Monday, November 14, 2005

It's That Time of Year Again: Seasonal Affective Disorder

by, Deborah Serani, Psy.D.

Question: What is seasonal affective disorder?
Answer: Seasonal Affective Disorder (SAD) is a pattern of significant depressive symptoms that occur and then disappear with the changing of the seasons. SAD has also been called "Winter Depression" or "Winter Blues". The reason for these names is that SAD occurs when days get shorter around November and lasting until Spring.

Question: What's the difference between seasonal affective disorder and other forms of depression?
Answer: SAD is similar to other major depressions in its severity and symptoms; however, it occurs seasonally usually starting in the fall and lasting until early spring. This disorder is cyclical. SAD patients also tend to sleep and eat more compared to patients with other types of clinical depression — usually, depression patients have insomnia and loss of appetite.

Question: How many people are affected by this disorder each year?
Answer: SAD affects millions of individuals worldwide. The illness is more common in higher latitudes, that is locations farther north or south of the equator, because the timeline of darkness is longer.

Question: What are the symtpoms of SAD?
Answer: Symptoms include many of the same symptoms of depression: sadness, anxiety, lost interest in usual activities, withdrawal from social activities and an inability to concentrate. The difference though, is that these symptoms resolve each Spring and tend to occur again in late Fall.

Question: What is the cause of Seasonal Affective Disorder?
Answer: Melatonin, a sleep-related hormone secreted by the pineal gland in the brain, has been linked to SAD. This hormone, which may cause symptoms of depression, is produced at increased levels in the dark. Therefore, when the days are shorter and darker the production of this hormone increases.

Question: What kind of treatments are available?
Answer: Phototherapy or bright light therapy has been shown to suppress the brain’s secretion of melatonin. Although, there have been no research findings to definitely link this therapy with an antidepressant effect, many people respond to this treatment. The device most often used today is a bank of white fluorescent lights on a metal reflector and shield with a plastic screen.

For mild symptoms, spending time outdoors during the day or arranging homes and workplaces to receive more sunlight may be helpful. One study found that an hour’s walk in winter sunlight was as effective as two and a half hours under bright artificial light.

If phototherapy doesn’t work, an antidepressant drug may prove effective in reducing or eliminating SAD symptoms.

Daily exercise has been shown to be helpful, particularly when done outdoors. For those who tend to crave sweets during the winter, eating a balanced diet may help stave off SAD.

Question: How Do I Seek Treatment for SAD?
Answer: If you have noticed a pattern to your depressive symptoms, make an appointment with your physician and bring this to his or her attention. Medical tests and exams should be up to date to rule out any other reason for depressive symptoms. Thereafter, a consult with a psychologist, social woker, psychiatrist or psychopharmacologist so that together you can formulate a treatment plan with light therapy, medication, talk therapy or a combination of them.

Seasonal Affective Disorder Association:

Society for Light Treatment

The Circadian Lighting Association:


CrackerLilo said...

I discovered that I get it in NYC last year! (Living in Florida, it just didn't affect me very much--there's always light.) I see the true value in the Pagan Winter Solstice celebration now. It's celebrated on the shortest day of the year, to remind us that more light is coming, and in many parts of the world, you desperately need to know that. I use lots of light and bright colors, look for natural beauty (I love the beach in winter, and go there a *lot*), and try to enjoy peculiarly *wintery* pleasures like snuggling under the blankets and wearing fuzzy socks.

I n g e r said...

Did you ever see that flick with Al Pacino and Hilary Duff? Both detectives--he travels to the northern part of Alaska to help solve a crime, and it's midnight sun time--no darkness ever? He almost goes mad, from the flip side: no darkness, no restful sleep. Not the greatest movie, but the phenomenon is fascinating.

Theo said...

so, that explains it.

Cathy said...

who knew that I could blame my craving for sweets during this season on something other than their tastiness:) Seriously, though. Thanks for this, Dr.Deb. I can't imagine how terrible this must be for those who suffer through it.

Dr. Deborah Serani said...

