Spring break is here and Chicago weather is stuttering slowly towards brighter days, with a scent of blooming flowers and an explosion of colors and energy. I’ve always liked the beginning  of spring and  childhood memories of march are shadows of  fresh green paving the roads towards school, with my mother’s high hills knocking the streets, and me laughing ,immaturely amazed by the rebirth of life, daring the scent of spring. It’s said that the life begins again every spring and most of us feel energetic, optimistic, ready to live.

 

Every year before spring break , I see, however, a lot of patients with the opposite feelings; more anxious, depressed, irritable, struggling with the “spring melancholia”.

No wonder so many poets voiced the melancholic spirit of  spring, contrasting with the powerful scent of surrounding vitality. Spring talks in emotions and no logic, thus, spring has been perceived as a season of  rebirth but also of ambivalence. Poets of spring combined the joy of  rebirth with sadness and doubt, and associated life with a sense of death. We find a hint of  sadness and depression  in many spring poems of  W Shakespeare, Emily Dickens and Philip Larkin .

There is a known fact that weather affects our behavior and health . Light and temperature seasonal fluctuations impact our sleeping patterns, energy level, appetite, desire to socialize, affecting our mood. Like heart attacks are linked to cold weather and beginning of snow, many other health conditions occur cyclic, in response to seasonal changes.

The phenomenon of mood swings in regards to weather is called Seasonal affective disorder, (SAD) consisting  of recurring depression for short periods of time,  around the same time each year. Typically, they begin in fall or winter and subside in spring. But in about one out of 10 SAD sufferers, the pattern is reversed, with depression returning in the spring or summer. 

Based on the study “Come rain or come shine: individual differences in how weather affects mood.”, – Epub 2011 Aug 15., there are 4 types of emotional response to weather: Summer Lovers (better mood with warmer and sunnier weather), Unaffected (weak associations between weather and mood), Summer Haters (worse mood with warmer and sunnier weather), and Rain Haters (particularly bad mood on rainy days). 

As a cardiologist, I always think of a connection with Heart Disease : depression and anxiety are  known risk factor for Heart attack, mostly in women. Depression – induced  coping mechanisms are also risk factors for Heart disease, in both genders. Think of depressed mood, and sedentary life, fatty ,comfort foods, alcohol consumption. 

Common symptoms of reverse SAD include depressed mood,irritability, restlessness, poor appetite, trouble sleeping, and weight loss.

There are multiple theories trying to explain this reverse pattern of depression, harder to understand than the more common winter’s blues. 

• Allergies and toxins; the change to warmer temperature, blooming flowers and blowing winds trigger allergens with the release of cytokines , which in turn promote inflammation in our body and brain. This heightened inflammatory state is associated with ” a sickness behavior”- somnolence, tiredness, decreased appetite,reduced sex drive, but also  anxiety. Allergy symptoms interfere with a good,  restoring sleep, leading to insomnia, associated with tiredness, irritability. A few researches have found a correlation of spring pollen and an increase in suicides ( 2008, University of Maryland). Also, “the cure for allergies” the antihistamines, can be “worse than the disease”, since they may cause increased anxiety and insomnia.

• The biological clock, circadian rhythm is disrupted by the change in temperature and light, overwhelming our emotional ability to quickly adjust. Some hormones ( melatonin) and chemical neurotransmitters (serotonin) are affected by light , triggering a change in mood. These substances play a role in classical SAD and also in reverse SAD.

• Disruption in schedule.  By definition, human nature is resistant to change, and the more sensible individuals have a reduced ability to adapt; change alone can trigger anxiety, fear, depression. Spring and summer are the seasons prone to disruption in daily routine, with most vacations, time off, and holidays.

• Body image perception can trigger depression in spring and summer, when less layers of cloths are worn, and ” summer body deception” gains more attention. 

How to fight the spring blues

• Acknowledge that you are not alone and this emotional state is temporary. Don’t feel guilty that you are out of step compared to others around. It’s not your fault and guilty feelings would make depression worse. 

• “Lower your expectations” ; many times the conflict between what we expect and what we are and feel is lingering the depression. There is no expectation of you to feel perfect and enjoy a specific time, event, occasion or to “keep up” with the people around you. It is OK to feel down. You don’t disappoint your family, friends, but you should rely on them and have their understanding. You are not sick, you are just moody.

• Avoid being alone and dwelling into the circle of sadness, guilt, depression, deep thinking; avoid your thinking and thoughts, force yourself to be among others, and let them lead the way to social interactions.

• Avoid unhealthy coping mechanism; alcohol, recreational drugs, smoking give a short temporary relief, but worsen the depression and may lead to dependency. 

• Avoid treating yourself, but rather ask for professional help. Psychotherapy and antidepressant medications may blunt the sadness of spring. 

• Remember, even though it’s a cyclic condition, does not have to be present every single year.