«Blue Monday», is the third Monday in January really the saddest day of the year?

Blue Monday, as we know, has little that is scientific, even if the discovery of saddest day of the year is attributed to a psychologist from Cardiff University in 2005 (but there would be a marketing operation behind it). Generally it falls on the third Monday of January, so for 2024 we are talking about the 15th. Although it is an invention, There is a real possibility that sadness increases at this time of year. It's cold, the days are short, the holidays are over, we return to the daily routine, perhaps with difficulty: for some this mix can be hard to digest.

Aware of the discomfort

After the end of the Christmas holidays, as in autumn, we see a surge in requests for help from a psychologist. There may be the risk of so-called “seasonal depression”: first of all, it is important be aware of this discomfort, awareness is already a first step. In the most serious cases, it is necessary to ask for help – explains the president of the National Council of the Order of Psychologists, David Lazzari —. We are not machines and we are affected by changes, not only climate changes. Then we need to understand what makes us feel better to counteract this sense of sadness: for some this may be enough a film at the cinema or a show at the theatreFor others it is beneficial to be with friends or practice an outdoor sport. If we can't, it's best to contact a specialist.

Seasonal depression

Blue Monday, although created by design, has the advantage of drawing attention to extremely important issues related to mental health. There is a biological basis linked to light, temperatures and the fact that depression, together with other mental pathologies, has a seasonal trend – he states Claudio Mencaccipresident of the Italian Society of Neuropsychopharmacology, past president of the Italian Society of Psychiatry -. In the Northern Hemisphere the photoperiod, i.e the duration of daily lighting, the lower, therefore the quantity and duration of the light to which we are exposed is shorter. These light/dark rhythms are important for the balance of our psyche.

Sleep or eat more

They also deal with the expenses we incurred during the holidays and, at the beginning of the year, finances can be a little more complicated than usual – adds the psychiatrist -. But it is also a period in which real depression can appear: the further north you go, the more the discomfort is felt (especially among women), in a population generally over 35-40 years old, with even slightly atypical symptoms such as the propensity to sleep or eat more. There is a risk of entering a vicious circlewith eating behavior that leads to carbohydrate hunger and the consequent increase in body weight.

A widespread disorder

In Italy little is said about seasonal depressive disorder, which on the contrary is very widespread. Often the symptoms are characterized not only by a depressed mood but also by slowing down and tiredness, increased appetite and hours of sleep. The seasonal trend is more frequent in females and tends to weaken over time, this is confirmed Giancarlo Cerveri, director of the complex Psychiatry operational unit at the ASST of Lodi. Seasonal depression (in English SAD, seasonal affective disorder) a form that occurs only in certain periods: more often in autumn-winter, rarely even in spring-summer. The main symptoms are
excessive drowsiness, with difficulty waking up in the morning, lack of energy and pleasure in carrying out any activity, depressive episodes, sometimes anxiety (especially in the summer version). The desire to sleep is also associated with the desire to eat more, especially carbohydrates. The most widespread seasonal disorder is in the Nordic countries, where in the cold months the part of the day that is illuminated is significantly reduced.

Recognize the symptoms

Seasonal depression has different symptoms than classic depression, which often causes, on the contrary, insomnia and poor appetite. Seasonal depression has long been considered a mild form of depression, whereas it is a real pathology. In some cases the two disorders are associated, with seasonal worsening of symptoms. Those who suffer from seasonal disorder are perfectly healthy for part of the year, drowsy and depressed when the season arrives. The criteria to define this type of disorder and differentiate it from major depression (without seasonal characteristics) I am:
1) relationship between major depressive episodes and particular moments of the year;
2) complete remission at other times of the year;
3) in the last two years at least two depressive episodes show a temporally similar trend: that is, it is not a single episode but a repeating cycle;
4) seasonal episodes exceed non-seasonal episodes: the subject may present other depressive episodes, but seasonal ones are clearly prevalent.

The role of neurotransmitters

At a biological level, various brain areas and neurotransmitters are involved in the disorder, in particular those responsible for motivation, vital energy and circadian rhythm. Two neurotransmitters, dopamine and norepinephrine, are implicated in how we wake up in the morning and how we activate the brain.. Another hormone, melatonin – which controls the sleep-wake rhythm – could also play a role in SAD: it has been hypothesized that the physiological regulation of the sleep/wake rhythm could be delayed in patients, i.e. the release of melatonin would occur at the wrong times of the day. Finally, serotonin, a neurotransmitter that contributes to the modulation of mood and anxiety, appears to be involved in the genesis of the disorder. Several studies suggest that alterations in serotonin transmission could be directly linked to light.

Light therapy

How is seasonal depression treated? The so-called light therapy, which is carried out through a particular lamp (a medical device) capable of activating the neurotransmitters we talked about. There light therapy effective in patients with mild or moderate forms and with the classic symptoms of excessive drowsiness and carbohydrate hunger. In more serious cases, light therapy must be combined with antidepressant drugs. They have proven to be equally useful cognitive behavioral therapies.

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