With the holidays over, winter weather here, and spring a long way off, many people may not feel like themselves.
For some, it can be a serious problem - Seasonal Affective Disorder - which can complicate other medical issues.
Human beings need sunlight to power the internal clock that regulates alertness, sleepiness, appetite, and body temperature.
When shorter days and longer nights disrupt that clock, people may feel more sluggish or sleepy.
"I hear the term winter blues thrown around a lot," says Dr. Nithya Cherukuru, a psychiatrist at Fox Chase Cancer Center.
But Dr. Cherukuru says it shouldn't be confused with the more serious Seasonal Affective Disorder.
"It (SAD) is really a subtype of major depressive disorder," she notes.
"You're having the same symptoms as those more major mood episodes, but more so in a seasonal pattern that can come typically in winter," she explains.
SAD also interferes with a person's daily functions, including how they care for themselves.
Dr. Cherukuru believes cancer patients in active treatment are more vulnerable to SAD.
"Chemo, radiation, even surgery, or the cancer itself can have different physical effects on the body and can result in sleep disturbances, more fatigue, difficulty concentrating, changes in appetite," she says.
Adding in SAD can hamper treatment or recovery.
Dr. Cherukuru says differentiating between SAD and the effects of the cancer can be difficult, but there is another key difference between the milder winter blues and SAD.
"If there are certain hobbies, activities that they used to enjoy doing, that they're not able to get that same pleasure from, that's a sign," she points out.
SAD patients need extra support, and effective treatments like bright light therapy, antidepressant medications, counseling, taking daily walks, regular exercise, and prioritizing sleep to help ease the symptoms.
"And I think it's important to continue to monitor for mood throughout their treatment," adds Dr. Cherukuru, noting that ongoing emotional distress can lead to more serious mood disorders.
She says patients and caregivers shouldn't ignore SAD, waiting for the change of seasons.
"With each episode that you have, that increases your risk for further episodes in the future," the doctor says.
But with treatments, future episodes can be milder, or avoided entirely. The doctor suggests keeping notes to track symptoms. It can help with diagnosis - and - SAD isn't always in winter.
Dr. Cherukuru believes mental health is as important in cancer care as treatment itself.
And patients shouldn't shy away from taking medication for it.
"Emotional health kind of takes a backseat to all of this, because you're doing so much you're kind of inundated with doctor's appointments, going to the hospital, different medications, more medications than you've probably had to take previously in your life. So adding one more to that, which may not seem like it's at the forefront of your mind or treatment, it's very easy to neglected that as well."