Are you Sad?

Sure everyone gets sad at one time or another but I am not referring to that typical sadness that comes after a death in the family or some other type of loss. S.A.D. stands for seasonal affective disorder, which is a form of depression. S.A.D. is different from the ordinary depression in that it only occurs during the winter months of the year.

SAD Demographics

Approximately 10 million American people suffer from SAD. The incidence of SAD is higher in the more northern latitudes, such as New Hampshire. In New Hampshire approximately 9.7% of the residents develop SAD. In Florida, however, the incidence is much lower, at 1.4%. Around 70-80% of SAD sufferers are women. The most common age of onset is a person in their thirties.

During winter we are not exposed to as much sunlight as we are during the other seasons of the year. SAD was first discovered in 1845 but was not officially named until the early 1980s. Sunlight affects the seasonal activities of animals, such as bears, who must hibernate during the winter. As the seasons change, there is a change in our biological internal clocks or circadian cycle. This is due partly to the changes in the sunlight patterns. This causes our internal clocks to be out of sync with our daily life. The most difficult time for a person with SAD is during the months of January and February.

Symptoms

The symptoms of SAD closely resemble that of atypical depression.

• Usually desire to oversleep and difficulty staying awake but, in some cases, disturbed sleep and early morning wakening
• Feeling of fatigue and inability to carry out normal routine
• Craving for carbohydrates and sweet foods, usually resulting in weight gain
• Feelings of misery, guilt and loss of self-esteem, sometimes hopelessness and despair, sometimes apathy and loss of feelings
• Irritability and desire to avoid social contact
• Tension and inability to tolerate stress
• Decreased interest in sex and physical contact
• In some sufferers, extremes of mood and short periods of hypomania (overactivity) in spring and autumn.

Sufferers of SAD are also prone to weakening of the immune system during the winter months and therefore are more vulnerable to infections and other illnesses.

Possible Cause

The problem develops because of lack of bright light during the winter months. There is a sleep-related hormone that is linked to SAD. During the winter months of the year, this hormone is produced at greater levels than in the other seasons of the year.

Treatment

Light therapy has been proven to be effective in approximately 85% of the diagnosed cases reported. Exposure to a very bright light for several hours (usually up to four hours a day) improves symptoms of SAD. You don’t get the light from ordinary light bulbs. The bright light you need will come from a 2500lux lamp. Lux is the technical measure of brightness. This is five times the brightness of an ordinary well-lit office. Brighter lights up to 10000 work faster. The device most often used today consists of a bank of white florescent lights on a metal reflector and a shield with a plastic screen.

Before beginning a course of treatment under a light box, it is important that you receive an evaluation from a psychiatrist. Often times a medical illness can make it appear that you have depression when in fact you don’t. Individuals who use a 10000-lux box will only need at least 30 minutes of light therapy. The amount of light therapy does fluctuate from person to person. You may need to experiment to see what will work for you.

The light treatment is often used first thing in the morning. For people who have trouble awakening in the morning, having the light box on just before they wake up. There is a product called a Dawn Stimulator that is programmed to increase the intensity of the light gradually until the full force of the light is on upon awakening. Some people, however, place the light box beside their bed and have it set to turn on shortly before awakening.

For milder symptoms from SAD, simple exposure to the sunlight will be helpful. There is one study that states that one-hour walking in the sunlight is equivalent to two and a half hours under the light box. Outside light is often brighter than light from a light box. Spending time outside does produce great benefits both mentally and physically but often times it is hard for a person to get outdoors during the day.

Just as there are side effects from antidepressants, there are also side effects from doing light therapy. The potential side effects include jitteriness, a feeling of eyestrain, and headaches. Side effects are rare in light therapy.

There are other methods of treatment to consider. There is the use of antidepressants. Antidepressants, such as Selective Serotonin Reuptake Inhibitors (SSRI), are often preferred method of treatment for SAD. Some examples of SSRI are Zoloft and Paxil.

Some individuals will need a combination of both light therapy, antidepressants and talk therapy to completely recover from SAD.

Daily exercise is also another proven way to improve SAD. For those who crave sweets during the winter, eating a balanced diet usually improves the SAD. As the mood improves the craving for sweets diminishes.

Psychotherapy is another form of treatment that is often times used in conjunction with antidepressants to help a person recover. Psychotherapy helps the person look within herself to see if there are any negative thoughts and false assumptions that come with depression.

Tips for Avoiding the Winter Blues

• Pay attention to your moods and energy levels
• Plan active events in advance for yourself for the fall and winter.
• Expose yourself to as much bright light you can.
• Stay physically active.
• Seek professional help if you find yourself sinking.
• Avoid unnecessary stress if possible. Don’t put yourself in positions that will cause unnecessary stress.
• Learn relaxation techniques.

How Others Can Help

• Accept that your friend or loved one feels bad.
• Offer practical assistance.

There is no immediate cure for SAD except to live within 30 degrees of the equator. So unless you are planning a trip near the equator, accept that you will have your moments with SAD and have a plan of action when you are feeling down.