Friday, November 06, 2009

Seasonal Affective Disorder

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. For some individuals, seasonal changes cause a "Reverse Seasonal Affective Disorder" where symptoms of mania, elevated mood, racing of thoughts and pressured speech can occur. In this case, Reverse Seasonal Affective Disorder stems from Bipolar Disorder. SAD can also occur in summer months.

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 symptoms 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. A dip in Serotonin has also been associated with SAD.

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 worker, 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: