Expert Advice

Seasonal affective disorder

October 04, 2007|By Holly Selby

Brilliantly colored leaves. Crisp air. Changes in light. All are nature's way of signaling fall has arrived and will eventually give way to winter. For some people, however, the changes in light may cause a type of depression called seasonal affective disorder, says Karen Swartz, director of clinical programs for the Johns Hopkins Mood Disorder Center.

According to the American Academy of Family Physicians, as many as a half-million people in the United States may experience significant symptoms of SAD or "winter depression." Another smaller group of people may have milder symptoms.

Could you describe the symptoms of SAD?

Seasonal affective disorder is a form of depression that occurs during the winter months.

The symptoms are essentially the same as those of major depression: changes in mood, energy and appetite, having a sense of being sad or depressed.

But people with SAD also tend to sleep more than usual and to crave sugary or starchy foods, and a classic case of SAD resolves itself during the summer and spring months.

What causes SAD?

When the seasons change, the amount of sunlight available each day decreases. These changes in light can affect the body's circadian rhythm, which in turn affects the body's eating and sleeping patterns and hormone production, among other things.

Getting less sunlight combined with changes in the body's circadian rhythm can cause depression in some people.

When should a person consult a doctor?

Anytime someone is having a change in mood that leads to a significant change in energy, sleep or motivation, he or she should consult a doctor. They don't have to consult a psychiatrist; they can discuss how they feel with the family physician.

If someone is hopeless or having thoughts of suicide, then that is an emergency, and he or she should consult a doctor right away.

If your level of functioning is being changed by these kinds of symptoms, there is no reason to suffer unnecessarily.

What is the treatment for SAD?

For mild to moderate seasonal affective disorder, bright light therapy is often effective. This involves sitting in front of full-spectrum lights that mimic sunlight on a regular basis -- typically for about 30 minutes to 60 minutes before 10 each morning. (These are specially designed lights for this purpose that are made to minimize eye and skin damage; don't just go buy bright lights.)

For severe SAD, lights are often inadequate. The treatment is medication, psychotherapy and possibly the lights.

How do the patients who consult you about this disorder typically describe their symptoms?

They describe a medical condition that interrupts how they function at home and at work. It changes your emotions: You feel sad or irritable or nothing. It affects basic things like ability to sleep, concentration, motivation -- very basic things you need to get through life.

But the most serious symptoms are how they feel about themselves: self-critical, that they are a burden. You see, depression, including seasonal affective disorder, is relatively common, but also potentially life-threatening and that is why it is so important to seek help.

What advice would you give to people who think they may have seasonal affective disorder?

Speak to your physician directly. It is important not to wait until the dead of winter to seek help. A lot of people will wait until the light completely changes, but it is far better to seek help early on.

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