The weather is getting cooler and the days are getting shorter, and for some people that means seasonal affective disorder is on the way.
Dr. Sam Schiavone, a psychiatrist at Inova Fairfax Hospital, says SAD is “a different type of depression.” For one thing, while symptoms of typical depression generally include a loss of appetite and of sleep, in seasonal depression “we want to sleep a lot; we tend to eat a lot more; we crave carbs.” He adds that many SAD patients gain 6 to 10 pounds over a fall and winter.
The overarching theory holds that seasonal depression has to do with an evolutionary response to a lack of sunlight, bringing on a state that mimics hibernation, Schiavone says. Whatever the causes, it hits about 3 percent of people, and it can hit just as hard as non-seasonal depression.
“Folks can develop suicidal thoughts, or they may have suicidal thoughts at the onset,” Schiavone says. “And it does cause significant disruption in their daily lives. On the other side, people may just be ‘Hey, I’m sleeping more and I’m eating more; I need to get outside more.’ That can be viewed as a milder form, not quite developing full depressive criteria.”
He adds that the best way to screen for seasonal depression is a regular depression screening, although seasonal depression can be difficult to spot. It relies on the patient to notice the correlation with the passing of the summer. Very few people look out the window and consciously think that they’re depressed literally because of the changing of the season, so patients and/or therapists have to be perceptive to notice the seasonal pattern.
“You just feel depressed,” Schiavone says. “And then it might be, ‘Oh, the holidays are coming up; holidays are always a stressful time for me,’ when in reality it could be the lack of sunlight and sleeping more.”
The symptoms may last four to five months per year, according to the National Institute of Mental Health, which lists a comparison of depression, winter pattern SAD, and summer-pattern SAD.
Possible Treatments for Seasonal Affective Disorder
To counter SAD, Schiavone recommends maintaining good sleep hygiene and exercising outside (even if it’s only a 30-minute walk in the sunshine), which is good treatment for depression. “But for some folks, that’s not enough,” he says.
Schiavone says regular depression treatments, such as selective serotonin reuptake inhibitors or an antidepressant, work best for seasonal depression. For people who want to supplement the medication or don’t feel comfortable taking antidepressants, light therapy is an option, although Schiavone calls it “tedious,” since it requires buying a high-powered light box and sitting in its glow for 30 minutes every morning.
He’s careful to advise people interested in trying this route to consult with a psychiatrist to make sure they get a proper light box — one that gives off about 10,000 lux of light (the measure of the intensity of the light), which is still well below the sunlight level of 50,000 to 100,000 lux, but way more than the typical household bulb’s 250 or so. ”A lot of people may buy these light box therapies off Amazon or something, and they’re not getting the actual necessary minimum,” he says.
For seasonal affective disorder, Schiavone also recommends trying dawn simulation therapy, which requires a different kind of light machine that begins brightening up the bedroom about 90 minutes before your wakeup time. An NIH study concludes it is “similarly effective to bright light in the treatment of winter depression.”
Feature image, stock.adobe.com
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