Dear Crackerlilo,
I also like the beach in the wintertime and enjoy the wintery pleasures too. They are so comforting. Color and brightness *do* help a great deal in the parts of the world where dark and coldness abound.

Dear Inger,
I remember that movie "Insomnia". Robin Williams was creepy in it. It is a good contrast to point out!

Dear Theo,
Aren't insights great? I like that A-ha moment when something makes sense.

Dear Cathy,
I think my mood can take a downward tilt during the winter months. I fill my home and office with light and color to help keep vibrancy and vitality. Good reasoning there on the sweets. :p


Heidi said...

I've heard that November has the highest rate of depression/suicide...Most prob due to Seasonal Affective Disorder..

SAD for short..How ironic.

scrappy rose said...

thanks again for sharing your wisdom with us...I wish we could hear about you, about some blogs about your day or what really drives you crazy or makes you happy, happy, happy...

A Flowered Purse said...

I actually have SAD but it doesnt get really bad til mid december. I always expect it like clock work!
Thanks for that article :o)
I am gonna check into getting one of those lamps one day!!

Anna Mason said...

hey...I need one of those light things. I'm pretty much depressed all the time, so can't specifically relate to the sadd....and the early darkness is kind of comforting. Anyway, hope you are doing well.

Shirazi said...

I am better prepared to combat depression now. Thanks.

Jackie said...

Heck......I think you visit my blog as a case study!!!!

I do find that when I visit MOA,(Mall of America) with the huge indoor theme park, it tends to help when I am really blue. (They pump in warm air and fake is great)

I also think that there is just such high anxiety around the holidays.......heck a totally sain person can become a bit blue!!!!!

Love and Hugs,

just one of many said...

SAD sucks...our pdoc (np) suggested a light box just the other day...I am looking into it.

I posted a question for you on your question and answer post.

Pewzen said...

Seasonal depression is well known up here in north; in Norway the Winterland! This year we have no snow yet.

With me it`s opposite: I use to be depressed spring/summertime. I do`nt like warmth and light nights at all.

I`m thankful for that we humans are all that different!

Colleen said...

I hope this doesn't sound stupid - but - I seem to have the opposite of this disorder! I always get depressed in the summer, especially in the month of August.

Once October comes, my mood starts to get better - and continues to be good through Christmas. In late February - my mood starts to come down again.

I guess I'm a true oddball!?!

kath said...

I don't think I have this.. I love the fall .. the soft greyness of winter. It makes me feel, somehow.. and gives me an excuse to stay home and just be .. with my furkids and a book or movie.. or nothing

i love the way the darkness folds itself around me and I feel like i can hide there forever. ( but sometimes, it is a lonely place, too .. the dark.. )

And I admit that those first days of warm sun on my face.. my back.. are welcome.

Jessie said...

One tip on using the light: don't use it as an alarmclock.. when you wake up..
Nothing ruins your day as waking up with your head in a neonlight :S

Jon S. said...

The winter can be a battle sometimes, but I find that if I can get out of doors for an hour or so each day during the daylight, I feel much better. Entering and leaving work or school in the darkness will make anyone go a little SAD, try getting outside if you can.
Thanks for the post Dr. Deb. Drop me an email if you can,, I have a question for you. Thanks!

Dirk the Feeble said...

It's a depressive disease with the abbreviation "SAD." That's kind of . . . . uh, unhappy.

Dr. Deborah Serani said...

Dear Heidi,
I call it by its long name, and do find the abbreviated terminology ironic too.

Dear Scrappy Rose,
The post before this was a tag post, and I also have a 7 MeMe in the archives. Check em out for more info.

Dear Dianna,
Amazing how our bodies work, isn't it?

Dear Anna,
Many people like darkness. It makes them feel safe and blanketed. I like the light and the sun, but can really enjoy the colder kinds of days were colors are washed out and days are shorter. I live under blankets, read lots of books, listen to my cats purr and drink tea.

Dear Shirazi,
Every little piece of knowledge helps, right? So glad this post was helpful. Hope you are well.

Dear Jackie,
My hubby loves the Minnesota Vikings and has been to your state cheering them on many times. He felt the same way about the MOA as do you.

