Seasonal Affective Disorder -- November 24, 2008 -- Dr. Art Williams - NewsChannel5.com | Nashville News, Weather & Sports

Seasonal Affective Disorder -- November 24, 2008 -- Dr. Art Williams

Seasonal Affective Disorder

What is Seasonal Affective Disorder?

Some people suffer from symptoms of depression during only the winter months, with

symptoms subsiding in spring and summer. This may be a sign of Seasonal Affective

Disorder (SAD). SAD is a mood disorder associated with depression episodes and

related to seasonal variations of light. For some individuals, SAD can be a disabling

illness, hindering their usual routines.

Though noted before 1845, SAD was not officially named until the early 1980s. As

sunlight has affected the seasonal activities of animals (i.e., reproductive cycles and

hibernation), SAD may be an effect of seasonal light variation in humans. As seasons and

patterns in sunlight change, there is a shift in a person's "biological internal clocks" or

circadian rhythm. This shift can cause biological clocks to become "out of step" with

daily schedules. The most difficult months for SAD sufferers are January and February.

How common is SAD?

As many as 10 million Americans may have SAD, while another 25 million may

experience mild SAD often referred to as "the winter blues" or "the winter blahs." SAD

is more common in women than in men. Although some children and teenagers may

experience SAD, it usually does not occur in those under age 20. For adults, the risk of SAD decreases as they age. SAD is more common in northern geographic regions.

What is the cause of SAD?

Melatonin, a sleep-related hormone secreted by the pineal gland in the brain, has been

linked to SAD. This hormone, which may cause symptoms of depression, is produced at

increased levels in the dark. Therefore, when the days are shorter and darker, the

production of this hormone increases.

Symptoms of Seasonal Affective Disorder

The symptoms of Seasonal Affective Disorder usually recur each winter, starting between

September and November and continuing until March or April. January and February are

the worst months for SAD. A diagnosis can be made when an individual experiences three or more consecutive winters with symptoms. Symptoms include:

1. Sleep Problems: Desire to oversleep, disturbed sleep or difficulty staying awake

2. Lethargy: A feeling of fatigue and inability to carry out normal routines

3. Overeating: Craving sugary or starchy foods

4. Depression: Feelings of sadness, guilt, hopelessness or despair

5. Social Problems: Irritability and desire to avoid social situations

6. Anxiety: Tension and inability to tolerate stress

7. Loss of Libido: Decreased interest in sex or physical contact

8. Mood Changes: Extremes in mood and short periods of hypomania in spring and

autumn in some sufferers

Most SAD sufferers show signs of a weakened immune system during winter, and are more vulnerable to infections. SAD symptoms disappear in spring. The symptoms may disappear suddenly with a short period of hypomania or hyperactivity, or gradually, depending on the intensity of sunlight in the spring and early summer. In mild SAD, also known as sub-syndromal SAD, symptoms such as tiredness, lethargy, sleep and eating problems occur, but depression and anxiety are absent or mild.

This information was culled from the National Mental Health Association and the Seasonal Affective Disorder Association. For more information please visit www.nmha.org.

Treating Seasonal Affective Disorder

Light Therapy

Phototherapy or bright light therapy has been shown to suppress the brain's secretion of

melatonin. Although no research findings definitely link this therapy

with an antidepressant effect, many people respond to this treatment. The device most

often used today is a bank of white fluorescent lights on a metal reflector and shield with

a plastic screen.

Generally, light therapy works best if used for about 30 minutes each day throughout fall

and winter, when an individual is most likely to feel depressed. If light therapy is

helpful, an individual can continue using it until enough sunlight is available naturally,

typically in the springtime. Stopping light therapy too soon can allow the symptoms to

come back.

Tanning beds should not be used to treat SAD. The light sources in tanning beds are high

in ultraviolet (UV) rays, which harm both eyes and skin. For mild symptoms, spending time outdoors during the day or arranging homes and workplaces to receive more sunlight may be helpful. One study found that an hour's walk in winter sunlight was as effective as two and a half hours under bright, artificial light.

Medications and Psychotherapy

If phototherapy does not work, an antidepressant medication may prove effective in

reducing or eliminating SAD symptoms, but there may be unwanted side effects to

consider. Individuals should discuss their symptoms thoroughly with a family doctor

and/or mental health professional. In addition, psychotherapy, counseling or "talk" therapy that helps an individual manage SAD can be helpful.

Holiday Depression

The holiday season is a time of joy, cheer, parties and family gatherings. However, for many people, it is a time of self-evaluation, loneliness, reflection on past failures and anxiety about an uncertain future.

What causes holiday blues?
Many factors can cause the holiday blues: stress, fatigue, unrealistic expectations, over-commercialization, financial constraints and the inability to be with one's family and friends. The demands of shopping, parties, family reunions and house guests also contribute to feelings of tension. People who do not become depressed may develop other stress responses, such as headaches, excessive drinking, over-eating and difficulty sleeping. Even more people experience post-holiday let-down after Jan.1. This can result from disappointments during the preceding months compounded with the excess fatigue and stress.

Coping with Stress and Depression During the Holidays

• Keep expectations for the holiday season manageable. Try to set realistic goals for yourself. Pace yourself. Organize your time. Make a list and prioritize the important activities. Be realistic about what you can and cannot do. Do not put entire focus on just one day (i.e., Thanksgiving Day). Remember it is a season of holiday sentiment and activities can be spread out to lessen stress and increase enjoyment.
• Remember the holiday season does not banish reasons for feeling sad or lonely; there is room for these feelings to be present, even if the person chooses not to express them.
• Leave "yesteryear" in the past and look toward the future. Life brings changes. Each season is different and can be enjoyed in its own way. Don't set yourself up in comparing today with the "good ol' days."
• Do something for someone else. Try volunteering some time to help others.
• Enjoy activities that are free, such as driving around to look at holiday decorations or going window shopping without buying.
• Be aware that excessive drinking will only increase your feelings of depression.
• Try something new. Celebrate the holidays in a new way.
• Spend time with supportive and caring people. Reach out and make new friends or contact someone you have not heard from for awhile.
• Save time for yourself! Recharge your batteries! Let others share responsibility of activities.

This information was culled from the National Mental Health Association, the American Academy of Family Physicians and the Seasonal Affective Disorder Association. For more information please visit www.nmha.org, or www.familydoctor.org.