Seasonal Affective Disorder (SAD)
Are the winter months particularly hard on you? As the number of hours of daylight decrease, do you find yourself feeling sad, moody, and just not yourself? Do the increased sunlight hours of the spring bring back the old you? You could be experiencing a type of depression called Seasonal Affective Disorder - commonly referred to as SAD. A milder version might be referred to as the "winter blues".
What is Seasonal Affective Disorder (SAD)?
SAD is a reoccurring major depression with a seasonal pattern. Most often people experience symptoms of depression during the winter months - especially during the shortest days of December, January, and February.
Individuals experiencing SAD may experience some of these symptoms:
- Feeling depressed most of the day, nearly every day
- Losing interest in activities you once enjoyed
- Having problems with sleep - often oversleeping
- Overeating, particularly with a craving for carbohydrates
- Social withdrawal (feeling like “hibernating”)
- Feeling sluggish or agitated
- Having low energy
- Feeling hopeless or worthless
- Having difficulty concentrating
- Having frequent thoughts of death or suicide
Who Experiences SAD?
Six percent of the US population are likely to experience SAD in any given year. And, another 14 percent of the adult US population suffers from winter blues. Most develop this condition in young adulthood.
Women are four times more likely to experience the condition than men.
And, those living in the norther regions (where there are shorter daylight hours) are much more likely to experience SAD. While SAD rates in Florida are under 1%, they may be as high as 10-14% in northern parts of North America and Canada.
In addition, someone who experiences winter blues when living in the southern US, may convert into full blown SAD when they move to a northern climate.
SAD is more common in people with major depressive disorder or bipolar disorder. Additionally, people with SAD tend to have other mental disorders, such as attention-deficit/hyperactivity disorder, an eating disorder, an anxiety disorder, or panic disorder.
What causes SAD?
While scientists do not fully understand what causes SAD, it may be related to serotonin or melatonin production - both of which are regulated by sunlight.
Serotonin is a brain chemical (neurotransmitter) which regulates mood. But in people with SAD, reduced activity may result in decreased serotonin levels in the winter.
Some research has suggested that people with SAD produce too much melatonin. Since melatonin is a hormone that's essential to help make us feel sleepy at night, overproduction can increase sleepiness.
Both serotonin and melatonin help maintain the body’s night-day cycle, changes can lead to sleep, mood, and behavior changes.
Low levels of vitamin D may also play a role. That's because vitamin D is believed to promote serotonin activity. While we get some vitamin D from the foods and drinks we consume, most is produced when the skin is exposed to sunlight. But, with less daylight in the winter, people with SAD may have lower vitamin D levels. Read more about Vitamin D HERE.
How is SAD Treated?
If you think that you are experiencing symptoms of depression or SAD, talk to your health care provider or a mental health specialist about your concerns right away.
Treatments usually include psychotherapy, light therapy, and antidepressant medications. Vitamin D supplements can help when low levels of vitamin D are found - be sure to ask your health care provider to check your levels.
Psychotherapy and antidepressants can be useful since negative thoughts and feelings about the winter and its associated limitations and stresses are common among people with SAD.
Light therapy has been a mainstay for the treatment of SAD since the 1980's. The purpose is to expose people with SAD to a bright light every day to make up for the diminished natural sunshine in the darker months. Some studies have shown light therapy to be comparable to those in many antidepressant pharmacotherapy trials.
For this treatment, one sits near a very bright light box (10,000 lux) every day for about 30 to 45 minutes, usually first thing in the morning, from fall to spring. I set mine off to the side, so it shines on the side of my face so I can read or do work without the lights bothering me.
These lights are about 20 times brighter than ordinary indoor light and filter out the potentially damaging UV light, making this a safe treatment for most. However, people with certain eye diseases or people taking certain medications that increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision.
Here's the therapeutic bright light therapy box that I use. It's portable, inexpensive, and provides the recommended10,000 lux treatment in just 30 minutes of exposure. Use it while reading or working on your computer.
Where to Get Help
If you or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK (8255) or the toll-free TTY number at 1-800-799-4TTY (4889). You also can text the Crisis Text Line (HELLO to 741741) or go to the National Suicide Prevention Lifeline website.
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