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Facts about Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder, a type of winter depression that affects millions every year between September and April, andparticularly during December, January and February.

While many admit to feeling “more and more tired” and have an aversion togo out during the winter months, people who suffer from SAD are typically debilitated by the condition and find it near impossible to function when participating in everyday activities.

Symptoms often include:

  • Difficulty in waking up in the morning
  • Decreased energy/lethargy
  • Craving for sweet and starchy foods (carbohydrates)
  • Increased appetite
  • Increased sleep
  • Weight gain
  • Difficulty concentrating
  • Decreased interest in sex (libido)
  • Withdrawal from family and friends
  • Depression/anxiety/irritability

Norman Rosenthal of the National Institute of Mental Health
first recognized SAD as a disorder in 1984. Rosenthal also gave the disorder its name and pioneered the first treatment that proved marginally effective for SAD. The disorder appears to have a strong connection to insufficient light and is thought to be caused by a biochemical or hormonal imbalance due to the shortening of daylight hours and the lack of sunlight in winter.

According to the Substance Abuse and Mental Health Services Administration at University of Michigan in Ann Arbor, mental health problems affect 1:5 young people at any given time. The age of onset for anxiety disorders and depression explains why so many college students are affected. Often college students who have been diagnosed with depression prior to entering college, may stop their anti-depressant medication in anticipation of drinking more on campus. This increases the likelihood that symptoms of depression will recur and may he complicated by seasonal factors.

According to a study conducted by the McKinley Health Center at the University of Illinois, while smoking and drug abuse are common addictions, those who consume large amounts of caffeine may also suffer from harmful repercussions down the line.  The most common short-term side effects of caffeine are headaches, stomach cramps and increased muscle tension. Some of the more serious symptoms include depression, diarrhea, sleep deprivation and an increase in blood pressure. This again, may be intensified further by the environmental triggers of SAD.

SAD rarely affects people who live in latitudes less than 30 degrees away from the equator, where daylight hours are many, and sunlight is constant and extremely bright.

Similarly, as one gets farther from the equator, the frequency of SAD also increases. Michigan is 42 degrees north.

Prolonged periods of overcast weather can also exacerbate SAD.

According to National Organization of Seasonal Affective Disorder (NOSAD), gender and age group may also play a role. Women are more susceptible to the effects of SAD and comprise 70 to 80 percent of cases, while the primary age of onset is 18 to 30.

Light therapy, the treatment first used by Rosenthal, is the
most common form of therapy for severe SAD. While people displaying non-debilitating symptoms can purchase their own UV light bulbs or other bright, sun-replicating light sources, doctor-mediated photo-therapy is recommended for patients with more severe forms of the disorder.

Light therapy may elevate melatonin and serotonin levels.

This type of therapy has been proven effective in more than 80 percent of diagnosed cases. NOSAD recommends at least 30 minutes of very bright light that is at least 10 times the intensity of ordinary domestic lighting.

Other severe cases of SAD are treated with psychotherapy and medication. According to NOSAD, traditional antidepressant drugs are not usually helpful for SAD because they tend to exacerbate sleepiness and lethargy. On the other hand, non-sedative drugs such as Prozac (fluoxetine) are effective in helping the depressive symptoms of SAD and combine well with light therapy.

Treatments for the milder version of SAD, or the winter blues, range from increased physical activity to the regulation of diet, especially control over the consumption of carbohydrates and sweets.

NOSAD recommends spending at least an hour a day outside in the sunlight – which is difficult when you are indoors all day and it gets dark so early in Michigan.

What differentiates SAD from “winter blues” and other depressions:

*Depression and other symptoms for a minimum of two consecutive years during the same season.

*Depression-free periods following episodes of depression

*Unexplained behavior and mood changes.

Birmingham Maple Clinic | Michigan Mental Health