What is Seasonal Affective Disorder?
Seasonal Affective Disorder (SAD) is a type of depression that occurs at the same time of year annually. The more common is the winter depression which starts in the fall and goes through to early spring. Less common is the SAD that occurs in the spring over the summer time. SAD has only been recognized since 1985 and tends to occur more frequently the further away from the equator people live. Incidence is around 5%, with upwards of 20% of people having some symptoms of SAD. It occurs four times more often in women than men, and the average age of onset seems to be around 23 years old. Symptoms can start mild at the beginning of the season and worsen as the season goes on.
Symptoms & Features
A thorough mental health diagnostic evaluation should be sought if you notice the same symptoms come and go away each year in a cyclical pattern for the past two years.
- depressed (sad or empty) mood most of the day,
- hopelessness,
- weight gain,
- oversleeping,
- lowered energy level/fatigued,
- anxiety,
- social isolation,
- indecisiveness or lack of concentration,
- loss of interest in formerly pleasurable activities,
- increased appetite, especially for carbohydrates.
The causes of the seasonal affective disorder remain unknown however some factors have been implicated. Serotonin levels are known to affect depression, and it is believed that reduced sunlight can cause a drop in serotonin. Melatonin levels can also be affected by seasonal changes and have been shown to affect mood and sleep patterns. Circadian rhythms are your natural body clock, and the changes in sunlight could affect your circadian rhythms and result in depression. Risk factors for SAD include being female, living far from the equator, having
low levels of vitamin D, and having a family history of seasonal affective depression.
Treatment
Generally, seasonal affective disorder is treated with anti-depressant medication, psychotherapy, or light therapy (photo light). The best course of treatment for each person is something that can be discussed with a psychiatrist or psychologist at I.P.C. Anti-depressant medications are designed to target neurotransmitter dysregulation, especially serotonin (SSRIs). Although SAD is more of a chemical imbalance, psychotherapy can help focus on negative thoughts and distortions. Light therapy is a specialized box that emits light that is about 25X brighter than normal lights used in a home. It’s recommended people use the light for 30 minutes a day. It seems the quantity, not
the quality (lesser than actual sunlight), of light, is what’s important. Light therapy seems to have no identified negative side effects.
What Can I Do To Help Myself?
If you have many or most of the SAD symptoms or at any time have suicidal thoughts, you should see a healthcare professional immediately. It is important not to ignore symptoms, as this often leads to mild depression becoming moderate or severe over time. In addition, you can read about SAD and its treatment. You can join a support group, try to get outside more, make your environment sunnier, exercise regularly, talk with your physician about melatonin supplements, take a trip in the winter if possible, manage stress, and be social.