Are You S.A.D?
Seasonal Affective Disorder (SAD) affects many Americans, particularly those who live in the North with longer and colder winters. Also known as seasonal depression or the winter blues, SAD usually results in depression symptoms during the winter months. Symptoms of SAD may include: tendency to overeat and oversleep, lack of energy, difficulty concentrating, withdrawal from friends, family, and social activities, difficulty waking in the morning, irritability, anxiety, and sometimes suicidal thoughts. Some winter sluggishness is normal. On an evolutionary basis, we need to slow down in the winter to conserve energy when food supplies are low. Even when full, we don’t usually become excited over cold, cloudy days. Our moods normally dull at bit as the world around us becomes gray and void of color. These feelings are normal and not a symptom of Seasonal Affective Disorder. Actually, Seasonal Affective Disorder (SAD) is not a clinical term. The clinical diagnosis is Major Depressive Disorder, Recurrent, With Seasonal Pattern. In other words, SAD is not a unique clinical diagnosis, but rather it is a type of Major Depression. People with SAD experience symptoms of depression during only one season (winter or summer) year after year. Patients must show a history of depression at the same time of year for at least two consecutive years to be clinically diagnosed. Only a licensed professional can diagnose you, so see your doctor or therapist if you think you may have SAD. Even if you do not meet the criteria for a clinical diagnosis of SAD, there are things you can do to help relieve your winter blues. It appears that SAD is caused by a lack of necessary sunlight. We now know that sunlight is a major component in how we obtain vitamin D, and low levels of vitamin D have been associated with depression symptoms. Furthermore, sunlight plays a key role in regulating melatonin levels in the body, which control our sleep cycles. Treatments for Seasonal Affective Disorder include: light therapy, medication, cognitive‐behavioral therapy, and carefully timed melatonin treatment. Light therapy is one of the most popular and most effective treatments of SAD. Light therapy uses a lightbox which produces far stronger light than a common lightbulb. Bright light therapy is typically prescribed using a white “full spectrum” light at 10,000 lux. Lightboxes are commonly available online through several retailers, but be sure to find a clinically effective lightbox. The patient is usually asked to sit at distance of about 18 inches from the lightbox for 30 to 60 minutes per day. The patient should face the light but do not look directly into the light. Many patients see results during the first week of use but should continue light therapy for several weeks and up to the end of the season. Seasonal Affective Disorder is also treated with medications. Many antidepressants have been found effective for SAD; most commonly SSRI antidepressants including Paxil, Zoloft, and Prozac. Counseling is another effective treatment for SAD, as it is with all types of depression. Cognitive‐behavioral counseling can teach positive thinking, coping skills, challenge irrational thoughts, and provide support. Melatonin is an over the counter medication often used to treat SAD. Melatonin naturally occurs in the body and regulates circadian rhythms. It is sometimes used for insomnia, but the effects are not immediate. Melatonin should be taken approximately 4 hours before bedtime for a period of a few weeks to realign circadian rhythms and normalize your sleep cycle. Of course, check with your doctor before beginning any treatments.