FORT LEE, Va. (Dec. 6, 2012) -- As indicated by its name, Seasonal Affective Disorder is a change in emotional state that occurs with the changes in seasons.
SAD is a recurrent depressive disorder which occurs at particular times of the year. Typically, it is seen in the transition from fall to winter, and the symptoms disappear with the onset of the sunnier days of spring and summer. It is estimated that 4 to 6 percent of the U.S. population experiences SAD.
There is also a SAD version that has an onset during summer with some similar but also opposite symptoms from the more typical winter SAD. Causes for both types are unknown but are thought to relate to seasonal changes to sufferers’ biological clocks, which are dependent on sunlight levels. A drop in the levels of serotonin, a neurotransmitter that affects mood, also occurs with reduced levels of sunlight, which may trigger depression. Melatonin levels, which also affect sleep and mood, also vary in response to changes in sunlight levels.
A note of caution is that the symptoms of SAD are similar to those seen with other conditions. If one is experiencing significant symptoms, it is recommended that the individual consult with a medical or mental health provider to ensure that SAD is indeed the problem rather than some other disorder that would require a different treatment regimen. If symptoms include suicidal ideation, no matter how fleeting in nature, consultation with a mental health professional is highly recommended.
Winter onset SAD symptoms include depression, anxiety, hopelessness, loss of energy, social withdrawal, oversleeping, a craving for high carbohydrate foods, weight gain, loss of interest in favorite activities, reduced sex drive, and difficulty concentrating.
Light therapy is a first line treatment that yields results in a few days, which reinforces the idea that changing daylight levels trigger the disorder. Some studies have shown that two-thirds of patients benefit from this treatment. Other than the inconvenience of scheduling time for light therapy, there are no significant side-effects. For those patients for whom light therapy doesn’t work, or for those patients who aren’t compliant, the use of antidepressants is recommended. Disadvantages of the use of antidepressants include delayed onset of therapeutic effects and the possible need to try different medications to find one that is effective and has the fewest side-effects. Psychotherapy, especially cognitive-behavioral therapies, is useful to help manage symptomatology via lifestyle changes and changes in thinking and behavior patterns.
Summer onset SAD symptoms include anxiety, depression, hopelessness, insomnia, irritability, agitation, weight loss, poor appetite and increased sex drive (many of which are opposite of the symptoms seen with winter onset SAD). Summer onset SAD is comparatively rare, occurring in about a tenth of SAD cases. It is thought that high temperatures and high levels of humidity may play a role in triggering the disorder. While some individuals find that going to cooler climates may be of some help, exposure to air conditioning has not been found to be useful. It may be that even transient exposure to high temperatures and humidity trigger the summer SAD symptoms.
Although light therapy is not generally used with summer SAD, the other treatment modalities discussed earlier are recommended. Some researchers are more concerned about the possibility of suicidal behavior with summer onset SAD due to the higher energy levels associated with it (in comparison to winter onset SAD).
The “holiday blues” may be a result of winter onset SAD for a small percentage of people, but much of the depressive symptoms that are experienced during the holiday season may be due to unrealistic expectations, high demands by self and others, financial concerns and social support deficits. Many people have found that by simplifying their holiday goals and plans, and concentrating on the underlying reasons for the season, they will experience a much more relaxing and rewarding holiday.
Kenner Army Health Clinic