A healthy living blog from Marshfield Clinic Health System

Seasonal affective disorder (SAD): Everything you need to know

women sitting in front of a light to help with seasonal affective disorderWe know. It is that time of year again. The sun goes down earlier and you are thinking about bedtime by 5 p.m. Many of us struggle with the cold weather and lack of sunlight, and for some, it is due to seasonal affective disorder (SAD).

“SAD is a depression related to changes in seasons, beginning and ending at about the same time every year,” said Dr. Justin Schoen, Marshfield Clinic Health System psychiatrist. “Most people’s symptoms start in the fall and continue into the winter. Less often, SAD occurs in the spring or early summer.”

Seasonal affective disorder symptoms

Seasonal affective disorder comes with a variety of possible symptoms including:

  • Increased sleep and daytime drowsiness
  • Irritability
  • Fatigue or low energy level
  • Decreased sex drive
  • Diminished concentration
  • Difficulty thinking clearly
  • Increased appetite, especially for sweets and carbohydrates
  • Weight gain

Causes and diagnosis

Decreased sunlight and overcast days are considered culprits. SAD is more common in northern regions. Also, varying levels of serotonin and the sleep hormone melatonin may play a role.

“Light goes through the eyes and retina and transfers impulses to your brain that regulate your body’s sleep-wake cycle,” Schoen said.

He added that while experiencing SAD during the winter months is most common, it’s also possible for people to feel the impact of light deprivation during the summer.

“In our modern society, you can have a person working long hours in a windowless office. Regardless of the season, that deprivation of light could impact a person’s mood,” said Schoen.

SAD can be difficult to diagnose because symptoms are the same as other illnesses and some psychiatric conditions.

Who is affected by SAD?

Although it can affect anyone, women, adolescents and young adults may be more susceptible. SAD sufferers also tend to have a family member with mental illness, such as depression or alcohol abuse.

Fall onset, sometimes called winter depression, begins late fall to early winter. Spring onsets, or summer depression, begins in late spring to early summer.

“You can try to get light naturally by going outside, but in the colder months, especially in a climate like Wisconsin, it may make more sense for people affected by SAD to purchase a light box,” Schoen said.

Treatment options

Treatment is based on age, health and medical history; extent of the disease; tolerance for specific medications, procedures or therapies; and expectations for the course of the disease.

Treatments may include a combination of light therapy, antidepressant medications and psychotherapy. Schoen said bright light can have a more rapid and possibly larger antidepressant benefit than antidepressant drugs. When people stop using a light box, depression can return.

You can try to get light naturally by getting outside, but in the colder months, especially in a climate like Wisconsin, it may make more sense for people affected by SAD to purchase a light box,” Schoen said.

Schoen said there are quality light boxes available from online retailers. He added that the key in purchasing a light box is that it should have at least 10,000 lux, which is a measure of how intense the light is. The proper way to use the light box is to be about 18-24 inches from the light and to use it 30 minutes each day.

You also may be able to get a light box via prescription.

Healthy sleep routine

Having a consistent sleep routine with the right practices can help get you back on a better sleep schedule, which can help with mental health.

One major part of a healthy sleep routine is going to bed around the same time every night. Other tips for sleep include no naps for more than 30 minutes, turn off distractions like television and phone, and use your bed for sleep and sex only. By doing so, your brain will only associate the bed with those things and the blue light from your phone or tablet won’t keep your brain stimulated and awake.

The bottom line

SAD can have a serious impact on your life and your loved ones. For those who suffer, there is an abundance of help and resources available. If you’re concerned about seasonal affective disorder, talk with your doctor.

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