Hygge (hue-geh) is a word that has made its way into the lexicon of people far away from Denmark, the homeland of this borrowed term. The Scandinavian concept of settling into one's environment, snug as a bug in a rug, has great appeal, especially for anyone who lives in a northern clime.A Northern Latitude Issue

Adapting the home to hygge includes soft lighting, candles, lots and lots of blankets, thick socks, and the like. It means breaking up large, airy spaces into smaller, cozy areas that invite intimate conversation and genuine interaction with friends and family. Snuggling together under layers of down comforters to watch a movie, with comfort foods at hand and a hot drink nearby is a physical definition of hygge.

Embracing the wonders of winter takes practice for some, but focusing on the good points (fresh air, outdoor exercise, time to read, natural beauty) and aiming for a sunny attitude when winds blow cold and icicles the size of clubs hang from the eaves may bring a sense of hygge within.

But hygge is not always achievable for the approximately six to ten percent of the population that suffers from seasonal affective disorder (SAD), depression that is believed to be triggered in some people by winter's decreased natural light. Those people whose lives are curtailed during the colder months due to SAD need the empathy of others and expert care. Cozy slippers, macaroni and cheese, and a walk in the woods are not enough to sway the feelings of despair that accompany the start of the winter solstice.

There is no certainty as to what causes SAD. The shorter, darker days of winter and more indoor activities that deprive one of natural sunlight are suspect. Lacking the hours of light that are experienced during spring and summer months can lead to an upset to the biological clock. Sleep becomes disrupted, adding to the feelings of exhaustion that prevent participating in usual activities. Some experts believe that the dearth of light also affects levels of serotonin in the brain, the "feel good" brain chemical.

According to information at mayoclinic.org and webmd.com, SAD's symptoms - desire for carbohydrates, weight gain, general loss of interest, lack of energy, and moodiness - are experienced as cooler weather sets in and linger until spring is underway. It is a problem that recurs every fall for those affected by SAD.

SAD is quite prevalent in the New England region, said Dr Anton Trinidad, chairman of the Department of Psychiatry at Norwalk Hospital. A general study from the 1980s, he said, has since been confirmed, showing that the more north in terms of latitude one lives, the more prevalent are cases of SAD.

SAD can be difficult to diagnose, Dr Trinidad said. He suggested that SAD should be considered as an issue if friends or families notice a change in one's personality; an extreme weight loss or gain; or a reverse or altered sleep cycle. "With classical SAD, people get better as daylight gets longer," and that is the most obvious clue, he said. "And certainly, if anyone starts thinking of death or suicide," professional help is needed.

This seasonal disorder can also run in families.

"It has to do with their biochemical makeup, which is typically genetic," Dr Trinidad noted.

Generally, more women than men find themselves in the grips of SAD, with the onset occurring between the ages of 15 and 55. Living far north of the equator and having a relative who has experienced SAD makes one more susceptible to this seasonally disabling syndrome.

One Newtown woman believes SAD has affected her life for the past decade.

"For at least ten years I have experienced feelings of depression, lack of motivation, fatigue, and irritability during the winter months. I am usually fine until January, after the craziness of the holidays. The severity of the symptoms depends on the harshness of the winter," she shared. "I am particularly sensitive to extremely cold temperatures and prolonged periods of time with no sun, [which] really tend to affect me. I also find myself eating more junk food than I usually would, which is not good."

While never officially diagnosed, she has observed that there are winter days when she just does not want to get out of bed, and will turn down social invitations. "The feelings of being constantly tired add to the unwillingness to get up and out," she said.

To combat SAD, she said, "I try to schedule things to do - movies, getting together with friends - to keep myself distracted and busy... If I could take a vacation, even a brief one for a long weekend in Florida or one of the islands, I so would."

From personal experience with wintertime blues, this resident said, "If you think you have [SAD] and are not inclined to go to a doctor, keep moving. Find a project to keep you busy... cook, read, clean, volunteer, shop, take an exercise class. Make yourself get out of the house; reach out to friends and family. "

This is good advice. Dr Trinidad noted that he usually treats SAD with light therapy, and recommends staying physically active. Light boxes have become more affordable over the years, he said, and spending $100 to $200 dollars on a light box is approximately equivalent to the monthly cost of medications to treat depression. There are instances, however, said the doctor, when medication is the best answer to tackling symptoms of SAD, or used in conjunction with light therapy.

Be proactive to deal with the symptoms of SAD, said Dr Trinidad.

Daily exercise is an important means of combatting SAD symptoms, "and don't stay in bed. Get up - the vertical position of the body actually reboots our system. Open up the shades and face the window," Dr Trinidad advised, even on a gray winter day. Eating something right away, or even drinking a glass of juice is also helpful.

"Digestion," said Dr Trinidad, "tells the body that this is daytime."

SAD symptoms mimic those of other serious depression disorders, so a visit to the doctor to rule out any other reasons for feeling low may be necessary.

The motivation to undertake useful therapies is difficult for someone suffering from SAD. Talk therapy or counseling, though, can be useful tools in moving through the dark, cold months.

"Be aware that this is part of where we live and be proactive," Dr Trinidad urged. "SAD is very treatable. Ask for help when it really gets bad."

Spring will come; and with professional advice when SAD is overwhelming, winter can become just another season in one's life - and practices like hygge can be welcomed with open arms.