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Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder - also abbreviated as SAD - is a type of depression that is related to changes in the seasons. SAD begins and ends at about the same times every year. Most people with SAD, have symptoms that begin in the fall and continue into the winter months, draining their energy and making them feel moody. Though rare, SAD can occur during the spring or early summer. 

If you experience the below symptoms of SAD, don't brush it off as simply a case of the winter blues, or a seasonal funk that you have to tough out on your own. There are steps that you can take to keep your mood and motivation steady throughout the year. 

Symptoms of Seasonal Affective Disorder

In most cases, SAD symptoms appear during late fall or early winter and go away during the sunnier days if spring and summer. Less commonly, people with the opposite pattern have symptoms that begin in the spring or summer. In either case, symptoms may start out mild and become more severe as the season progresses.

Signs and symptoms of SAD may include:

  • Feeling depressed most of the day, nearly every day
  • Losing interest in activities you once enjoyed
  • Having low energy
  • Having trouble sleeping 
  • Experiencing changes in your appetite or weight
  • Feeling sluggish or agitated
  • Having difficulty concentrating
  • Feeling hopeless, worthless, or guilty
  • Having frequent thoughts of death or suicide  

Fall and Winter SAD

Symptoms specific to winter-onset SAD, sometimes called winter depression, may include:

  • Oversleeping
  • Appetite changes, especially a craving for foods high in carbs
  • Weight gain
  • Tiredness or low energy 

Spring and Summer SAD

Symptoms specific to summer-onset SAD, sometimes called summer depression, may include:

  • Insomnia 
  • Poor appetite
  • Weight loss
  • Agitation or anxiety 

Seasonal Changes in Bipolar Disorder

In some people who have Bipolar Disorder, spring and summer can bring on symptoms of mania, or a less intense form of mania - hypomania, and fall and winter can be a time of depression. 

When to See a Doctor

It's normal to have some days when you feel down, but if you feel down for days at a time and you can't get motivated to do activities you normally enjoy, see your doctor. This is especially important if your sleep patterns and appetite have changed, you turn to alcohol for comfort or relaxation, or you feel hopeless or think about suicideSee your doctor. 

Causes of SAD

The specific cause of SAD remains unknown. Some factors that may come into play include:

Your biological clock, or circadian rhythm: The reduced level of sunlight in fall and winter may cause winter onset SAD. The decrease in sunlight may disrupt your body's internal clock and lead to feelings of depression. 

Serotonin levelsA drop in serotonin, a brain chemical, or neurotransmitter, that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression

Melatonin levels: The change in season can disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood. 

Risk Factors for SAD

Seasonal Affective Disorder is diagnosed more often in women than in men, and SAD occurs more frequently in younger adults than in older adults. Factors that may increase your risk of SAD include:

Family history: People with SAD may be more likely to have blood relatives with SAD or another form of depression.

Having major depression or bipolar disorder: Symptoms of depression may worsen seasonally if you have one of these conditions.

Living far from the equator: SAD appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter and longer during the summer months.

Complications From SAD

Take signs and symptoms of seasonal affective disorder seriously. As with other types of depression, SAD can become worse and lead to other problems if it's not treated. These can include:

Treatment can help prevent complications, especially if SAD is diagnosed and treated before symptoms get worse. 

Diagnosis of SAD

Even with a thorough evaluation, it can sometimes be difficult for your doctor or mental health professional to diagnose SAD because other types of depression or other mental health conditions can cause similar symptoms.

To help diagnose SAD, your doctor or mental health professional may do a thorough evaluation, which generally includes:

Physical exam: Your doctor may perform a physical exam and ask in depth questions about your health. In some cases, depression may be linked to an underlying physical health problem.

Lab tests: For example, your doctor may do a blood test called a CBC, or complete blood count, or test your thyroid to make sure it's functioning properly.

Psychological evaluation: To check for signs of depression, your doctor or mental health professional may ask about your symptoms, thoughts, feelings and behavior patterns.

DSM-5: Your mental health professional may use the criteria for seasonal depressive episodes listed in the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.

Treating Seasonal Affective Disorder

Treatment for SAD may include light therapy, medications and psychotherapy. If you have Bipolar Disorder, tell your doctor - this is critical to know when prescribing light therapy, or an antidepressant. Both treatments can potentially trigger a manic episode.

