seasonal affective disorder

Seasonal Affective Disorder: A Guide

It’s been rainy and dreary in Pittsburgh lately. The seasons are changing. The days are getting shorter. And with the lack of sun, many of us are going to feel this shift. Especially for those that suffer from Seasonal Affective Disorder. Seasonal affective disorder (SAD) is a type of depression that’s related to changes in seasons. SAD begins and ends at about the same times every year. If you’re like most people with SAD, your symptoms start in the fall and continue into the winter months. Your energy feels drained and you may feel moody. Less often, SAD causes depression in the spring or early summer.

Symptoms

In the average case, Seasonal Affective Disorder symptoms appear during late fall or early winter. And they tend to go away during the longer and brighter days of spring and summer. This pattern has been reversed in some cases though. In either scenario, symptoms may start out mild and become more intense as the season goes on.

Signs and symptoms of SAD may include:

  • Feeling depressed most of the day, nearly every day
  • Losing interest in activities you once enjoyed
  • Having low energy
  • Having problems with sleeping
  • Experiencing changes in your appetite or weight
  • Feeling sluggish or agitated
  • Having difficulty concentrating
  • Feeling hopeless, worthless or guilty
  • Having frequent thoughts of death or suicide

Specific SAD Fall and Winter Symptoms

Symptoms specific to winter-onset SAD, sometimes called winter depression, may include:

  • Oversleeping
  • Appetite changes, especially a craving for foods high in carbohydrates
  • Weight gain
  • Tiredness or low energy

 Specific SAD Spring and Summer Symptoms

Symptoms specific to summer-onset seasonal affective disorder, sometimes called summer depression, may include:

  • Trouble sleeping (insomnia)
  • Poor appetite
  • Weight loss
  • Agitation or anxiety

Causes

Unfortunately, we still have not found any specific causes of SAD. But there are a few factors that may come into play. The first is your biological clock or circadian rhythm. The reduced level of sunlight in fall and winter may cause winter-onset SAD. The lack of sunlight may mess with your body’s internal clock. And could lead to feelings of depression.

The second is serotonin levels. Serotonin is a neurotransmitter that affects mood. When serotonin levels drop, so does mood stabilization. It is also important to note that serotonin levels can also be affected by lack of sun. The final suspect is the level of melatonin. You guessed it. The change of season can disrupt the body’s level of melatonin. Melatonin is a hormone that plays a role in sleep patterns and mood.

Risk Factors

SAD is diagnosed more often in women than in men. And SAD occurs more frequently in younger adults than in older adults.

Factors that may increase your risk of seasonal affective disorder include:

  • Being a young female. SAD is diagnosed more often in women than in men. And comparatively, in more younger adults compared to older adults.
  • Family history. People with SAD may be more likely to have blood relatives with SAD or another form of depression.
  • Having major depression or bipolar disorder. Symptoms of depression may worsen seasonally if you have one of these conditions.
  • Living far from the equator. SAD appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter and longer days during the summer months.

Treatments and Therapies

There are four major types of treatment for SAD which include medication, light therapy, vitamin D, and psychotherapy. They can be used alone or in combination with each other.

Medication

In regards to medication, Selective Serotonin Reuptake Inhibitors (SSRIs) are often used to treat SAD. However, as with other medications, there are side effects to SSRIs. Talk to your doctor about the possible risks of using this medication for your condition. You may need to try several different antidepressant medications before finding the one that improves your symptoms without causing problematic side effects.

Light Therapy and Vitamin D

Light therapy has been a mainstay of treatment for SAD since the 1980s. The idea behind light therapy is to replace the diminished sunshine of the fall and winter months using daily exposure to bright, artificial light. Symptoms of SAD may be relieved by sitting in front of a light box first thing in the morning. Especially when done on a daily basis from the early fall until spring.

In conjunction with light therapy is supplementing vitamin D. Currently, vitamin D supplementation alone is not regarded as an effective SAD treatment. But supplementing could be beneficial. Low levels of vitamin D have been found in people with SAD due to insufficient dietary intake or exposure to sunlight.

Psychotherapy

Cognitive behavioral therapy (CBT) is a type of psychotherapy that is effective for SAD. CBT relies on techniques such as identifying negative thoughts and replacing them with more positive. CBT also uses something called behavioral activation. Behavioral activation seeks to help the person identify activities that are engaging and pleasurable, whether indoors or outdoors, to improve coping with winter.

Let CPA Help Too!

We know you need a toolbox full of skills in order to cope with the challenges life throws at us. At CPA, we will always encourage patients to explore coping mechanisms that work best for them. However, we also know that a number of those skills come from counseling and different methods of therapy. Cristina Panaccione and Associates has two locations in the South Hills. We are currently accepting a limited number of new patients, so check out our videos to learn more about how we can help teach you the skills to fight depression!

Darlene Friend – MSW, LCSW, EMDR

Darlene graduated from California University of Pennsylvania with a bachelor’s and master’s degree in Social Work. As well as an Aging Specialist Certificate in Gerontology. She is a Licensed Clinical Social Worker in Pennsylvania. And a Licensed Independent Clinical Social Worker in West Virginia. She provides individual therapy, family therapy, and couples counseling, as well as group services. She is experienced in a wide variety of mental health conditions ranging from chronic and persistent mental illness to adjustment disorders and grief.  Darlene specializes in Eye Movement Desensitization and Reprocessing (EMDR), therapy utilized for big and little traumas that affect the whole person.  She received training in many areas of behavioral health such as trauma and sexual assault.  She incorporates multiple modalities and evidenced-based practices in therapy. This includes transactional analysis, cognitive behavioral therapy, and motivational interviewing.

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