Seasonal affective disorder: Communication Can Help

May 2021

Choosing to live in a cold, dark climate means you'll be at the mercy of the seasons. That can be both good and bad, depending on your state of mind. Here's what you need to know about one particular seasonal phenomenon: Seasonal Affective Disorder (SAD). SAD is a form of depression that happens in the fall and winter months, when there's less natural light. 

There has been for some time a debate among professionals about whether or not SAD is really a recognized medical condition. Up until recently, the official view was that it was not -- but, since the usefulness of light therapy in treating this disorder has been established, more and more professionals are including it in their diagnostic armory. 

One of the main arguments against SAD is that it's really just seasonal affective disorder, and that all depressions are psychological in nature. This is a misconception. Certain physical conditions do have symptoms that are totally psychological in nature, such as obsessive-compulsive disorder, but not all depressions do. In fact, some people go through their whole lives without ever experiencing a true depressive episode. 

The good news is that light therapy will eventually get you well by giving your system some much-needed vitamin D. Vitamin D helps your body become more sensitive to sunlight exposure and it tends to be deficient during the dark season for melatonin production, which can lead to depression and insomnia. 

The time to start light therapy is when you feel the onset of SAD symptoms, because this problem is a lot like a cold or the flu, in that it comes on gradually. Once the symptoms are established -- typically around October/November -- you will need much more powerful light to reverse the damage that's already been done. 

As you begin your light therapy program, it's important to realize that exposing yourself to too much light can actually make things worse. This usually happens when people are starting out with too many minutes; they literally can't stand the light at first and get worse instead of better. It's different from regular depression because it comes around predictably every year and has its own set of symptoms. It can also be harder to tell SAD apart from regular depression without a doctor's diagnosis. 

According to the Anxiety and Depression Association of America, SAD affects an estimated 3 to 5 percent of school-age children and 3 percent of adults. Symptoms typically start from late fall until wintertime. Despite this, some people experience SAD year-round. Because it's not as well known as other types of depression, people may mistakenly think SAD is caused by being under the weather instead of genetics or environment. People with family members who have been diagnosed with SAD may notice symptoms that are similar to depression: the inability to cope with daily activities, low self-esteem, and suicidal thoughts or attempts. About 80 percent of people affected by SAD have a family member with it as well. 

Many people are able to treat SAD with light exercise and bright lights, but sometimes medication is needed. The most commonly prescribed medications for SAD include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). Antidepressants can help relieve symptoms as well as minimize the risk of a relapse. The challenge is finding the right medication and dose. Because SAD has such a long-lasting effect, these drugs have to be taken long-term, usually for one year after they're brought up to date.

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