Shining a light on seasonal affective disorder

Anyone feeling blue during the shorter, darker days of autumn and winter has good reason. People are affected by sunlight or the lack of it, both physically and emotionally.  If long winter months get you down only to feel much better when sunny spring days arrive, you may have a type of clinical depression called seasonal affective disorder or SAD.  The depression of SAD is triggered typically during the winter when night comes early and the weather can be cloudy and bleak.  People with SAD often feel hopeless but is considered more severe and debilitating than simply being tired of winter. 

SAD will go away on its own once warmer, sunnier days arrive but it can last from late autumn until late winter or for a full five months in which you can feel miserable. 

Risk factors for SAD

All of us are at risk of developing SAD but there are factors that can increase one’s likelihood of developing it:

·      Being a woman

·      People who live far from the equator where winter daylight hours are very short

·      People between the ages of 15 and 55.  The older a person becomes, the less the risk of developing SAD.

·      People with family members who have had SAD

·      In the United States, it is more common in the norther regions of the country where the winters tend to be long with less sunlight

·      Having depression or bipolar

It is estimated that between 4% and 6% of the population in the United States suffer from SAD but up to another 10% to 20% may experience it in a milder form. 

How would you know if you have SAD?

You would think that everyone with SAD feels the same way or has the same symptoms.  However, this not true as two different people with SAD can each have different ways of how they feel. 

Here are some typical symptoms associated with winter-onset SAD:

·      Tend to eat more (especially carbs)

·      Winter weight gain

·      Fatigue and feeling unproductive

·      Sleeping more than normal finding it hard to get out of bed

·      Difficulty concentrating

·      Irritability and anxiety

·      Increased sensitivity to rejection

·      Avoidance of social situations

·      Loss of interest in activities they usually enjoy

·      Feelings of guilt or hopelessness

·      Physical problems such as headaches

·      Less physical activity

Surprisingly, there can also be a summer-onset SAD people may develop.  Symptoms of this type can include loss of appetite, weight loss, insomnia, irritability and anxiety, and agitation.

What causes SAD?

The main reason for most people who have SAD is usually related the lack of sunlight as the days get shorter in the fall and winter with a higher frequency of cloudy days.   Reduced sunlight has effects on the body more than we may realize as researchers have discovered.  These factors include the following:

·      Circadian rhythm or our biological clock – When there is a disruption in the amount of sunlight we receive this disrupts our body’s natural rhythms that can lead to feelings of depression.

·      Serotonin levels – When sunlight is lacking, levels of the brain chemical called serotonin, begin to drop which also triggers depression.

·      Melatonin levels – Another brain chemical called melatonin is what regulates our sleep.  The higher the percentage of darkness during the day, the more melatonin we produce making us feel tired and fatigues, both common symptoms of depression.

·      Vitamin D levels – Our main source of vitamin D is from the sun, but if sunlight is infrequent, then we can develop a deficiency of vitamin D.  Lacking vitamin D means we do not produce sufficient serotonin which again can result in depression.

Diagnosing SAD

To get an accurate diagnosis, it is best not to self-diagnosis but to go to your primary care physician.  They can do a physical exam along with lab tests to rule out any other conditions that have symptoms similar to SAD.  They may also want to refer you to a psychologist or a psychiatrist if your symptoms are especially prevalent causing multiple issues.

Treatment of SAD

Fortunately, there are ways to treat SAD that can be effective for many people.  The three main ways to treat SAD are the following:

1.  Light therapy

Since the 1980s, light therapy has been used to make up for the lack of sunlight during the fall and winter.  Light therapy involves sitting in front of a special light box every day between 20 and 60 minutes.  The box emits a bright white light mimicking natural sunlight which causes a change in brain chemicals regulating your mood.

Besides sitting in front of a light box, other light therapies include wearing a visor that emits light or using a “dawn simulator” in which this light turns on early in the morning in your bedroom, mimicking natural sunlight as it gradually increases in brightness.  This allows you to wake up naturally without using an alarm.

There are few side effects from using light therapies other than possible eyestrain, headache, fatigue, and irritability.   Do not rely on tanning beds as a form of light therapy. Tanning beds use ultraviolet (UV) rays which can harm your eyes and can cause skin cancer.

2.  Behavioral therapy

To help identify negative thought, talk or behavioral therapy can be of benefit.  In this type of therapy you will lean to replace negative thoughts with more positive thoughts while helping your learn healthy ways to manage symptoms of SAD.

3. Medication

If symptoms of SAD are severe such as causing suicidal thoughts, your doctor might recommend medication such as Selective Serotonin Reuptake Inhibitors (SSRIs) to treat depression.  Sometimes it can take more than one medication for severe symptoms to subside.

Other ways to treat SAD can include:

·      Opening draperies and blinds letting in as much natural sunlight as possible in your home.  Also sitting during the day next to a window and keeping your environment as bright as possible.

·      Going outdoors frequently.  Even on cold, cloudy days, being outside in the light can help with feelings of SAD.

·      Remain physically active as exercise boosts endorphins relieving stress.