SAD (Seasonal Affective Disorder)

As the days grow shorter and the temperatures drop, you may find yourself experiencing the blues. Everyone feels them now and again especially in the winter months. However, if you can’t seem to shake your poor mood and constant fatigue and these symptoms reoccur at the same time every year, you may be suffering from Seasonal Affective Disorder, or SAD.

According to the Academy of American Family Physicians, SAD is a form of depression that is triggered by the seasons of the year. About six percent of Americans suffer from the disorder and you guessed it ...those who have experience trauma or PTSD have a higher rate of experiencing it. So it is important that we talk about some of the signs, symptoms and treatment.

The information below is from the NAMI website- (National Association for Mental Illness)

What are the patterns of SAD?

Symptoms of winter SAD usually begin in October or November and subside in March or April. Some patients begin to slump as early as August, while others remain well until January. Regardless of the time of onset, most patients don’t feel fully back to normal until early May. Depressions are usually mild to moderate, but they can be severe.

The usual characteristics are

• oversleeping, 
• daytime fatigue 
• carbohydrate craving and weight gain, 

Additionally, there may be some of the following features of depression:

•  decreased sexual interest
• hopelessness
• suicidal thoughts
• lack of interest in normal activities
• social withdrawal.

Light therapy is now considered the first-line treatment intervention, and if properly dosed can produce relief within days. Antidepressants may also help, and if necessary can be used in conjunction with light.

SAD is often misdiagnosed as hypothyroidism, hypoglycemia, infectious mononucleosis, and other viral infections.

How is winter SAD treated with light?

Bright white fluorescent light has been shown to reverse the winter depressive symptoms of SAD. Bulbs with color temperatures between 3000 and 6500 degrees Kelvin all have been shown to be effective. The lamps are encased in a box with a diffusing lens, which also filters out ultraviolet radiation. The box sits on a tabletop, preferably on a stand that raises it to eye level and above. Studies show between 50% and 80% of users showing essentially complete remission of symptoms, although the treatment needs to continue throughout the difficult season in order to maintain this benefit.

There are three major dosing dimensions of light therapy, and optimum effect requires that the dose be individualized, just as for medications.

Light intensity. The treatment uses an artificial equivalent of early morning full daylight (2500 to 10,000 lux), higher than projected by normal home light fixtures (50 to 300 lux). A light box should be capable of delivering 10,000 lux at eye level, which allows downward adjustments if necessary.
Light duration. Daily sessions of 20 to 60 minutes may be needed. Since light intensity and duration interact, longer sessions will be needed at lower intensities. At 10,000 lux – the current standard – 30-minute sessions are most typical.

Time of Day of exposure. The antidepressant effect, many investigators think, is mediated by light’s action on the internal circadian rhythm clock. Most patients with winter depression benefit by resetting this clock earlier, which is achieved specifically with morning light exposure. Since different people have different clock phases (early types, neutral types, late types), the optimum time of light exposure can differ greatly. The Center for Environmental Therapeutics, a professional nonprofit agency, offers an on-line questionnaire on its website, www.cet.org, which can be used to calculate a recommended treatment time individually, which is then adjusted depending on response. Long sleepers may need to wake up earlier for best effect, while short sleepers can maintain their habitual sleep-wake schedule.
Side effects of light therapy are uncommon.

What should I do if I think I have SAD?

If your symptoms are mild – that is, if they don't interfere too much with your daily living, you may want to try light therapy as described above or experiment with adjusting the light in your surroundings with bright lamps and scheduling more time outdoors in winter

If your depressive symptoms are severe enough to significantly affect your daily living, consult a mental health professional qualified to treat SAD. He or she can help you find the most appropriate treatment for you. To help you decide whether a clinical consultation is necessary, you can use the feedback on the Personalized Inventory for Depression and SAD at www.cet.org.

Now let me say I am the first person to question unconventional types of treatment..so years ago when I first learned about light therapy I had questions. I want you to know that this type of therapy has been around for years and researched thoroughly and to me it does make sense. Being someone who definately feels different during the winter months, I see how the lack of light effects my mood and I know it is important to get outside despite the cold and get some Vitaman D and sun rays. If you don't feel the need for light therapy but just want to add some natural light into your life --think about how you can make that happen with your daily schedule. How will you fit it in ? What has worked in the past ?