Seasonal Affective Disorder (SAD)

This condition is a form of depression that occurs mostly during the winter season. SAD occurs in the southern and northern hemispheres and is very rare for people living inside 30 degrees of the equator because of the long, extremely bright and constant the daylight hours. There is an estimated one out of one hundred people in UK who suffer from SAD during the months of September and April. This condition is severe during the months of December, January and February. For those people affected with SAD, they cannot function normally during the winter months if they do not have a continuous treatment. There is a milder version of SAD called the sub-syndromal SAD or the winter blues. It develops in people who have inadequate bright light. The use of light therapy is used for most of the cases.

Symptoms

SAD symptoms appear at any age but appear mostly at ages 18 to 30. The symptoms appear between the months of September to November and often continue to March and April. A diagnosis is done after the patient has had two or more successive symptoms. The common symptoms of the condition include the following:

  • Sleep problems – oversleeping, rises early in the morning and have a hard time staying awake
  • Overeating – craves carbohydrates and sweetened foods that makes them gain weight
  • Lethargy – lack of energy and is unable to do their normal routines because of fatigue.
  • Depression - feeling low, sad, weepy, worthless, hopeless
  • Social problems – becomes irritable and socially withdrawn from friends and other people
  • Apathy – lack of motivation
  • Loss of ability to concentrate
  • Anxiety - feels tense and cannot cope up with stress.
  • Decrease in sexual drive and physical contact
  • Does not have interest in pleasurable activities.
  • Changes in mood – excessive happiness or hypomania in the autumn and the spring
  • Weak immune system – susceptible to having flu and colds during the winter

Causes

The condition occurs when the person has insufficient bright light in the winter season. This is also caused by the imbalance of biochemical substances in the brain’s hypothalamus which controls the sleep, appetite, sex drive, temperature and the mood. When lights goes in to the eyes, it signals an impulse to the hypothalamus but if light is insufficient or if there is an abnormality on the nerve pathway, the activity and the functions of the hypothalamus is hindered.

Treatment

Light therapy is effective to up to 85% of the diagnosed cases. This treatment involves having the patient exposed to light for four hours a day that has at least 10 times more intensive than domestic lighting. There is a special light box that allows the light to enter the eyes. The special light box is used during the dull periods at summer and in early autumn if the symptoms appear. The patient can just glance at the box and stare at it completely so he could do other things efficiently. This treatment is effective for 3 to 4 days and can be useful if used every day. Evidence points out that dawn simulation devices could do well to treat this condition as well because it can mimic the dawn before the person wakes up.

Dawn simulators and light boxes cannot be bought from NHS and cost from £60 to £400 from retailers. Try light treatments before thinking of buying them. Aside from light therapy, studies have been done to see if there is any relation to the high amounts of negative ions in seashore and the low amounts of negative ions indoors during winter. Anti-depressant drugs are prescribed for those who suffer from severe SAD but some old anti-depressant drugs can increase the patient’s lethargy and sleepiness. New anti-depressant drugs have been found to be more effective than the old ones when used in combination with other therapies.

Self-help

The patient should be able to accept that he cannot function well during the winter season. He should prioritize his work to do minimal work during this season. He should try considering doing the major projects at summer instead. He should use the summer and spring months for his plans in the future like socializing and doing what he finds pleasurable. Go outdoors and fully utilize the bright light. Try decorating the house with light colours and always stay at windows whenever you are at a shop or at your work place. Consider having a vacation at January or February but also know that some patients may feel worse when they return to the UK after such trips. It is also wise to eat properly and exercise regularly. These two have known positive effects on the mental well-being of a person. Eat a lot of fresh fruits and veggies and refrain from drinking too much alcohol. If the symptoms persist after more than two weeks after the winter season, consult a doctor.

Help from family and friends

It is hard for a person to deal with SAD but the patient has to accept this especially when his symptoms are awful during the winter season. The patients need to know that they have little or no control in their behaviour. If you have a family member or knows someone suffering from SAD, encourage them to continue their treatment and never tell them that they are not trying hard to recover. The family and friends should be sensitive to their situation and to their needs. They should also be caring and patient. The patient should be encouraged to look forward to spring as it means that they will recover from their condition.