton and Totem Lake. To better serve its patients, PacMed plans to open a clinic in Lacey in December 2016. PacMed serves patients with commercial insurance, retired military and their families, family members of active-duty personnel, as well as the underserved in our community. www.PacMed.org