Seasonal Affective Disorder (SAD)
Seasonal affective disorder (SAD) is a type of depression that’s related to changes in seasons — SAD begins and ends at about the same times every year. Seasonal affective disorder (SAD) is another term for major depressive disorder (MDD) with seasonal pattern. If you’re like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. These symptoms often resolve during the spring and summer months. Less often, SAD causes depression in the spring or early summer and resolves during the fall or winter months.
Symptoms may start out mild and become more severe as the season progresses.
Signs and symptoms of SAD may includes –
• 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
• Having problems with sleeping too much
• Experiencing carbohydrate cravings, overeating and weight gain
• Having difficulty concentrating
• Feeling hopeless, worthless or guilty
• Having thoughts of not wanting to live
▪︎ Fall and winter SAD
Symptoms specific to winter-onset SAD, sometimes called winter depression, may includes –
• Appetite changes, especially a craving for foods high in carbohydrates
• Weight gain
• Tiredness or low energy
▪︎ Spring and summer SAD
Symptoms specific to summer-onset seasonal affective disorder, sometimes called summer depression, may includes –
• Trouble sleeping (insomnia)
• Poor appetite
• Weight loss
• Agitation or anxiety
• Increased irritability
Actual cause of seasonal depression is not known but lack of sunlight may trigger the condition if you’re prone to getting it. The theories suggest some of the causes which includes –
• Biological clock change
When there’s less sunlight, your biological clock shifts. This internal clock regulates your mood, sleep and hormones. When it shifts, you’re out of step with the daily schedule you’ve been used to and can’t adjust to changes in daylight length.
• Brain chemical imbalance
Brain chemicals called neurotransmitters send communications between nerves. These chemicals include serotonin, which contributes to feelings of happiness. If you’re at risk of SAD, you may already have less serotonin activity. Since sunlight helps regulate serotonin, a lack of sunlight in the winter can make the situation worse. Serotonin levels can fall further, leading to depression.
• Vitamin D deficiency
Your serotonin level also gets a boost from vitamin D. Since sunlight helps produce vitamin D, less sun in the winter can lead to a vitamin D deficiency. That change can affect your serotonin level and your mood.
• Melatonin boost
Melatonin is a chemical that affects your sleep patterns and mood. The lack of sunlight may stimulate an overproduction of melatonin in some people. You may feel sluggish and sleepy during the winter.
• Negative thoughts
People with SAD often have stress, anxiety and negative thoughts about the winter.
Risk Factors –
• Residents of less sunlight areas
People who live in areas that have long winter nights (due to higher latitudes) and less sunlight are more likely to experience SAD. For example, the condition is more common in Canada and Alaska than in sunnier Florida.
The condition occurs more frequently in women than men, and it’s most likely to begin in younger adults between the ages of 18 and 30.
• Family History
People with a family history of SAD and other psychological conditions are at greater risk for SAD.
• Mental Health Compromised People
Additionally, individuals with other mental health conditions are more likely to experience SAD. Around 25 percent of people with bipolar disorder and between 10 to 20 percent of people with major depressive disorder also have SAD.
As with other types of depression, SAD can get worse and lead to problems if it’s not treated. These can include –
• Social withdrawal
• School or work problems
• Substance abuse
• Other mental health disorders such as anxiety or eating disorders
• Suicidal thoughts or behavior
If you have symptoms of seasonal affective disorder (SAD), don’t try to diagnose yourself. See your healthcare provider for a thorough evaluation.
Your health care provider may diagnose you with SAD if you have –
• Symptoms of major depression.
• Depressive episodes that occur during specific seasons for at least two consecutive years.
• Depressive episodes happening more frequently during a specific season than during the rest of the year.
There’s no blood test or scan to diagnose seasonal depression.
Your health care provider will tell you about treatment options. You may need a combination of treatments, including –
• Light therapy
Bright light therapy, using a special lamp, can help treat SAD.To use light therapy or phototherapy, you purchase a special lamp. It has white fluorescent light tubes covered with a plastic screen to block ultraviolet rays.To use phototherapy, don’t look directly into the light. Your exposure to the light should be indirect. Place the lamp about two to three feet away while you read, eat, work or do other activities.
• Cognitive behavioral therapy (CBT)
CBT is a type of talk therapy. Research has shown it effectively treats SAD, producing the longest-lasting effects of any treatment approach.
• Antidepressant medication
Sometimes, providers recommend medication for depression, either alone or with light therapy. Medications called selective serotonin reuptake inhibitors (SSRIs) can treat SAD. They improve your mood by regulating serotonin levels in your body.
Examples of some SSRIs includes Fluoxetine,Escitalopram,Sertraline etc.
• Spending time outdoors
Getting more sunlight can help improve your symptoms. Try to get out during the day. Also, increase the amount of sunlight that enters your home or office.
• Vitamin D
A vitamin D supplement may help improve your symptoms.
Lifestyle and Home Remedies –
In addition to your treatment plan for seasonal affective disorder, one should follow these remedies also –
• Make your environment sunnier and brighter.
Open blinds, trim tree branches that block sunlight or add skylights to your home. Sit closer to bright windows while at home or in the office.
• Get outside.
Take a long walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun. Even on cold or cloudy days, outdoor light can help — especially if you spend some time outside within two hours of getting up in the morning.
• Exercise regularly.
Exercise and other types of physical activity help relieve stress and anxiety, both of which can increase SAD symptoms. Being more fit can make you feel better about yourself, too, which can lift your mood.
• Normalize sleep patterns.
Schedule reliable times to wake up and go to bed each day. Especially for fall-winter-onset SAD, reduce or eliminate napping and oversleeping.
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