Managing Seasonal Affective Disorder (SAD)
Seasonal affective disorder (SAD) is a type of depression that occurs when the seasons change. While it can occur in the spring or early summer, most people with SAD experience symptoms in the fall and winter when there is less daylight.
The symptoms of SAD are similar to those of depression that is not related to the change of seasons. The difference is that SAD starts and stops at about the same times of year. Symptoms may include:
- Having a gloomy outlook
- Feeling hopeless, worthless, sad and irritable
- Being tired and lethargic during the day
- Sleeping more and struggling to wake up
- Losing interest in activities you normally enjoy
- Avoiding social events with family and friends
- Gaining weight and craving starchy foods and sweets.
What Causes SAD?
The cause of SAD is not fully understood, but there are several factors that may be related. Researchers have noted that people with SAD tend to have a drop in serotonin (the brain chemical that regulates mood) and overproduce melatonin (the hormone that controls sleep). Melatonin is produced at increased levels in the dark so when days are shorter and darker, the production of this hormone increases. Increased melatonin can disrupt the body’s circadian rhythm—the internal biological clock that helps us sleep and wake. The disruption can sap energy and cause sadness. Also common among SAD sufferers is low vitamin D levels, which may interfere with serotonin activity and be linked to depression.
According to the National Institutes of Health, SAD is four times more likely to occur in women than men. It affects younger adults (and even children) more than older adults; the most common onset is between 18 and 30 years. Other factors that can increase the risk of having SAD is having a family history of depression and living far from the equator where sunlight is reduced during the winter. Depressive symptoms may worsen in the winter months for people who already have depression.
Need A Winter Tune Up?
Psychologists suggest keeping a regular schedule of activities to improve mood:
- Get regular exercise, outdoors if possible for more natural light exposure. Exercise releases chemicals in the brain that help us feel happier, boost energy and curb appetite.
- Keep a regular sleep schedule by going to sleep and waking up at the same time.
- Make plans with family and friends or volunteer for your favorite charity to stay socially engaged.
- Spend time outdoors and sit near a window to get the benefits of sunshine.
- Eat a healthy diet rich in low fat protein, fruits and vegetables.
Just the ‘Winter Blues’?
Many people feel a little blue when the days are shorter and colder. But when feelings of depression begin to affect your enjoyment of life and ability to work, it’s time to take action. SAD, like other kinds of depression, can lead to work or school problems, lack of social contact, substance abuse, anxiety and eating disorders. When is it time for help? Psychologists agree that you should see a doctor if you feel down for days at a time and avoid activities that you’d normally enjoy, especially if you are also oversleeping, turning to alcohol for comfort, feeling hopeless or thinking about suicide.
Treatments for SAD include counseling, medications, light therapy, and numerous lifestyle changes that support a brighter mood. Counseling, also called cognitive behavioral therapy or talk therapy, teaches you strategies for dealing with SAD. A therapist might be a licensed clinical social worker (LCSW) or psychologist, who are trained to help you manage stress and turn negative feelings into positive thoughts and actions. Psychiatrists (medical doctors) also provide therapy and can be particularly helpful with medication management. Most employers offer Employee Assistance Programs (EAP) that include some free counseling sessions. Ask your Human Resources department or KnovaSolutions clinician for EAP contact information.
Antidepressants are medications that can increase serotonin levels and reduce symptoms of depression. For treating SAD, providers may recommend that an antidepressant be started two weeks or so before seasonal symptoms usually begin and continued a bit beyond the time symptoms usually end. If starting an antidepressant for the first time, keep in mind that it may take several weeks to notice its full benefit. It may also be necessary to try different antidepressants; there are many options and each work a little differently.
Believed to increase serotonin levels, light therapy involves sitting close to a light therapy box daily (can be done while working or performing other stationary tasks). It emits bright light that mimics natural outdoor light and has been shown to slow the brain’s secretion of melatonin. Some use light therapy as a first line of defense against SAD, while pregnant to avoid taking medications, or with an antidepressant and/or counselling. Using light therapy may make it possible for your medication dose to be reduced.
Since light therapy may not be appropriate for people with conditions (or who use medications) that make them especially sensitive to light, it is a good idea to discuss the safety of light therapy with your provider. Light therapy boxes are designed to filter out harmful ultraviolet (UV) light but not all are created equal; look for one that emits as little UV light as possible.
National Suicide Prevention Lifeline
Let’s all work together to prevent suicide. The National Suicide Prevention Lifeline is free, confidential and available 24/7. If you or a loved one is in distress, call: 800/273-8255
Sitting Near Bright Windows
Besides counseling, medications and light therapy, there are many other ways to cope with SAD. Start by taking care of yourself! Follow your treatment plan if you have one, set a regular sleep habit so you get enough rest but not too much, make healthy meal choices, and exercise. Exercise — that thing everyone always recommends — helps reduce stress and increase serotonin. An added benefit, being more fit makes you feel better about yourself. Meditation, tai chi, listening to music, guided imagery and yoga are other effective ways to relieve stress. They also help you avoid overeating and other unhealthy behaviors.
Look for ways to make your work space or home sunnier and brighter, such as opening blinds and trimming trees that block light. Even on cold or cloudy days, getting outside exposes you to more natural light and can lift your spirits. Is it possible to sit closer to bright windows at home or work?
KnovaSolutions can help you understand more about SAD. We’ll offer support and resources as you adopt strategies to reduce symptoms of depression. Call KnovaSolutions at 800/355-0885, Monday through Friday, 8 am – 5 pm, Mountain Time.
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The information contained in this newsletter is for general, educational purposes. It should not be considered a replacement for consultation with your healthcare provider. If you have concerns about your health, please contact your healthcare provider.