Seasonal Affective Disorder: More Than Just The Blues

By: Diana Barnes-Brown for Body1

What Is Seasonal Affective Disorder? What Causes It?

As the days become colder and darker and winter approaches, most people who live in temperate climates experience a sense of sadness and low energy often referred to as the “winter blues.” For some, though, these symptoms are magnified to the extent that they interfere with daily life, disrupting work, family and social activities. These individuals are said to have seasonal affective disorder (SAD), a disorder characterized by sadness and depression, lack of energy, food cravings, increased sleeping, and loss of interest in hobbies or activities.

Take Action

Call your doctor if you notice any of the following symptoms of SAD: Low energy or lethargy Sad or depressed mood Loss of interest in activities once enjoyed Low motivation Negative thinking, feelings of guilt, unworthiness and self-doubt Overeating and food cravings for carbohydrates Changes in sleep patterns, especially excessive sleep or difficulty waking

While the exact cause of SAD is not known, it seems to diminish with exposure to natural light. Because SAD is related to light rather than temperature variation, even people who live in mild climates may be at risk for developing the disorder. This relationship explains the many reports of people afflicted in Seattle and Vancouver – both of which are cities known for mild, overcast winters. Similarly, people who live near the Arctic Circle often report that they notice seasonally-linked depression. It has been argued that depressive behaviors including suicide are more likely to occur during winter months in these regions, and certain research supports this view. For example, the suicide rate in Finland – known for its long, dark winters – is among the highest in the world; and suicide was roughly twice as prevalent in Alaska as in other U.S. states. Many researchers have speculated that seasonal variations in brain chemicals known to cause depression are to blame.

The hormone melatonin, produced by the pineal gland, helps to regulate cycles of sleep and wakefulness; it has been shown that stimuli received by the retina (the part of the eye that processes light) directly influence the activities of the pineal gland. Others have argued that less exposure to daylight causes slower serotonin production. Serotonin is responsible for influencing moods, so a lack of serotonin may lead to symptoms of depression.

Diagnosis and Treatment

People who think they may be suffering from SAD can seek a doctor evaluation, which usually involves a detailed case history, discussion of other contributing factors, and questions about symptoms and behaviors. Once diagnosed, patients can get started on a treatment plan.

Light boxes are available by prescription, and can be used to supplement lacking daylight when days are shorter and darker. They work by providing a replacement source of light very similar to sunlight. Recent research from the National Institute of Mental Health has found that morning light therapy in combination with afternoon doses of the hormone melatonin significantly improve SAD symptoms.

If light and melatonin therapy prove ineffective, selective serotonin reuptake inhibitors (SSRIs) such as Zoloft, Paxil, Prozac and Wellbutrin may be helpful in combating SAD. And not only is psychological counseling recommended for any type of depression, but researchers at the University of Vermont found that cognitive therapy in particular is effective for those afflicted with SAD.

An additional treatment option is ionized-air reception, which involves having patients breathe concentrated ionized air for a certain amount of time each day. On average, people can expect to improve about 50 percent as a result of both ionized-air reception and light therapy.

Finally, clinical studies as well as anecdotal evidence show that exercise, increased time spent outside during daylight, and behavioral and dietary changes may all help diminish the symptoms of SAD and other forms of depression. While those experiencing the symptoms of SAD may feel helpless, there are a number of successful treatments to try. With commitment and care, most patients can beat the blues and begin to enjoy the winter months once again.

Last updated: 04-Dec-06