Dear Sera, One of Many,
I don't know how much the light boxes are, but there are versions of them, even visors that have the light built into the cap. I'll check out your question.

Dear Pewzen,
SAD can occur in the summer seasons, though it is more rare. Like Inger posted, too much light at night can throw ourselves out of rhythm the move "Insomnia". I have never visited Norway. It must be a beautiful country!

Dear Colleen,
Like I just said above, SAD can occur in the summer months, but is more rare. You are not an oddball, LOL.

Dear Kath,
As I mentioned above in the comments, a lot of people enjoy the winter, darkness and even the cold for the very same reasons. I guess the key is to balance it all, right?

Dear Jessie,
I guess that could be true.

Dear Jon,
Getting out always helps me feel better, no matter the weather. Something about nature, fresh air and all. I'll email you ASAP.

Dear Amaedes,
There are soooo many psychological Faux Pas when it comes to naming things. I agree, it is kinda weird.


ellesu said...

Ummmm, since I'm eating and sleeping up a storm, I guess I'm not depressed. Ever since Katrina I find myself constantly eating. And....I'd done so good on Weight Watchers back during the summer....

Down where I live, we get plenty of light all year long --usually. But, I can remember a couple of years when we had some really cold winters. It didn't take but a few of those dark, dreary days for me to realize how quickly one could get cabin fever.

ByeBye said...

I thought this was the best time of the season for lovers? most babies are created this time of the year so why the depression? I must be missing something. I also know this is the worse time of the year for singles.

just one of many said... regards to your answer to my question...fair enough. My T is very aware of the situation and is a tremendous help. I think perhaps I phrased my question unclearly...I'm looking for ideas on how to make my blog safer. However I think I found a way. At least a way that might help.

Rose said...

This is great information. With your permission I would like to use this and I will give you credit and include your link to your blog. I think this is great information to share. I wrote a small piece on depression for the holidays but this is really good information, deeper.

just one of many said...

Deb...I have moved my blog can you please email me and I will give you the new link...I want to wait a bit before making comments with the new name and link, incase the person I don't want reading my blog has followed me here.


Dr. Deborah Serani said...

Dear Ellsue,
You, and so many there in the Gulf Coast, are experiencing Post Traumatic Stress Disorder and Traumatic Stress reponses. If I were living there, I'd been grabbing and eating comfort foods all the time. It is really very normal for you and others to lean on such "comfort" behaviors in times of disaster and death. Give yourself time to heal.

Dear Envizable,
The cold and the darkness are great ambience for hookups, no doubt about that. I guess there's room for many kinds of experiences around this time of year!

Dear Warrier,
I don't know how to make a blog safer save for starting a new one and making it more anonymous.

Dear Rose,
Feel free to use whatever info you find helpful. There are really wonderful sites on the internet to about Seasonal Affective Disorder.


Michelle said...

I have a co-worker that suffers from this and she is using phototherapy as treatment. Walking in her office feels like walking directly across the is soooo bright, but apparently it works! During the day, she doesn't appear to suffer from depression.

Even though I know someone with SAD, you never know how they will be if you ask lots of questions. When I initially asked about the bright light she told me about what she was dealing with and I wanted to know so much more but didn't ask. Thanks for giving us a closer look at this disease.

p.s. On a previous response to one of my posts, you mentioned you were reading my book!! Thanks for the support. I hope you won't think I need therapy after reading it. :-)

Be blessed.

Nancy said...

Hey Deb. You are right, I do have a narcissistic neighbor!

GOM has SAD. His mother identified it when he was a little boy growing up in NYC. She didn't have a name for it, but she recognized it. He has one of those lamps at the office and recently got it out, at my suggestion.

The lamp does help a lot. Amazing really.

Great post as usual!

Deb S. said...

Excellent post. The links are also good resources. It seems as if a lot more is known about treating SAD now, compared to 20 years ago when I wrote a news report on this topic. Thanks for such thorough information, Deb.

Groove said...

