seasonal affective disorder

Seasonal Affective Disorder

Some of us notice that we don’t feel so good in the Winter, we don’t have the same motivation we did in the long, warm Summer days. This feeling can quite easily interfere with your day to day life, some people might remark that they feel like they need to hibernate but many people don’t realise they are suffering from Seasonal Affective Disorder (SAD).

So what is SAD?

SAD has  alot in common with depression, check out our blog post on Depression for more specific information. The main symptoms of SAD are:

  • Low mood
  • Lack of interest in hobbies
  • Neglect of everyday chores or tasks
  • Reduced desire for self care

Often these symptoms also occur:

  • Being less social
  • Low energy
  • Easily irratated
  • Eating more
  • Sleeping more

If you are suffering from SAD you may find it difficult to wake up in the mornings and find the motivation to get out of bed, you may find yourself lacking motivation or energy to get through the day often feeling sleepy in the afternoon or desiring a nap in the evenings. You may find yourself binging on carbohydrate based foods much more than normal such as white bread or sweets resulting in weight gain.

Usually, most – if not all – symptoms disappear in the Spring or Summer with most sufferers noticing a dramatic increase in motivation and energy during these periods.

SAD is about 3 times more common in Women than it is Men but much less common in children and older adults. Many of us feel differently during the Winter months, with the days drawing shorter and the temperatures dipping, many people find themselves spending evenings inside much more often but if your symptoms are severe enough to be affecting your day to day life then you may very well be suffering from SAD. About 3% of the population in the UK suffer from significant Winter depression.

There has been a lot of research exploring how daylight can influence appetite, wakefulness and mood. However people living in more Northern areas do not appear to suffer at a higher rate than those living in regions closer to the equator so other factors may be related and some people even report feeling more depressed during the Summer months.

SAD can be treated the same way as Depression with a few lifestyle changes and in extreme cases, talking therapies and antidepressant medication. Light box therapy also has been shown to significantly improve the mental health of individuals but research into this is still at early stages.

Self-help

Some symptoms of SAD can create extra problems which make you feel even worse – ‘vicious circles’:

  • If it is dark and you feel tired all the time, you will probably do less – and this can make SAD worse. Try to get as much natural sunlight as possible. Take a walk during daylight hours or carry on any exercise you would normally do. Remind yourself that days will get longer again in the spring.
  • If you are eating more, you may put on too much weight which makes you feel worse. Remind yourself that most people put on weight in autumn and early winter.
  • Sleepiness, lack of motivation and irritability can all cause problems at home, with your friends, and at work. The feelings of not getting things done can make you feel stressed. Tell your family and friends so that they can understand what is happening and be supportive.

Medication

Antidepressants may be useful in the treatment of SAD although any treatment that would potentially make you more sleepy should be avoided, for this reason SSRI antidepressants are usually used. Usually a medication such as Sertraline, Citalopram or Fluoxetine. Many patients usually pre-emptively start taking the medication at the beginning of Autumn and then come off them in the Spring. However studies of the effect of medication to treat SAD has shown it to only be a minor benefit and self-help or therapy is generally preferred.

Cognitive Behavioural Therapy (CBT)

There is evidence that CBT can help treat Winter Depression and even stop its recurrence in future years.  CBT is a treatment for anxiety and depression in general where you have weekly sessions with a qualified therapist and then do some homework through the week like keeoing a diary.

Light Therapy

The idea behind light therapy is that you make up for the reduced hours of sunlight during the day by using a “light box”. A light box is a powerful lamp that tries to mimic sunlight but without any of the dangerous ultravoilet rays, the idea is that it helps the individual produce less of a hormone called melatonin.

Usually a lightbox will be used for about 30 minutes each day, often in the morning while the individual is getting ready for the day, a big upside of this type of therapy is that strong improvements are usually noticed in the first week so it’s quite easy for an individual to tell if it’s working for them or not.

Another type of light therapy is a “Dawn-simulating alarm clock”, similarly to a traditional alarm clock you can set a time to be woken up but instead of being jarred awake by the dreaded monotone beeping, the dawn simulating alarm clock comes on dimly about an hour before you need to be woken up and then the light gets progressively brighter the closer it gets to your alarm time. This way you are woken up naturally and peacefully.

Best Treatment?

Generally for mild symptoms the best treatment is the self help described above, however if you find that this isn’t enough you may need to to speak to your Doctor about medication or therapy, your Doctor will usually discuss available options that are convenient and appropriate for you.