Got The Seasonal Blues? You May Have SAD
Seasonal Affective Disorder, or SAD, is a form of depression that occurs in annual cycles due to the change in seasons. It is more commonly associated with the onset of winter; however, there are rare instances where people experience cases of “summer depression”.
“SAD is a very real disorder for people at risk. These would be those with a family history of the disorder, or those who have pre-existing mental health disturbances. It is classified under major depressive disorder and it should be regarded as a form of atypical clinical depression rather than a separate disease entity.” Says Dr Ryan Fuller, MBBCh, MRCPsych, CST, Psychiatry.
It is important to remember that while we are all affected to some degree by the change in season – for example we may eat a little more or tend to sleep longer – individuals with SAD will experience a much greater effect on their mood or levels of energy, to the extent that it has a significant impact on their day-to-day lives.
SAD is of greater prevalence in countries further away from the equator, which experience shorter daylight hours during winter.
What are the Symptoms of SAD?
The symptoms of SAD come and go at the same time every year and are closely associated with a specific season. They are:
- Feeling sad, grumpy, moody, or anxious.
- Losing interest in your usual activities.
- Eating more and craving carbohydrates.
- Gaining weight.
- Sleeping more but still feeling tired.
- Having trouble concentrating.
What Causes SAD?
“There is no doubt that certain individuals have sensitivity to sunlight and suffer with depressive symptoms that impair their functionality, during the winter months, as a direct result of this.” Says Dr Fuller.
While it remains unclear what the exact cause of SAD is, experts link it to the triggering of hormones made deep within the brain which affect mood changes at certain times of year. This is most commonly linked to the brain/body’s response to a lack of sunlight. When our levels of exposure to sunlight are lowered our brain produces less serotonin. Serotonin is important to the neurological pathways that affect mood. Depression is as a result of these pathways not functioning properly.
“There appears to be a link to the hypothalamic–pituitary–adrenal axis. This influences the neuro-transmitters that regulate mood, specifically; melatonin, serotonin and possibly the reproductive hormones in females.” Says Dr Fuller.
Dr Ryan Fuller goes on to explain that a pre-existing psychological disorder will also play a part in whether or not an individual develops SAD:
“20% of people with SAD have bipolar and the reverse is also true. Those with pre-existing psychological disorders will be at a higher risk of developing SAD as most severe and enduring mental health disorders are associated with social isolation and maladaptation to external stressors. These individuals are less resilient and tend to be more brittle such that seasonal change, may trigger depressive episodes.”
How is SAD Diagnosed?
“Known risk factors include; female gender (although men are less likely to develop SAD those that do suffer more severe symptoms than women), 20-40 year olds, and the pre-existence of bipolar disorder.” Says Dr Fuller.
To distinguish SAD from other types of depression your doctor will ask you the following:
- Have you been depressed during the same season, and then gotten better when the seasons changed, for at least 2 years in a row?
- Do you have the symptoms that are often associated with SAD, such as being very hungry (especially craving carbohydrates), gaining weight, and sleeping more than usual? (To a significantly greater extent than those around you.)
- Has a close relative been diagnosed with SAD?
Your doctor will also run a blood test to rule out any other conditions, such as Hypothyroidism. They will then do a mental health assessment to test how well you think, reason and remember.
“Symptoms are only relevant if they are persistent and pervasive. They need to occur on most days during a two week period, at the start of winter, and typically these symptoms need to be evident in different situations in a debilitating fashion in order for a doctor’s visit to be required.” Says Dr Fuller
SAD is most commonly treated with the use of Light Therapy. As SAD is linked to our chemical response to a lack of sunlight, light therapy is aimed at mimicking the affects of sunlight on our body. It modifies our melatonin and serotonin levels, reducing drowsiness and producing an anti-depressant affect.
The therapy consists of a full spectrum bright light that shines into your eyes from about half a meter away. You will begin with 10-15 minute sessions once a day and then progress to 30-45 minute sessions. A doctor may prescribe the treatment twice a day in serve cases. You should not look directly into the light as this will cause your eyes damage.
Some people respond fairly quickly to light therapy, but are encouraged to continue the treatment until the season changes in case the depression should return.
SAD is also treated with anti-depressant medication and cognitive behavioral therapy, on occasion.
What Can You Do Before Seeing A Doctor?
- Start Exercising: This will get you outside where you have increased exposure to light. It will also help to increase your energy levels and reduce your feelings of severe depression.
- Use a 10,000 lux light box when Autumn begins, to prevent the onset of SAD.
- Eat a balanced diet, despite craving carbohydrates, as this will increase your energy levels.
- Maintain social interaction, this is very important in combating depression.
Dr Fuller advice is: Exercise, exercise, exercise…and do so on a daily basis. Exercise outdoors helps to increase your exposure to sunlight. Practice a healthy eating pattern as well. He is an advocate for the Five “Fs” Diet; Fruit, Fiber, Fish, Fowl and Fun. All to help keep SAD away!
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