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How Seasonal Affective Disorder is Diagnosed, Treated, and Prevented

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Treatment of SAD

The cooler temperatures, along with the shorter days of fall and winter months, come as a relief from the excruciating summer heat and exposure to the sun. They can, for some people, bring about changes in mood. 

Some of these lifestyle changes might end up taking the form of SAD –seasonal affective disorder. It is a form of depression that occurs in particular seasons of the year – gradually improving with the start of the next season.

In many cases, SAD is more noticeable during the colder winter months. Almost half a million people in the United States go through the symptoms of winter-related SAD every year.

The exact cause of SAD is unknown. However, some people living in the northern latitudes or those with a family history of SAD, are at a greater risk of getting SAD than others. Additionally, women are more prone to getting seasonal affective disorder compared to men.

Many researchers agree that exposure to natural light has a lot to do with this type of mood disorder. The lack of sunlight interrupts the body’s biological clock, which normally controls sleep, mood, and hormone levels. 

No matter what its causes are – if SAD is left untreated – it can directly disrupt your daily life while also increasing the risk of more serious overall health issues.

Diagnosis of Seasonal Affective Disorder

If you have reasons to believe that you are going through major depressive disorder or the depressive symptoms of SAD – discuss it with your healthcare provider or with a mental health specialist for professional help. 

They may have you answer a specific set of questions to see if your symptoms meet the criteria for diagnosis of SAD, in addition to doing a thorough physical exam.

Criteria for diagnosing SAD

For a proper diagnosis of SAD, a person must meet the following criteria;

  • People must be displaying symptoms of major depression or the specific symptoms of seasonal affective disorder.
  • Their depressive episodes must occur during specific seasons, either during the winter months or the summer months (AKA summer depression or summer-pattern SAD) – for at least two consecutive years. 
  • These episodes of depression must be more frequent compared to other depressive episodes that a person may have had at other points in their life.

Risk Factors for SAD

SAD is more likely to affect women compared to men, and it is more common in people who are living farther north. 

Farther north is where there are short daylight hours in the winter months. For instance, people living in Alaska or Indiana are more likely to develop or experience SAD symptoms compared to people living in Florida.

Seasonal affective disorder is more common in people who also suffer from major depressive disorder or bipolar disorder, such as bipolar II disorder. 

Bipolar II disorder is associated with recurring episodes of depression and hypomanic episodes, which are less severe compared to hypermania of bipolar I disorder.

Most SAD patients also have a family history of depression or other types of mental health disorders or illnesses, such as schizophrenia or major depression.

It is important to gather authentic information on the disorder, as it helps in keeping the severity of the symptoms at bay.

Causes of SAD

Scientists and researchers do not fully understand the actual root causes of SAD.

Research shows that people going through SAD many suffer from the reduced activity of the brain chemical (neurotransmitter) serotonin – which is responsible for regulating mood. 

Research also suggests sunlight controls levels of vitamin D that help with maintaining normal serotonin levels; however, with people going through SAD, their bodies do not regulate serotonin properly, which results in decreased serotonin levels in the winter season.

Other study findings also suggest that people experiencing SAD produce too much melatonin – which is a hormone central for maintaining normal sleep-wake cycles. Overproduction of melatonin increases sleepiness. 

Serotonin and melatonin both help maintain the daily rhythm of the body that gets tied to the seasonal night and day cycle. People with SAD go through changes in serotonin and melatonin levels which disrupt normal daily rhythms. 

Vitamin D deficits might exacerbate the SAD symptoms and the problems associated with them – as vitamin D is known to promote serotonin activity. 

In addition to vitamin D consumed via food, the human body produces vitamin D with exposure to sunlight on the skin. With a lack of sunlight in the winter months, people with SAD may suffer from lower vitamin D levels, which hinders serotonin activity. 

The negative thoughts and feelings associated with winter and associated limitations and stresses are common in people who are going through SAD – as well as with others. 

However, it is still unclear whether these are the causes and effects of SAD. Still, they can be a useful focus of treatment.

Easing Symptoms of SAD

SAD symptoms are expected to improve with the beginning of a new season change – it can be winter giving way to spring or summer giving way to fall. 

