seasonal depression

How to Treat Seasonal Depression

Posted on March 11th, 2017
Posted in Articles, Depression

People with seasonal depression have a form of major depression that tends to occur at the transition point between fall and winter, or (in a much smaller number of cases) spring and summer. The official name for this condition is seasonal affective disorder (SAD). Doctors have four treatment options to help their patients affected by SAD: antidepressant medications, light therapy, cognitive behavioral therapy and vitamin D supplementation. These treatments may be used separately or together.

Antidepressant Medications

Doctors often use antidepressants called SSRIs (selective serotonin reuptake inhibitors) to ease the effects of seasonal affective disorder. These medications provide their benefits by increasing brain levels of the natural mood-regulating chemical serotonin. Common examples of widely available SSRIs include:

  • Prozac (fluoxetine)
  • Zoloft (sertraline)
  • Lexapro (escitalopram)
  • Paxil (paroxetine), and
  • Celexa (citalopram)

In addition, doctors sometimes prescribe another, non-SSRI antidepressant called bupropion (Zyban, Wellbutrin). This medication provides its benefits by altering your brain’s levels of serotonin and two other chemicals, dopamine and norepinephrine.

Light Therapy

Diminished exposure to sunlight in the fall and winter can play an important role in the onset of seasonal depression. Light therapy provides its benefits by providing you with a bright source of artificial light to increase your daily light exposure. During treatment, patients typically sit in front of a 10,000 lux fluorescent light for anywhere from 20 minutes to an hour each morning. The light used has a cool-white quality that mimics natural sunlight; a filter system eliminates the presence of harmful UV radiation. Daily use of light therapy typically begins in the early fall (before sunlight levels start declining significantly) and continues into the spring, when sunlight levels have increased substantially above their winter lows.

Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, is a specific form of psychotherapy. Participants in this therapy learn to understand how their habitual thoughts and behaviors can have a negative impact on their well-being. They also learn how to replace damaging thoughts and behaviors with new alternatives that support well-being.

Doctors have developed a special type of cognitive behavioral therapy for people with seasonal affective disorder. The common term for this illness-specific treatment is CBT-SAD. In addition to identifying and replacing negative trains of thought, CBT-SAD participants learn how to offset their seasonal depression by actively participating in enjoyable indoor and outdoor activities.

Vitamin D Supplementation

Vitamin D is naturally generated in your body when you expose your skin to sunlight. When sunlight levels drop in the winter months, your levels of this vitamin can drop off significantly, as well. People affected by SAD frequently have low vitamin D levels, and supplementation is designed to offset this issue. However, researchers don’t universally agree on the benefits of vitamin D supplementation as a SAD treatment. Some studies show positive outcomes on a par with light therapy; however, other studies show no real benefit whatsoever.

Combined Treatment

Doctors frequently combine the available treatments for seasonal affective disorder. For example, if you receive antidepressants, you may also participate in light therapy and/or CBT-SAD. In addition, your doctor may combine the use of an SSRI medication with bupropion. Vitamin D supplementation is always used together with at least one other SAD treatment option.

 

Resources

National Institute of Mental Health: Seasonal Affective Disorder https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml#part_152433

U.S. National Library of Medicine – MedlinePlus: Seasonal Affective Disorder https://medlineplus.gov/seasonalaffectivedisorder.html

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