Tis the Season for SAD

Identifying and managing Seasonal Affective Disorder

by jennifer molk

Nightfall comes earlier and earlier now, thanks in part to Daylight Savings Time. For parents of small children, the time change may be an opportunity to rein in ambitious youngsters who need to get homework done. For farmers however, the time change means one less hour of sunlight showering over their crops.

     Another adverse side affect of shorter days and longer nights is the risk of Seasonal Affective Disorder (SAD), sometimes referred to as the “winter blues.”

    “Seasonal Affective Disorder is a kind of depression that is present only during low light months,” says Dr. Martha Rhoades, with Billings Clinic. “It is more common in areas farther away from the equator. It can exist separate from other forms of depression, or can be a seasonal exacerbation of depression.”

     The National Mental Health Association reports half a million people experience Seasonal Affective Disorder between September and April, with cases peaking December through February.  The NMHA also says three out of four sufferers are women between the ages of 18 and 30 living in the northern hemisphere, where winters are longer and harsher.

     “One explanation for seasonal mood disorder is that people convert sunlight to vitamin D,” Dr. Rhoades explains. “In low light conditions, people may become vitamin D deficient. In northern states like Montana, many people have low vitamin D levels in the winter. Some people experience depression when their vitamin D level is too low.”

     SAD isn’t necessarily exclusive to the winter months however.

     “If a person gets depressed during the winter, then feels better in the spring and summer, it is likely that person has SAD,” says Mary L. Sarff, a counselor at St. Vincent Healthcare Behavioral Health. “However, some individuals may experience SAD during summer months but the symptoms will likely include decreased eating and sleeping rather than increased eating and sleeping, which is more prevalent during fall and winter occurrences of  SAD.”

Symptoms of SAD

            Mary L. Sarff offers additional factors to consider when identifying Seasonal Affective Disorder.  “It is thought to be related to ambient light, body temperature, and hormone regulation,” she says.  It could quite possibly be hereditary as well. “It is more common when people have a close relative with SAD,” she says.

            Sarff lists the symptoms of Seasonal Affective Disorder as some or all of the following symptoms that may be present: 

Depression

Lack of enjoyment

Loss of energy

Increased need for sleep (Decreased sleep if SAD occurs in the summer months)

Difficulty concentrating

Decreased functioning

Increased appetite  (decreased appetite for SAD in the summer months)

Craving carbohydrates

Isolating oneself

Increased irritability, tearfulness

Decreased sex drive

Suicidal thoughts, feelings or attempts

 

 

Identifying the symptoms

     Identifying SAD might just start right at home.  “Family members may be aware that their relative is less interested in doing things, more withdrawn, more irritable, and somewhat sad in the winter,” suggests Dr. Rhoades. “They may think of them as having the ‘winter blues.’ It may be helpful to tell a family member that they have noticed they don’t enjoy life much in the winter months and ask if that fits their own perception.  If it does, mentioning the possibility of Seasonal Affective Disorder would be useful.”

Seeking help

      “Antidepressants like Prozac, Paxil, Zoloft, Lexapro, Celexa, Cymbalta, Effexor or Pristiq can help SAD significantly,” offers Dr. Rhoades. “For people already taking one of these, a slightly higher dose in winter months may be of use in some cases.”

     Bright light therapy is another option for treatment. “This requires 10,000 lux full spectrum fluorescent light for about 30 minutes in the morning,” says Dr. Rhoades. “Glancing at the light every few minutes without corrective lenses may increase its effectiveness.            Staring at the light, however, is not recommended.” 

     Checking a vitamin D level with a blood test and taking 50,000 international units weekly until the level is about 50 is a third method of treatment. “Ask your physician to order a vitamin D level,” Dr. Rhoades suggests. “If it is above 50 it is more likely you have a form of depression other than SAD.”

     Some patients can benefit well with one of the above treatments; others may need a combination of treatments, Dr. Rhoades cautions. 

     For those lucky enough to be able to hop a plane and leave winter behind, Dr. Rhoades has one final suggestion.

     “Travel to a bright sunny location near the equator, like the Caribbean,” she offers. “It may be just as effective as the above therapies, and more fun!”  But, she warns, unless you can afford to winter there all season, SAD may return a few weeks after you return home.

Jennifer Molk is a freelance writer who resides in Billings.  She enjoys writing about topics and issues she herself seeks the answers to.  She is a mother of two.