Seasonal Affective Disorder (SAD) - Signs, Treatments, Therapy
Seasonal Affective Disorder is also known as winter depression and is a type of depression that comes and goes in a seasonal pattern and is related to changes in seasons. SAD begins and ends at about the same time every year. Although some people who struggle with SAD may have symptoms during the summer, it is far more common for the symptoms to show and be severe during the winter months.
The symptoms of Seasonal Affective Disorder can include low mood and increased irritability, daytime fatigue, difficulty concentrating, lack of interest in social activities, feelings of hopelessness, feelings of despair, guilt and worthlessness, unhappiness, reduced sexual interest, unhealthy food cravings and weight gain. In severe cases, SAD can cause suicidal thoughts and excessive anxiety.
Seasonal Affective Disorder is diagnosed more often in women than in men. However, while 3 out of 4 sufferers of SAD are women, men often experience more severe symptoms. It also occurs more frequently in younger adults than in older adults. There are several factors that increase the risk of having SAD such as family history, having major depression or bipolar disorder and living far from the equator. It is important to take SAD seriously, as it can lead to greater problems and concerns if it’s not treated. These may include: social withdrawal, substance abuse, school or work problems, suicidal thoughts or development of other mental health disorders such as anxiety or eating disorder. Treatment can often prevent these complications and stop seasonal affective disorder from developing to severe levels.
The two most common treatments for SAD are psychotherapy and light therapy. Psychotherapy for SAD includes talking therapies and counselling. Therapists can help with controlling negative thoughts, attitudes and behaviours that make the disorder worse. Therapists can also help to guide the patients through SAD by teaching how to manage these symptoms and deal with stress in healthy ways. For many people, therapy can be as effective as the treatment with light therapy or antidepressants, but without any side-effects.
Therapy is based on the idea that the way a person is behaving affects the way they feel. Changing the way someone thinks about situations and what they do about them can help them feel better. Therapy involves a number of sessions with a specially trained therapist, usually over several weeks or months. This can include an individual programme of self-help, a programme designed for couples (if SAD is affecting the relationship), a group programme with other people in a similar situation or online therapy.
Light therapy can be done in two ways, with a light box or with a dawn simulator. A light box involves using a specialised light or visor for at least 30 minutes each day to replicate natural light, by sitting about 12 inches in front of it. The light box emits a controlled amount of white light, with harmful ultraviolet (UV) rays filtered out. While the light needs to enter the eyes, it is important not to stare directly at the light box, but rather continue with the normal morning/evening routine, such as eating breakfast, reading a book or working at a computer. A light box can be bought without a prescription, although it is best to work with a professional to monitor the benefits of the treatment. While light therapy carries few side effects, it is important to consult with a doctor about any eye or skin problems before using a light box. Also, the light therapy may trigger a manic episode to someone who struggles with a bipolar disorder. If that happens, it is essential to contact a doctor immediately.
A dawn simulator is a device that gradually increases the amount of light in the bedroom, in the morning to simulate the rising sun. The light gradually increases, just as natural sunlight does, over a period of 30 to 45 minutes. Instead of waking up in darkness, a patient wakes up to what looks like a sunny morning. This can help reset circadian rhythm and improve the mood. While light boxes may trigger hypomania or mania in those with bipolar disorder, there is no such risk with a dawn simulator.
Other than psychotherapy and light therapy, it is important to engage in self-care activities which also help to minimise SAD symptoms. These include healthy diet with lean protein, fruits, and vegetables, regular exercise, going for walks in the daylight (this includes going outside during lunchtime and on the weekends, particularly if you work inside during daytime), regular exercise and fixed sleep schedule.
People with severe SAD symptoms may benefit from medications such as antidepressants.
It is important to seek help from a professional in order to be assessed and given a diagnosis for SAD, as it’s symptoms can mirror several other conditions including bipolar disorder, hypothyroidism and mononucleosis. A doctor or therapist may recommend several tests to rule out these conditions before they can diagnose SAD. They may ask you about your mood, lifestyle, eating habits and sleeping patterns, plus any seasonal changes in your thoughts and behaviour.
If you experience symptoms associated with SAD, see a doctor, counsellor or psychiatrist.