Seasonal Affective Disorder

Overview

Seasonal affective disorder (SAD) is a type of depression that occurs seasonally, typically starting and ending around the same time each year. It is commonly associated with the onset of winter, causing symptoms like low energy, mood swings, and feelings of sadness. In some cases, SAD may also affect people during the spring or summer. Treatment options for SAD may include light therapy, psychotherapy, and medications.

Understanding the disease

Symptoms

The symptoms of seasonal affective disorder (SAD) include feeling listless, sad or down most of the day, nearly every day; losing interest in activities you once enjoyed; having low energy and feeling sluggish; experiencing carbohydrate cravings, overeating, and weight gain; having difficulty concentrating; feeling hopeless, worthless, or guilty; and having thoughts of not wanting to live. Symptoms specific to winter-onset SAD (also called winter depression) may include oversleeping, appetite changes, especially a craving for foods high in carbohydrates, weight gain, tiredness or low energy. Symptoms specific to summer-onset SAD (also called summer depression) may include trouble sleeping (insomnia), poor appetite, weight loss, agitation or anxiety, and increased irritability.

Risk Factors

Risk factors for developing seasonal affective disorder include:

1. Family history: People with a family history of depression or other mood disorders may be more likely to develop SAD.
2. Gender: SAD is diagnosed more often in women than in men.
3. Age: SAD tends to occur more frequently in younger adults than in older adults.
4. Living far from the equator: SAD appears to be more common among people who live far north or south of the equator, where sunlight is scarcer during winter months.
5. Low levels of vitamin D: Vitamin D can help boost serotonin activity, which is affected by seasonal changes. People with insufficient levels of vitamin D due to limited sunlight exposure may be at higher risk of developing SAD.
6. History of major depression or bipolar disorder: Individuals with these conditions may experience worsening of symptoms during specific seasons.
7. Insufficient sleep: Disrupted sleep patterns, including excessive daytime sleepiness or oversleeping, can increase the risk of SAD. It's important to note that not everyone experiencing these risk factors will develop SAD, and some individuals without known risk factors may still develop the condition.

Development

Seasonal affective disorder (SAD) develops when a person experiences symptoms of depression during specific seasons of the year, usually fall and winter. The exact cause of SAD is not known, but several factors are believed to contribute to its development. These include changes in the body's biological clock (circadian rhythm), reduced sunlight causing a drop in serotonin levels, and disruptions in the balance of melatonin levels. SAD is diagnosed more often in women than in men and tends to occur more frequently in younger adults. Family history and having bipolar disorder are also considered risk factors for developing SAD. Poor appetite, weight loss, agitation, anxiety, and increased irritability are common symptoms of SAD.

Assessment and Diagnosis

Triage

You should see a doctor if you notice symptoms of seasonal affective disorder (SAD) and they are affecting your daily life, causing distress, or if your sleep patterns and appetite have changed. It is especially important to seek medical advice if you feel hopeless, have thoughts of suicide, or turn to alcohol for comfort or relaxation. Remember, it's normal to have some days when you feel down, but if these feelings persist for an extended period, it's essential to consult with a healthcare provider.

Diagnosis

To diagnose seasonal affective disorder (SAD), a thorough evaluation is typically conducted by a healthcare provider or mental health professional. This evaluation may include a physical exam, lab tests, and a psychological evaluation. The psychological evaluation may involve discussing thoughts, feelings, and behavior, as well as completing a questionnaire. A diagnosis of persistent depressive disorder requires depressed mood to occur most of the day for two or more years for adults, and at least one year for children. Symptoms caused by persistent depressive disorder can vary from person to person, and the condition can start before age 21 (early onset) or at age 21 or older (late onset).

Management and Treatment

Complications

Complications of seasonal affective disorder (SAD) may include social withdrawal, school or work problems, and substance abuse. If left untreated, SAD can worsen over time and lead to these complications. It's essential to take the symptoms of SAD seriously and seek treatment to manage and prevent these potential complications from occurring.

Home Remedies

Home remedies that may help alleviate SAD symptoms include:

1. Increasing exposure to natural sunlight: Spending time outdoors, especially in the morning, can help boost your mood and energy levels.
2. Regular exercise: Engaging in outdoor activities or exercising indoors can help combat SAD symptoms and improve your overall well-being.
3. Maintaining a healthy diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help support your mood and energy levels.
4. Staying socially connected: Maintaining strong relationships with friends and family and participating in social activities can help combat feelings of isolation and loneliness.
5. Practicing relaxation techniques: Techniques like meditation, deep breathing, or yoga can help reduce stress and improve your mood. While these home remedies may provide some relief, it's important to consult a healthcare professional if you suspect you have SAD or if your symptoms are severe.

Treatment

Treatment for seasonal affective disorder (SAD) may include light therapy (phototherapy), psychotherapy, and medications. Light therapy involves exposure to a special light box that simulates natural outdoor light. This can help regulate the body's internal clock and alleviate symptoms. Psychotherapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT), can help individuals identify and cope with negative thoughts and behaviors related to SAD. Medications, including antidepressants, can also be effective in managing symptoms of SAD. It's important to consult with a healthcare professional to determine the most appropriate treatment plan based on individual needs and circumstances.

Preparing for medical consultation

To prepare for an appointment for seasonal affective disorder (SAD), follow these steps:

1. Gather information: Before your appointment, research seasonal affective disorder to better understand the condition, its symptoms, and available treatments. This will help you communicate more effectively with your healthcare provider.
2. List your symptoms: Make a list of the symptoms you've experienced, including any that may seem unrelated to SAD. Note the severity, duration, and any factors that seem to worsen or improve your symptoms.
3. Track your mood: Keep a mood diary or journal to track any changes in your mood, energy levels, and sleep patterns. This will help you identify patterns and provide valuable information to your healthcare provider.
4. Prepare a medical history: Compile a list of any other physical or mental health conditions you have, as well as any medications, vitamins, herbs, or supplements you're taking, and their dosages.
5. Bring a support person: Consider bringing a family member or friend to your appointment, as they can help you remember important details and provide additional insight into your situation.
6. Prepare questions: Create a list of questions to ask your healthcare provider, such as:
   • What is the most likely cause of my symptoms?
   • Are there any other possible causes?
   • What treatments are available for SAD, and which do you recommend for me?
   • Are there any lifestyle changes I can make to manage my symptoms?
   • What is the expected duration of treatment?
   • Are there any potential side effects or risks associated with the recommended treatment?
   • Will my current medications interact with any new treatments? By preparing in advance and being proactive during your appointment, you can ensure that you receive the most appropriate care and treatment for your seasonal affective disorder.