While Colorado winters are not what you may envision when thinking of cold, wintry weather, they do tend to have a noticeable effect on people's moods. If ever you feel out of sorts over a beautiful, sunny, snowy day in Denver or the mountains, know that altitude could be contributing. The relationship between altitude and seasonal depression is more interesting, and more worthy of our attention than we've probably ever considered.

Does Altitude Affect Mental Health?

Research into this very subject has yielded enough evidence for us to understand that the link between altitude and depression, is one that is not as uncommon as you might think. For instance, while there may be contributing factors to a person's depression or mental health struggles, such as a lack of resources available to them in rural areas, the altitude itself can act as an added obstacle for those who live in the Front Range region. With the average elevation of the Denver area being 5,280ft, and other places throughout the state peaking at over 9,000ft, we all live and work at incredibly high altitudes in Colorado.

This is not to say that the altitude is necessarily to blame for depression, but only that it can act as a coexisting contributor for those struggling with it.

Altogether, research indicates that altitude may play a surprising role in depression, anxiety, and other mental health concerns. These are important things to consider for both locals and visitors who may find themselves struggling with some of these issues.

Effects of High Altitude on the Brain

When spending time at very high altitudes, the most prominent effects felt are on a physiological level; however, those changes can very quickly bleed into our mental health. In short, the lower barometric pressure seen at incredibly high altitudes means that the air we breathe contains proportionally less oxygen. While it's unlikely for people who live at very high altitudes to experience immediate health effects from this loss of oxygen, sustained time away from sea level can certainly make a noticeable difference, especially in someone who is already struggling with depression. Hypobaric hypoxia, or reduced oxygen levels seen at very high altitudes, has been shown to have an effect on serotonin levels, which contribute heavily to our mood. Researchers suggest that an altitude-related change in the way that your brain produces serotonin could very well be the reason for an increased rate of depression observed in high altitude regions around the world (Kious et al., 2019). On a similar note, high altitude also plays a role in decreased sleep quality and lower than average blood oxygenation levels overnight, which can be especially damaging to the body if you're not accustomed to sleeping at higher elevations (Weil, 2004). Sleep loss and depression have a bidirectional relationship, meaning that one exacerbates the other, and we've written extensively on the importance of good sleep hygiene and its relationship to mental health here. Altogether, high altitude can certainly play a role in making the mental health struggles of those in the state more difficult.

Please keep in mind that none of this is meant to worry you if you're a local or frequent visitor to Colorado! In writing this, we simply hope to illuminate some of the ways in which this struggle manifests for the people of Colorado, as well as provide some information about the ways in which we can combat it. A deeper dive into this specific region's effects on mood and sleep can be found here in Navigating Altitude and Mood , while we discuss both the mental and physical ways in which residents can cope with this challenge. The connection between seasonal depression and altitude is an important one to understand if you want to combat the effects of living in Colorado or visiting the state.

What is Seasonal Depression?

Seasonal depression is a variation of major depression and often exhibits some of the same symptoms. For many people, this can fluctuate depending on the time of year they're in; however, this is much more nuanced than simply "feeling sad" when there isn't much sunlight. As the name suggests, this condition is closely linked to a lack of sunlight exposure as well as the reduction in daylight hours seen throughout the winter months: these have been shown to disrupt circadian rhythms and, consequently, sleep patterns, mood regulation, and countless other physiological processes. As you might imagine, Colorado's climate can contribute to the manifestation of the symptoms of seasonal depression in ways that other states can't; in particular, people here often experience symptoms such as fatigue even when they get plenty of rest, a depressed mood that seems to appear out of nowhere, or even an overall feeling of sluggishness and hopelessness. People often report feeling especially let down after visiting higher altitudes in the state, or if they've just moved from a lower altitude, and this can take a toll on their mental health. As you can imagine, the link between altitude and depression, anxiety, and seasonal depression can be incredibly confusing, especially if you're seeking out treatment. It can be especially confusing for a therapist who has only ever worked with patients who exhibit symptoms of seasonal depression to understand, since there is such an obvious connection between the amount of sunlight and a person's mood. A competent therapist, however, would be aware that the change in altitude takes a physiological toll on the body, so they would be able to work on understanding and treating both issues with greater precision and efficacy. If you want to dig into the ways in which the altitude can worsen your mental state, as well as what you can do about it, check out our piece on how daily habits affect mood and anxiety , as well as our post about mind-body connections and the ways in which they intersect with mental health concerns. You may also be interested to know that all of this applies to children as well. In fact, some symptoms of depression or anxiety can often be mistaken for regular adolescent behavior. If you find that a young person in your life is struggling with something, you might want to take a look at our page dedicated to teens and children and mental health.

Building Resilience in Colorado's Winter

While there is no magic bullet that would reduce the effects altitude has on the body and mind, there are a number of steps you can take to protect yourself against them. For instance, you will want to be extra careful to stay hydrated, since the dry air seen at higher altitudes can cause fluid loss more readily than you might expect. It is also a good idea to ensure that you get sufficient sleep, rest, and even fresh air when you can. Paying close attention to the ways in which altitude affects you and your body when you spend time at higher elevations than you're used to can allow you to better understand your body and react in time if some of the telltale signs of altitude sickness appear. Spending time outdoors can also be a great way to counter some of the physiological effects of higher altitudes on your body, if you're able to do so without putting undue stress on your system. In fact, this is the main reason why we created our Walk & Talk Therapy service : by engaging in conversation while you're outside, you can actually derive some of the physiological and mental benefits of being in such a beautiful place. If you want to learn more about what other ways in which Colorado can benefit your mental health, you may want to take a look at our post about Finding Calm in the Colorado Outdoors.

It can be incredibly difficult to deal with the challenges imposed by the altitude for people who are already struggling with some aspect of their mental health. For some people, this can be an additional challenge on top of an existing condition, such as bipolar disorder or PTSD – if this sounds like you, or if you think that it might, you may want to take a look at our page that overviews all of the conditions we treat . You may also have a number of questions regarding your treatment options and what they might entail, so we encourage you to take a look at our FAQ page.

Every person's struggle with seasonal depression and altitude is different, and there are no hard and fast rules about what you should or shouldn't do about it. Likewise, there is no one-size-fits-all timeline about when things will get better or when you should seek additional help. If you're struggling with any aspect of your mental health, or if you suspect someone you love is as well, our team is always here to listen and help you take the next step in finding relief. We offer individual, couples and family therapy options in both Denver and Lakewood, and even have telehealth options for those who wish to connect with us online rather than in person. We accept most insurances, including Medicaid and select health plans. If you wish to learn more about what we offer, you can take a look at our Insurance & Fees page , and if you want to schedule an appointment, we encourage you to get in touch with us right away!

References

• Kious, B. M., Kondo, D. G., & Renshaw, P. F. (2019). Living high and feeling low: Altitude, suicide, and depression. Harvard Review of Psychiatry, 27(5), 262–275.
• Weil, J. V. (2004). Sleep at high altitude. High Altitude Medicine & Biology, 5(2), 180–189.