Light Therapy

In light therapy, also called phototherapy, you sit a few feet from a special light box so that you're exposed to bright light within the first hour of waking up each day. Light therapy mimics the natural outdoor light and appears to cause a change in brain chemicals linked to mood.

Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to a few weeks and causes few side effects. Research on light therapy is limited, but it appears to be effective for most people in relieving SAD symptoms.

Before purchasing a light box, talk with your doctor about the best one for you, and familiarize yourself with the variety of features and options so that you buy a high quality product that's safe and effective. Also ask your doctor about how and when to use the light box.

Medications

Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe. An extended release version of the antidepressant bupropion, may help prevent depressive episodes in people with a history of SAD. Other antidepressants also may be commonly used to treat SAD.

Your doctor may recommend starting treatment with an antidepressant before your symptoms typically begin each year. He or she may also recommend that you continue to take the antidepressant beyond the time your symptoms normally go away.

Keep in mind that it may take several weeks to notice full benefits from an antidepressant. In addition, you may have to try different medications before you find one that works well for you and has the fewest side effects.

Psychotherapy

Also called talk therapy, is another option to treat SAD. A type of psychotherapy known as cognitive behavioral therapy can help you identify and change negative thoughts and behaviors that may be making you feel worse. You will learn healthy ways to cope with SAD, especially with reducing avoidance behavior and scheduling activities, and learn how to manage stress.

Mind-Body Connection

Examples of mind-body techniques that some people may choose to try to help cope with SAD include:

  • Relaxation techniques, such as Yoga or Tai Chi
  • Meditation
  • Guided Imagery
  • Music or Art Therapy   

Lifestyle & Home Remedies

In addition to your treatment plan for SAD, you can:

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 2 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 active and fit can make you feel better about yourself too, which can lift your mood. 

Alternative Medicine

Certain herbal remedies, supplements or mind-body techniques are sometimes used to try and relieve depression symptoms, though it's not clear how effective these treatments are for SAD. 

Herbal remedies and dietary supplements aren't monitored by the FDA the same way medications are, so you can't always be certain of what you're getting and whether it's safe. Talk with your doctor or pharmacist about what vitamins, minerals, or supplements are safe for you, as some do interfere with prescription medication and could cause dangerous interactions. 

Make sure you understand the risks as well as the rewards and benefits if you pursue alternative or complementary therapy. When it comes to depression, alternative treatments aren't always a substitute for medical care. 

Coping and Support

These steps can help you manage SAD: 

Stick to your treatment plan: follow your treatment plan and attend therapy appointments when scheduled. 

Take care of yourself: get enough sleep to help you feel rested, but be careful not to get too much rest, as SAD symptoms often lead people to feel like hibernating. Participate in an exercise program or engage in another form of regular physical activity. Make healthy choices for meals and snacks. Don't turn to alcohol or recreational drugs for relief. 

Practice stress management: learn techniques to manage your stress better. Unmanaged stress can lead to depression, overeating, or other unhealthy thoughts and behaviors. 

Socialize: when you're feeling down, it can be hard to be social. Make an effort to connect with people you enjoy being around. They can offer support, a shoulder to cry on, or shared laughter to give you a little boost. 

Pet your dog(s): if you have an animal, or animals, then spending time with them can have tremendous health benefits and improve your mood dramatically. Studies show that by simply petting a dog can decrease blood pressure, lower stress, and improve overall happiness levels. 

Take a trip: if possible, take winter vacations in sunny, warm locations if you have winter SAD, or to cooler locations if you have summer SAD. 

Preparing for Treatment

Before your appointment for treatment, make a list of your symptoms, your depression patterns, any other mental or physical health problems you have, any major stressors or life changes you've had recently, all medications, vitamins, herbs, or other supplements you're taking and all dosages, and any questions to ask your doctor or mental health professional.

Seasonal Affective Disorder is real and can impact your life. Don't be afraid to speak out and ask for help. Here at Mountainside Medical, we have many all natural products, light boxes, and more to help with SAD. Be sure to check them out at our website by clicking here, or by calling us at 1-888-687-4334 for more information!  

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