“People need to understand, mental illnesses don’t take a break during the holidays.” - Anonymous
Seasonal affective disorder, also shortened to SAD, is a type of depression occurring due to seasonal changes. It typically starts and ends at around the same time every year. For most people, the symptoms show up in the fall and continue throughout the months of winter. SAD often saps people’s energy and makes them moodier. It is comparatively uncommon to see SAD causing depression in the spring or summer months.
Symptoms
As mentioned before, symptoms of SAD manifest during the end of autumn or the start of winter and subside during spring or summer. The opposite pattern is also found but is not as common. In most cases, the symptoms are mild at the beginning but may turn severe as the season continues. The major signs and symptoms of SAD may be:
Being low on energy
Sleep problems
Difficulty in concentration
Changing appetite or weight
Feeling depressed for the majority of your day, every day
Agitation and sluggish feeling
Feelings of hopelessness, worthlessness, and guilt
Losing interest and motivation to participate in favorite activities
Frequently thinking about self-harming, death, and suicide.
Other than these general symptoms, some symptoms are generally specific to certain seasons.
Fall and Winter SAD
Some symptoms that are specific to winter-onset SAD, also known as winter depression can include:
Weight gain
Low energy, tiredness, and fatigue
Oversleeping
Changes in appetite, mainly cravings for carbohydrate-rich foods increasing
Spring and Summer SAD
Some symptoms that are specific to summer-onset SAD, also known as summer depression can include:
Weight loss
Insomnia and in general struggling to fall asleep
Anxiety and/or agitation
Lack of appetite/Poor appetite
It should also be noted that SAD can also affect pre-existing mental disorders in people. For example, if someone is diagnosed with Bipolar Disorder, they can express heightened symptoms of mania or hypomania in springs and summers or if a person has depression it could be made worse during the winters.
Causes
The specific causes of SAD cannot exactly be pinpointed, though some factors may include:
Levels of Serotonin: A drop in the levels of the neurotransmitter serotonin could play a role in SAD as the chemical affects mood. Reduced exposure to sunlight that may cause a drop in serotonin levels may also trigger depression.
Levels of Melatonin: The melatonin levels of the body can be disrupted due to the changing seasons and that could severely affect a person’s sleep and mood patterns.
Biological Clock/Circadian Rhythm: The reduced level and exposure to sunlight in the autumns and winters may cause winter-onset SAD. The decrease in the levels of sunlight can affect a person’s internal clock and may lead to depression.
Risk Factors
SAD has been diagnosed more commonly in women as compared to men and it is much more common in young adults in comparison to older adults. Factors that could increase your risk of developing SAD include:
Family history/Genetics: People diagnosed with SAD would most likely have relatives who have been diagnosed with SAD or any other form of depression.
Having pre-existing disorders: Symptoms of depression can significantly worsen if a person has a pre-existing mental illness, specifically if it is Major Depressive Disorder or Bipolar Disorder.
Distance from the equator: SAD is more commonly found in people who live extremely far North or South of the equator. This is said to be because of the reduction of sunlight during the months of winter and longer days during the summer months.
Complications
Signs and symptoms of SAD should be taken very seriously. As with the other types and forms of depression, untreated SAD can get worse and lead to serious problems. These complications may include:
Problems at school or work
Social withdrawal
Other mental disorders such as anxiety, depression, or eating disorders
Thoughts of self-harm
Suicidal thoughts and/or behaviors
Diagnosis
To diagnose Seasonal Affective Disorder, a thorough evaluation is conducted which generally includes physical exams, lab tests, psychological evaluation, and checking the criteria listed in the DSM-V.
Treatment
Treatment for SAD may consist of light therapy, medications, and psychotherapy, etc. It should be noted that you should inform your medical professional if you have bipolar disorder as light therapy or antidepressants could trigger a manic episode.
Light Therapy: Light therapy, also known as phototherapy, consists of a person sitting a few feet away from a special light box to make sure that they get exposed to bright light within the first hour of waking up every day. This form of therapy mimics natural light and appears to cause a change in the response of brain chemicals linked to behavior and mood. This therapy is usually the first treatment prescribed for winter depression. It has been said to start showing effects within the first few days to a few weeks and does not have many side effects. There has unfortunately not been much research done on light therapy but it seems to be effective for most people with symptoms of SAD. Also, make sure that you consult your therapist before you purchase a light box.
Medication: Medications, such as antidepressants are said to be helpful for people with SAD if their symptoms are severe. Your psychiatrist may prescribe you to start taking antidepressants before your symptoms begin every year. They can also recommend you to take the antidepressants even after your symptoms have gone away. It should be noted that antidepressants usually take a few weeks to show effects and different medications work for different people. Also, it is advisable to only take the prescribed dosage for the required amount of time.
Psychotherapy: Psychotherapy, also known as talk therapy is another way of treating SAD. One major form of psychotherapy used is Cognitive Behavioral Therapy (CBT). CBT is useful in identifying and changing negative thoughts and behaviors in a person, learning healthy ways of coping with SAD, and learning how to manage stress, etc.
Mind-Body connection: A lot of mind-body techniques that a person can try out to help cope with SAD are meditation, yoga, music therapy, and art therapy, etc.
Aside from these, you can also try to make your home environment sunny and bright, try to regularly go outside for walks and make sure you are healthy, and exercise regularly to lift your mood. Medication is usually the most helpful method to treat SAD but one should only adhere to the medication which is prescribed and not self-medicate. Unfortunately there is not enough research done on SAD to conclude if it's fully cured for a lifetime but many people have recovered from SAD by using treatment and medication.
Conclusion
Winter or Summer blues can have people feeling their lowest at times. One shouldn't take this lightly and also make sure that they aren’t suffering in silence. Thankfully at the very least, there are coping mechanisms that are helpful such as sticking to your treatment plan, socializing and making new friends, practicing stress management, and just, in general, taking good care of yourself.
References
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