Seasonal Affective Disorder

Twenty percent of the population experiences some seasonal fluctuation in sleep and mood; 1-10% of the population meet the criteria for Seasonal Affective Disorder (SAD).  Although many people are affected in some way by the changing  seasons, for most people, these changes do not cause problems.  For people who suffer from SAD, there is a greater sensitivity to the lack of natural light in winter.  The following information is designed to increase understanding of the disorder and may help those who suffer from it to seek help and support:

What is Seasonal Affective Disorder?
SAD is a mood disorder characterized by fall/winter depression alternating with spring/summer elation or "normal" moods.  The key indicator for SAD is seasonality.  Usually, symptoms will appear sometime in the fall and will remit sometimes in the spring.  Exactly when a person's symptoms begin and end varies by individual.

Symptoms of SAD
 

	Weight gain	Drop in energy level
	Reduction in sex drive	Reduction in the quality of sleep
	Avoidance of social situations	Decrease concentration
	Decreased creativity	Irritability
	Inability to complete tasks
	Change in appetite (especially craving for sweet or starchy foods)
	Change in sleep/wake patterns (especially a tendency to oversleep)

Some of these symptoms also may stem from other seasonal stressors such as family holidays or the anniversary or recent loss of a loved one.  If these symptoms are accompanied by continual feelings of deep depression, worthlessness or recurring thoughts of death or harming oneself, these are signs to seek help.

Facts about SAD

• Not all SAD sufferers have the same set of symptoms.

• Some SAD sufferers are affected whenever there are several overcast days in a row, regardless of the season.

• The onset of SAD typically occurs in an individual's third decade of life, however, younger persons are at higher risk, 4-13% of children and adolescents meet criteria for SAD.  Symptoms for children include:

• Women make up 60% - 90% of persons with SAD

• The condition is more likely to affect people living in the northern latitudes, where the winter days are shorter and nights longer.

Not just the "Winter Blues"
Commonly thought of as the "holiday blues" or Christmas depression" a season-long cause of the "blahs" is a form of depression for some people.  This condition takes on nearly debilitating proportions for some of its sufferers who may feel as though they cannot get out of bed all winter long.  Morning sunshine, so plentiful during the warmest months of the year, naturally suppresses melatonin, the body's sleep inducing hormone.  Dark winter mornings leave melatonin levels high, and sufferers feeling sluggish, for months at a stretch.  SAD involves both biological and psychological factors.

Treatment for SAD
As with any mood disorder, any treatment for SAD should be undertaken under the guidance of a qualified health professional.  Exposure to bright light, known as phototherapy, has been found to be an effective method of treating SAD.  Individual sensitivity to the light therapy varies, so it is necessary to work with a health professional in order to determine the optimal intensity, duration, and time of day for the treatment.  Medication is generally considered less effective than light therapy for the treatment of SAD, however, it is often used to supplement light therapy or used for those who cannot tolerate light therapy.

Other Helpful Strategies

• Increase amount of available indoor light by adding windows, lamps, and skylights

• Use bright colors in decorating

• Ask to be seated by windows at restaurants and take "window breaks" regularly at work

• Feelings of warmth (e.g. drinking hot tea, wrapping up in a blanket) have been reported to help

• Healthy diet and exercise habits

Advice for dealing with family and friends with SAD

• Learn all that you can about SAD and inform your loved ones that there is help available

• Encourage and remind them that their problems may be seasonal and will likely pass

• Avoid being judgmental and critical, as the SAD individual is likely already feeling that they have let themselves and others down

• Don't take the withdrawal from social engagement displayed by many SAD individuals as personal

• Don't assume it's your responsibility to make them feel better