However, when a person is at risk for SAD or has gone through SAD symptoms in the past, it becomes vital to learn and identify when an episode is coming to better manage these symptoms. 

It helps to stay aware of the seasonal shifts as this might help people become aware of the mood changes. It is better to try and capture those changes when seasonal changes hit – this way, patients do not have to suffer from sleep issues, fatigue, and irritability. 

SAD Effective Treatment Options

Bright Light Therapy

Daily light therapy has been a mainstay for the treatment of SAD since the 1980s.

Its aim is to expose people suffering from SAD to a very bright light source through a special light box every day to make up for the deficiency created by the lack of sunlight in the winter – to fight off the winter blues.

For such treatment, a person sits in front of a light therapy box set to at least 10,000 lux every day for 30 to 45 minutes. 

The bright light therapy should be done first thing in the morning, from fall to late spring. The bright light box filters out the potentially damaging UV light, making it a safe treatment for the most part. 

However, people who are suffering from certain eye diseases or people who are taking certain kinds of medications that are known to increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision.

Talk Therapy

Cognitive-behavioral therapy (CBT) is a type of talk therapy that aims to help people learn to cope with difficult situations by changing how those situations are perceived. 

Cognitive-behavioral therapy has also been used for people with SAD in a treatment known as CBT-SAD.

Cognitive-Behavioral Therapy -SAD

CBT-SAD is normally conducted in bi-weekly sessions for six weeks in total. This type of therapy specifically focuses on replacing negative thoughts commonly related to winter seasonal patterns with more pleasing and positive thoughts. 

CBT-SAD also uses a process known as behavioral activation, which helps individuals identify and schedule engaging, pleasant outdoor or indoor activities to combat the loss of interest they typically go through in the early winter months or the late fall.

When the researchers directly compared CBT with bright light therapy, both of these treatments were equally effective at improving the SAD symptoms. 

Some of the symptoms seemed to get better faster with the daily light therapy compared to the CBT. But a long-term study that followed SAD patients for two winters concluded that long-term benefits could be better achieved with CBT.

Medications for Treating SAD

As SAD, like other types of major depression, is linked with fluctuations or disturbance in serotonin activity, antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs) are also used for treating SAD symptoms. 

These agents are known to significantly enhance patients’ moods. 

The commonly used SSRIs include:

  • Fluoxetine
  • Citalopram
  • Sertraline
  • Paroxetine
  • Escitalopram

The United States Food and Drug Administration has also approved another type of antidepressant medicine – bupropion in an extended-release form, which prevents the recurrence of major depressive episodes when taken daily from fall until the following early spring.

All medications (including antidepressant medication) come with side effects. Talk to your healthcare provider or a doctor about the possible risks of these medications to your health condition. 

For basic information on SSRIs, bupropion, or other mental health medications, it is advised to consult your doctor or your health guidance counselor.

Vitamin D

Many people going through SAD often have vitamin D deficiency. Nutritional vitamin D supplements might help in improving their symptoms. 

However, some studies testing to see whether vitamin D is effective with SAD treatment have produced mixed findings. Some of the results indicate that it is as effective as light therapy; however, others detect no effect.

Frequently Asked Questions (FAQ)

Can SAD be prevented?

As the timing for the onset of winter pattern SAD is predictable, individuals with a history of SAD might benefit from beginning treatments mentioned in the post above before fall. Doing so will help in preventing or reducing the symptoms of depression. According to some studies, only preventive treatment with antidepressant bupropion is seen to prevent SAD; however, it also has a higher risk of side effects.

What are common problems associated with SAD?

SAD is known to disrupt the life of patients abruptly. Some SAD-related problems include:
Loss of appetite
Lack of self-care
Substance abuse
Lack of energy
Changes in weight
Changes in sleep patterns
Onset of other medical conditions

Treatment for SAD is Possible at The Recovery Team

Treatment for Seasonal Affective Disorder is possible under the compassionate medical team at The Recovery Team. 

Depression is a known silent killer, and we want to congratulate you for seeking help – treatment for any mental health disorder is possible with tons of emotional support and research-backed residential treatment programs.

At The Recovery Team facility, we have a holistic range of the most suitable treatment programs that are custom designed for the individual needs of our patients. At our facility, you will be heard and seen.

Call us today to start your journey toward the life you so deserve.