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Many people may notice a shift in mood during the winter months. You may tend to eat or sleep more when the temperature drops, and these feelings are often referred to as the "winter blahs". Seasonal affective disorder (SAD) is a type of depressive disorder which is related to seasonal variations of light. The most difficult months for SAD sufferers are January and February, and younger persons and women are at higher risk.
What Causes SAD?
The causes of SAD are unclear; however, it may have to do with the amount of sun you are exposed to. Although SAD can affect people anywhere, it becomes more common the farther north you live, probably due to decreased amounts of daylight for months at a time.
What are the Signs and Symptoms?
Regularly occurring symptoms of depression during the fall or winter
Anxiety, loss of energy, social withdrawal, sleepiness, loss of interest in everyday activities, overeating (especially foods high in carbohydrates), weight gain, and difficulty concentrating.
Full recovery from depression occurs in the spring and summer months.
Screening and Diagnosis:
It is often difficult for doctors to diagnose SAD because other types of depression may mimic SAD. Diagnosing SAD depends on whether:
You've experienced depression and other signs and symptoms of SAD for at least two years in a row, during the same season.
These periods of depression are followed by non-depressed seasons.
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There are no other explanations for the changes in your mood or behavior.
How is it Treated?
This is the main treatment for many people with winter depression. You sit a few feet from a special lamp for about 30 or more minutes each day, usually in the morning. You can do other activities, such as reading or eating breakfast while sitting in front of the light. Light therapy is easy to administer and has few side effects. About 70% of those who try daily light therapy experience a reduction of their symptoms, and about 50% experience remission. Light therapy needs to be used daily until spring, when the sun shines for longer periods of time during the day.
Medication: If light therapy does not work, your physician may prescribe an antidepressant medication in combination with light therapy, or as an alternative. Examples of common antidepressants are paroxetine (Paxil®), sertraline (Zoloft®), fluoxetine (Prozac®), and venlafaxine (Effexor®). In June 2006, the FDA approved buproprion extended-release tablets (Wellbutrin XL®) for prevention of depressive episodes in people with a history of SAD. Duration of medication treatment of SAD varies. Your physician may have you start your medication before the time your symptoms usually develop, and continue it beyond the time your symptoms typically go away.
Psychotherapy: Psychotherapy helps you identify and change negative thoughts and behaviors that may contribute to your SAD. You and your psychiatrist or psy
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chologist may talk about ways to reduce stress in your life.
Coping Skills:
Some changes you can make on your own may help you cope with SAD. Here are some suggestions:
Increase the amount of light in your home; this may be accomplished by opening blinds, adding skylights, and trimming tree branches that block sunlight.
Get outside and walk outdoors on sunny days, even during the winter.
Exercise regularly; physical activity helps relieve stress and anxiety.
Find ways to relax.
Take a trip; if possible, take winter vacations in sunny and warm locations.
For further information, please contact your local mental health association, physician or pharmacist, or use www.nmha.org as a guiding resource.
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