My mother calls this the "Winter Blues" This explains what she was talking about.

Dr. Deborah Serani said...

Dear Michelle,
Your writing is fantastic as are your characters. No therapy needed. You are fine getting all your "issues" out on paper. I'm getting mine out as well with a first draft fiction book.

Dear Nancy,
It is probably really good the GOM moved to the West Coast where the sun and milder temps occur more. The light therapy has helped MANY people. So glad it offers good things to your hubby.

Dear DCS,
You were ahead of your time! So much more information can be shared with all of the technology at our fingertips. Your writing about it 20 years ago probably helped a great many people!

Dear Nu Groove,
Winter Blues, yup, it is also called that too. Another smart Mom!


Anonymous said...

I want you to know how much I appreciate your blog. There is always something new and informative and it's just cool. Thank you so much for sharing with me...and all of us. Peace.

Dr. Deborah Serani said...

Hey Traci,
Your words are so nice to read! Thank You!


Blogzie said...

And here I thought it was just called 'Winter.'

Living on the West Coast this really isn't a problem for me.

I pretty much feel just as lousy in the winter months as I do all year long.

Fallen Angels said...

In the northern part of the west coast it is a problem...all that rain and gloominess.

dawn said...

thanks for the info, dr.deb. i think the 1st time i read anything about SAD was like 6 years ago, and it wasn't much. this is very informative, and i'm sure will help many :) hope you have a great weekend, everybody!

astrorat said...

hai.. enjoyed reading your post! i think that you might be interested to hear (quite logical too), that SAD is virtually not heard of in Asia! i confirmed that with some of the clinical staff from my uni faculty! the main reason is that there is no winter here! the closest you get is the nice n wet rainy/monsoon season. Perhaps a long vacation to Asia could work as treatment too ;)!

Dr. Deborah Serani said...

Dear Blogzie,
Yikes, that's not good! The one thing I really liked about visiting the west coast in California and Mexico was that the sun always had this golden glow day after day.

Dear Fallen Angels,
The Northwest is a dark and gloomy, you're right.

Dear DuskyDawn,
Hope you are enjoying your blog-vacation. I miss reading your posts.

Dear Astrorat,
What an interesting finding you are reporting!! Don't laugh, many recommendations for SAD include getting to places that are sunny and not wintery!


Lucy MacDonald said...

Hi Deb
I tried to send you an email at your yahoo address but for some reason it is bouncing back. Please do use my How to Stay Positive During the Holidays post. A great compliment coming from you!! I'd like to do the same with you SAD post.

Dr. Deborah Serani said...

Dear Lucy,

I will use your post after Thanksgiving. Thank You. Please feel free to use the SAD one as well. I must have typed my email address wrong on your typepad registration. NExt time I will make sure it is correct. I type fast and sometimes I don't check to be sure things are right!


for_the_lonely said...

This sure does explain a lot about me and the holiday's....

Wishing you and yours a happy Thanksgiving!


doulicia said...

my spouse has this and we've done everything short of antidepressants to perk him up. He has the full-spectrum light, which he reads in front of from 6:30-7 every morning. He walks the 4 miles to and from his office to get exercise and light exposure.

But Michigan in the winter is as dreary as the Pacific Northwest, so there's little ambient light to gather.

And to boot, he now gets cold-induced hives from the exertion in the cold! Too funny.

Thanks for the comprehensive post.

Dr. Deborah Serani said...

Dear Sarah,
Knoweldge *is* power as they say. Best wishes to you and yours at Thanksgiving as well.

Dear Doulicia,
As you know, each person is unique and so is each person's chemistry. I have depression and sunlight exposure helps me tremendously too. However, I get a sun rash and blister if exposed to the sun, so go figure. Your hubby and I can probably write a book about this subject!


Shirazi said...

What should I do when I have some thing off post to say. Like I want your expert opinion on this post:


Dr John Crippen said...

Yes, another great blog. SAD syndrome is under diagnosed in the UK for sure.

B said...

Is it important to use the light box at a specific time each morning or just sometime in the morning? I found some good advice here too: but I think I need a light box...