A: According to Mental Health America, there are people who suffer from symptoms of depression only during the winter months, getting “better” during the spring and summer months. These symptoms may be a sign of seasonal affective disorder (SAD) which is associated with depression and related to seasonal variations of light. SAD affects half a million people every winter between September and April, peaking in December, January, and February. The “Winter Blues,” a milder form of SAD, may affect even more people.
Prevalence
- The main age of onset of SAD is between 18 and 30 years of age.
- The severity of SAD depends both on a person’s vulnerability to the disorder and his or her geographical location.
Symptoms
A diagnosis of SAD can be made after three consecutive winters of the following symptoms if they are also followed by complete remission of symptoms in the spring and summer months:
- Depression: misery, guilt, loss of self-esteem, hopelessness, despair, and apathy
- Anxiety: tension and inability to tolerate stress
- Mood changes: extremes of mood and, in some, periods of mania in spring and summer
- Sleep problems: desire to oversleep and difficulty staying awake or, sometimes, disturbed sleep and early morning waking
- Lethargy: feeling of fatigue and inability to carry out normal routine
- Overeating: craving for starchy and sweet foods resulting in weight gain
- Social problems: irritability and desire to avoid social contact
- Sexual problems: loss of libido and decreased interest in physical contact
Causes
- As sunlight has affected the seasonal activities of animals (i.e., reproductive cycles and hibernation), SAD may be an effect of this seasonal light variation in humans. As seasons change, there is a shift in our “biological internal clocks” or circadian rhythm, due partly to these changes in sunlight patterns. This can cause our biological clocks to be out of “step” with our daily schedules.
- 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.
Treatments for Seasonal Affective Disorder
- 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, light therapy has been shown to be effective in up to 85 percent of diagnosed cases. Patients remain in light up to ten times the intensity of normal domestic lighting up to four hours a day, but may carry on normal activities such as eating or reading while undergoing treatment.
- 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 does not work, an antidepressant drug may prove effective in reducing or eliminating SAD symptoms, but there may be unwanted side effects to consider. Discuss your symptoms thoroughly with your family doctor and/or mental health professional.
If you think you or a family member is suffering from SAD, make an appointment and visit with one of our care givers. Call the Earlham Clinic in Earlham, (515) 758-2907, or Health Trust Physicians Clinic (515) 462-2950 in Winterset. We thank Mental Health America for providing the information on SAD.