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Seasonal Affective Disorder

Symptoms and treatment for SAD

Individuals with seasonal affective disorder (SAD) typically experience symptoms that come and go with the seasons. Symptoms, which come on gradually, typically worsen during fall and winter and disappear during spring and summer.

Symptoms

Symptoms of SAD include:

  • A sense of hopelessness
  • Anxiety
  • Loss of energy
  • Social withdrawal
  • Lethargy and oversleeping
  • Appetite changes, especially carbohydrate cravings
  • Weight gain
  • Decreased cognitive function

Causes

The cause of SAD is unknown; however, genetics, age and chemical makeup most likely play a role in the condition's onset. Those most at risk for SAD are individuals who live in northern locations where sunny days are at a premium. Though there are mixed reviews on genetic predisposition, some researchers believe that SAD runs in families. Clinicians link SAD to the following factors:

  • Circadian rhythm. Decreased sunlight may contribute to a disruption in your body's circadian rhythm. If the body's internal clock that tells you when to wake and sleep is out of rhythm, you can become depressed.
  • Hormone imbalances. The body produces more melatonin (a sleep-related hormone) when there is less sunlight, thus, melatonin stores increase during fall and winter. This can make you sluggish, decrease your energy and potentially lead to depression. In addition, serotonin, a natural brain chemical that affects mood, tends to drop with a reduction in sunlight.

Diagnosis and Treatment

If symptoms of SAD persist, seek medical advice – particularly if sleep and diet patterns are disrupted. While seasonal affective disorder is not recognized as a distinct disorder by the psychiatric community, it is considered a subtype of depression. Since SAD often mimics other mental health conditions, proper diagnosis depends on how honest and accurate you are in describing your symptoms.

Usually, your doctor will evaluate your condition by asking a series of questions related to mood, seasonal changes in thoughts and behavior, lifestyle and social changes, and sleeping and eating patterns. Your doctor may also perform a physical exam to rule out other causes of depressive symptoms.

Before your doctor's appointment, consider these questions to help your doctor assess whether you are experiencing SAD or full-blown depression:

  1. Have you experienced symptoms for at least two consecutive years? If so, were these bouts during the same season each year?
  2. Were seasonal bouts of depression followed by periods without symptoms?
  3. Could there be other causes, such as an unusually stressful situation?

Based on test results, your doctor will develop a treatment program that might include:

  • Light therapy. Although not FDA-approved, light therapy involves sitting a few feet from a special light box that mimics sunlight. This simple treatment has relatively few side effects. What's more, many of the new light boxes look like desk lamps so you can take them to work without drawing undue attention to your situation.
  • Medications. Antidepressants are often prescribed for SAD. Your doctor may prescribe an antidepressant at the same time each year, recommending continued treatment beyond the time your symptoms normally diminish.
  • Psychotherapy. Although SAD is thought to be a biochemical illness, mood and behavior may also contribute to your symptoms. If so, psychotherapy can help you identify negative thoughts and behaviors that may be worsening your feelings of depression and help you take steps to change those behaviors.

While there is no way to prevent seasonal affective disorder, the condition is nonetheless real. If left untreated, it can have serious complications, such as suicidal thoughts and substance abuse. Taking steps to manage your symptoms early can make a difference in heading off more serious problems later on.

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