Seasonal Affective Disorder

Brighten Up the Winter Blues

Many people get the "winter blues," which is really called  Seasonal Affective Disorder. SAD affects one to three percent of adults and can markedly decrease a person's quality of life and functioning. SAD shares characteristics of major depressive disorder (MDD). The major difference, according to Lawrence H. Price, MD, attending psychiatrist at Butler Hospital and professor of Psychiatry and Human Behavior at The Warren Alpert Medical School of Brown University, is that SAD symptoms follow a seasonal pattern, usually during the fall/winter months, with a full remission occurring in the spring/summer. 

Symptoms and Causes of SAD

Researchers have discovered that many of the specific symptoms of SAD are similar to those of depression -- loss of energy, interests, changes in appetite, and trouble sleeping and concentrating, etc. However, in SAD, there is a higher prevalence of fatigue, increased amounts of sleep, appetite increases, particularly for foods high in carbohydrates, and weight gain, than is seen in non-seasonal depression.

Price explains that there are many theories behind the causes of SAD, but the most widely accepted one is that the amount of sunlight people are exposed to diminishes in fall/winter. "If you look at prevalence of major depression at different latitudes, research shows it's pretty common in northern latitudes, like Maine, and much less common in southern latitudes, like Florida," says Price.

Sunlight affects an area of the brain called the suprachiasmatic nucleus, located in the hypothalamus, which is responsible for functions, such as sleep, heart rate and blood pressure, appetite, weight regulation, and sexual functions.

Help and Treatment for SAD

If you think you may be experiencing symptoms of SAD, talk to your primary care physician or a mental health professional. According to Price, "good evidence exists that light box treatment, which is 20 times brighter than normal indoor light, is very effective. Light boxes are commercially sold and easy to purchase; however, a person should not start light therapy without consulting their physician or psychiatrist since it can worsen certain eye conditions," cautions Price.

Although artificial sunlight generated from light boxes is effective, Price stresses nothing works better than natural, outdoor light. So how long does it take to feel better once spring rolls around and the days get longer? "In general, mood improvement tends to correlate with the lengthening of daylight," says Price, "so most people are feeling substantially better by the time spring is in full bloom." Cold weather and many overcast days make it challenging for people to get enough outdoor light during the fall/winter months.

According to Price, medications are also effective in treating SAD. Bupropion received FDA approval as a treatment for SAD in 2006, and, says Price, "other antidepressants are thought to be effective as well." Whether medications or light treatment alone is used, or a combination of both, anyone with SAD can benefit from making healthy lifestyle changes. A regular sleep and exercise schedule, a healthy diet, and pushing yourself to stay engaged in social activities with others, can reduce symptoms of SAD.

You can also help loves ones with SAD by being understanding and encouraging them to seek professional treatment. Other ways to help, says Price, is to "offer to do healthy things with a loved one, like exercising, engaging in social activities, and eating healthy." Remember, too, that, with recognition of symptoms and early treatment, effective therapies are available for preventing and managing symptoms of SAD.