Have a case of the winter blues? It’s not just an old-wives-tale explanation for why some people experience depression during the winter months. Seasonal affective disorder, which has the rather appropriate acronym SAD, is a real medical condition that can have a serious impact on your life. If left untreated, it can turn into ongoing depression. Fortunately, a number of effective treatments are available that can help alleviate symptoms and give you your life back. Jeff’s SAD story…
Jeff is an active, fitness-minded 35-year old married male with two children. He enjoys his job as the manager of a busy health club. Originally from San Diego, his company transferred him to Seattle 3 years ago when they opened a new health club there. Although he quickly fell in love with the beauty of the Pacific Northwest and enjoyed exploring the local culture with his family, he missed the endless sunshine of southern California. Each year, Jeff found himself struggling during the gray, rainy fall and winter months for which Seattle was notorious. Normally energetic and upbeat, his mood and energy levels would quickly begin to drop around early November. He felt tired and irritable, and getting out of bed each day was a challenge. He spent his weekends sleeping a lot and sitting around the house watching TV. He just couldn’t find the motivation or energy to do much else. But by late spring each year he started to feel like his old self again, and was able to enjoy the summer. It wasn’t until Christmas of their third year in Seattle that Jeff’s wife realized the significant change in his mood was following a consistent pattern. She encouraged him to get a physical and talk to his doctor about the depression he had begun experiencing every winter since they had moved. After ruling out any potential underlying medical problems, his doctor diagnosed Jeff with Seasonal Affective Disorder and recommended light therapy. Although Jeff still dislikes the gray Seattle winters, regular use of a special light therapy lamp keeps his depressive symptoms at bay.
Understanding SAD is an important first step in understanding good treatment options. As with clinical depression, people with seasonal affective disorder often have feelings of hopelessness accompanied by irritability, low energy levels, and loss of interest in normal activities. It’s common for those with this mental health condition to withdraw socially as well. SAD is sometimes misdiagnosed as mononucleosis or other types of infections. Researchers haven’t pinpointed the exact cause of SAD, which affects as many as 1 in 5 Americans – most of whom are women . It’s likely that a number of factors play a role in its development. For example, the extended period of darkness during winter months may affect levels of melatonin, disrupting the body’s natural internal clock and triggering depression as a result. Experts also believe that levels of serotonin, a brain chemical that helps regulate mood, contributes to seasonal affective disorder. Less exposure to sunlight in the winter may cause serotonin levels to drop, causing symptoms of depression to develop. Although the majority of individuals with SAD become symptomatic during the late fall and winter months, approximately one-tenth of cases occur during the opposite time of year. This is often referred to as “reverse” or “summer” SAD. With reverse SAD, individuals experience their depression during the summer months. Researchers believe this less common type of SAD is triggered by high heat and humidity.
Three Beneficial SAD Treatments
The Internet is packed with pages of fixes for seasonal affective disorder. Many of these include ineffective home remedies that have no scientific research to back up their claims. However, there are several established treatment options that mental health professionals recommend that can significantly reduce SAD symptoms and improve your quality of life.
Also referred to as phototherapy, this treatment often involves the use of special devises that simulate sunlight. Light therapy may also involve lifestyle changes that increase your daily exposure to natural light. The absorption of sunlight helps stimulate the production of serotonin in your brain. It’s believed that the light waves of morning sunlight offer the most effective treatment because they help reset your body’s internal clock. (It should be noted that light therapy is not an effective treatment for summer SAD.) If you have mild symptoms, adding regular outdoor activity – especially during the morning – to your daily routine may generate enough serotonin production to sufficiently reduce symptoms. Rearranging furniture in your home can also help. For example, you might move your desk so it’s next to a window that receives morning sunlight, allowing you to work while being exposed to beneficial light waves. When natural light isn’t enough or if you’re unable to increase your daily exposure, your therapist may recommend a light therapy box. This type of box emits very bright light that mimics sunlight. Your physician will likely prescribe a particular light box or recommend a model from a drug store or retailer. Sometimes you can rent a phototherapy light from a medical supply store or health and wellness center. Use only lights specifically recommended for treating seasonal affective disorder. The cost of the recommended light may be covered by your health insurance, so be sure to check with your provider to find out if it will cover the cost. During light sessions, you’ll sit near the box so the light can indirectly enter your eyes to naturally adjust your internal body clock. Typically, your treatment provider will recommend using the box immediately after you wake up in the morning. Some models feature a dawn simulator. This simulator turns the light on at a very low level and gradually increases before you wake. It may continue to gradually produce brighter light as the morning goes on. Your physician may recommend a specific length of time for your phototherapy sessions. These sessions may be anywhere from 15 minutes to two hours. It often takes a few days to two weeks to see an improvement in your symptoms. The key to making phototherapy effective is to follow your doctor’s instructions. Set the light box in an area where you can relax or work. If you place it near a desk, you can use your computer or talk on the phone while benefitting from the light therapy. You might place the light box on your kitchen counter if your morning is spent fixing breakfast, packing kids’ lunches, or doing dishes. Don’t discontinue treatment before the recommended time frame. If you do, your symptoms may return. Consistency gives you the best chance for overcoming SAD. Most people don’t experience side effects from light therapy. However, a word of caution is in order. If you have bipolar I disorder the light therapy may trigger a manic episode. Be sure to let your doctor know if you have bipolar disorder – or a family history of bipolar disorder – before using light therapy. He or she may recommend a mood stabilizing drug to help prevent a manic episode during treatment. Light therapy may not be safe if you have eye problems or take medication that makes you sensitive to light.
Psychotherapy or talk therapy, as it is sometimes called, can be an effective treatment for seasonal affective disorder. A psychologist or other type of trained therapist will help you understand why you’re experiencing negative thoughts and emotions, and help you develop effective ways to change negative thought patterns and improve your mood. Talk therapy may take place in individual, group, and / or family sessions.
Although light therapy and / or talk therapy are the primary treatments of choice for SAD, they aren’t always effective. Your therapist or doctor may also recommend an antidepressant. The most common antidepressants used to treat SAD are selective serotonin reuptake inhibitors (SSRIs). Atypical antidepressants, particularly bupropion (Wellbutrin) or venlafaxine (Effexor), may also be prescribed. These drugs are usually prescribed to work in conjunction with a treatment plan that also incorporates light therapy and/or talk therapy. Since antidepressants may have undesirable or even side effects, they should only be used if your SAD has not benefitted from other types of treatment. Seasonal affective disorder generates depressive symptoms that can significantly interfere with your life. When symptoms flare up, it can be difficult to work, maintain healthy relationships with your family and friends, or fulfill other important responsibilities. If your life has been disrupted because of SAD, seek treatment. A mental health professional, such as a psychologist or psychiatrist, will assess your condition and recommend an effective treatment. Treatment can help alleviate your symptoms so you can start feeling better and function optimally once again.