‘Tis done! dread Winter spread his latest glooms, and reigns tremendous o’er the conquered year! – James Thomson 

Seasonal Affective Disorder (also known as SAD or seasonal depression) is a mood disorder that refers to incidents of depression that occur annually, for most during the fall and winter, and in our local area, also often during what has come to be known as “May gray” and “June gloom”.  These are periods of less natural sunlight exposure.  SAD can cause a draining of energy and create an uneasy moodiness.  The cause(s) of SAD are not exactly known, but are believed to be associated with such things as hormone regulation, ambient light and body temperature. 

Symptoms of SAD vary, but often include:

• Sadness
• Hopelessness
• Helplessness
• Feelings of guilt/worthlessness; Loss of self-esteem
• Fatigue
• Appetite changes along with changes in weight
• Irritability/agitation
• Loss of interest in previously enjoyable activities
• Difficulty concentrating
• Difficulty sleeping
• Thoughts of suicide

Interestingly, some people experience what is known as “reverse” seasonal affective disorder.  For these individuals it is the typical periods of increased light exposure, spring and summer, which bring about symptoms of mania or hypomania (a less intense form of mania).  These symptoms include:

• Rapid thoughts and speech
• Persistently elevated mood
• Agitation
• Hyperactivity

Reverse SAD is considered a form of bipolar disorder. 

It is normal for most of us to have some “up” days as well as some “down” ones.  However, when the “down” feelings are sustained for days and weeks at a time, and associated extended periods of fatigue, it is time to see your doctor.  Treatment of seasonal affective disorder often includes counseling (psychotherapy), medication, carefully timed melatonin supplementation, and light therapy (phototherapy).

Approximately half of patients suffering from SAD will respond well to phototherapy alone.  Light therapy is administered by utilizing a special very bright, 10,000 lux, full spectrum light box, which produces considerably more lumens than a customary incandescent lamp, and is specifically designed to mimic sunlight.  These special light boxes are typically used for approximately 30-45 minutes per day, preferably in the morning hours in an attempt to imitate sunrise.  Patients utilizing phototherapy can experience improved mood and energy within a week or two, and often continue to benefit from treatment for up to several weeks.  The majority of light therapy studies have demonstrated that it is not necessary to use the light box all year round, but rather as a seasonal treatment over a period of several weeks to a few months, or until naturally occurring light exposure is able to be acquired.  Bright light therapy appears to work by activating the brain’s circadian rhythm ”pacemaker”, thereby improving mood and sleep.  Light stimulates this pacemaker of the brain targeting the chemicals within the brain associated with depression.  Getting regular exercise, and taking long walks during available daylight hours, can also help immensely in improving symptoms of seasonal affective disorder.

Antidepressant medication, specifically the selective serotonin reuptake inhibitors (SSRIs) and psychotherapy have also been shown to help reduce the symptoms of SAD, either used alone or in combination with phototherapy.  For many, the symptoms often get better on their own, but not until the seasons once again change.

If you or a loved one has seasonal affective disorder it is important to seek treatment early as the symptoms will most often persist for several months without appropriate intervention.

There are many capable psychiatrists and skilled psychotherapists within the Tri-Counties area that can effectively assist in treating SAD, and can be located by utilizing your favorite internet search engine.  I also highly recommend the book “Seasonal Affective Disorder For Dummies” by Laura L. Smith, Ph.D. and Charles H. Elliott, Ph.D. available at most local bookstores as well as at Amazon.com.