What Is Seasonal Affective Disorder?

Seasonal Depression (SAD): Symptoms & Treatments

What Is Seasonal Affective Disorder?

More than just «the winter blues,» seasonal depression, often called seasonal affective disorder (SAD), occurs at the same time each year. Fortunately, treatment is available.

Seasonal Depression

Seasonal affective disorder (SAD) is depression that gets triggered by a change in seasons, usually when fall starts.

This seasonal depression gets worse in the winter before ending in the spring.

Some people may get a mild version of SAD known as the “winter blues.” It’s normal to feel a little down during colder months. You may be stuck inside, and it gets dark early.

But full SAD goes beyond that — it’s a form of depression. Un the winter blues, SAD affects your daily life, including how you feel and think. Fortunately, treatment can help you get through this challenging time.

Can people get summer depression?

Some people get a rare form of SAD called “summer depression.” It starts in the late spring or early summer and ends in the fall.

How common is seasonal affective disorder (SAD)?

About 5% of adults in the United States experience SAD. It tends to start in young adulthood. SAD affects women more than men, though researchers aren’t sure why. About 75% of people who get seasonal affective disorder are women.

About 10% to 20% of people in America may get a milder form of the winter blues.

Who is at risk for seasonal affective disorder (SAD)?

SAD is more common in younger people and women. You’re also at higher risk if you:

  • Have another mood disorder, such as major depressive disorder or bipolar disorder.
  • Have relatives with other mental health conditions, such as depression or schizophrenia.
  • Live at high latitudes (farther north of the equator), such as Alaska or New England.
  • Live in cloudy regions.

People with seasonal affective disorder may also have other mental conditions, such as:

Researchers don’t know exactly what causes seasonal depression. The lack of sunlight may trigger the condition in people who are prone to getting it. The theories suggest:

  • Biological clock change: When someone has less exposure to sunlight, their biological clock shifts. This internal clock regulates mood, sleep and hormones. When it changes, people may have trouble regulating their moods.
  • Brain chemical imbalance: Brain chemicals called neurotransmitters send communications between nerves. These chemicals include serotonin, which contributes to feelings of happiness. People at risk of SAD may already have less serotonin activity. Since sunlight helps regulate serotonin, the lack of winter sun can make the situation worse. Serotonin levels can fall further, leading to mood changes.
  • Vitamin D deficit: Serotonin also gets a boost from vitamin D. Since sunlight helps us produce vitamin D, less sun in the winter can lead to a vitamin D deficiency. That change can affect serotonin and mood.
  • Melatonin boost: Melatonin is a chemical that affects sleep patterns. The lack of sunlight may stimulate an overproduction of melatonin in some people. They may feel sluggish and sleepy during the winter.
  • Negative thoughts: People with SAD often have stress, anxiety and negative thoughts about the winter. Researchers aren’t sure if these negative thoughts are a cause or effect of seasonal depression.

What are the symptoms of seasonal affective disorder (SAD)?

SAD is a type of depression, rather than a separate disorder. So people who have seasonal affective disorder may have signs of depression, including:

  • Sadness.
  • Anxiety.
  • Carbohydrate cravings and weight gain.
  • Extreme fatigue and lack of energy.
  • Feelings of hopelessness or worthlessness.
  • Inability to concentrate.
  • Irritability.
  • Limbs feeling heavy.
  • Loss of interest in usual activities, including withdrawing from social activities.
  • Sleeping more.
  • Thoughts of death or suicide.

People who have summer SAD may experience:

  • Agitation and restlessness.
  • Anxiety.
  • Decreased appetite and weight loss.
  • Episodes of violent behavior.
  • Trouble sleeping.

If you have symptoms of SAD, don’t try to diagnose yourself. See a healthcare provider for a thorough evaluation. You may have a physical issue that’s causing depression. But many times, seasonal affective disorder is part of a more complex mental health issue.

Your provider may refer you to a psychiatrist or psychologist. These mental health professionals talk to you about your symptoms. They consider the pattern of symptoms and decide if you have seasonal depression or another mood disorder. You may need to fill out a questionnaire to determine if you have SAD.

What tests will I need to diagnose seasonal affective disorder (SAD)?

There’s no blood test or scan to diagnose seasonal depression. Still, your provider may recommend testing to rule out other conditions that cause similar symptoms.

What are the criteria for a seasonal affective disorder (SAD) diagnosis?

Your provider may diagnose you with SAD if you have:

  • Symptoms of major depression.
  • Depressive episodes that occur during specific seasons for at least two consecutive years.
  • Depressive episodes that happen more frequently during a specific season than during the rest of the year.

Your provider will talk to you about treatment options. You may need a combination of treatments, including:

  • Phototherapy: Bright light therapy, using a special lamp, can treat SAD.
  • Cognitive behavioral therapy (CBT): A type of talk therapy called CBT can also effectively treat SAD. Research has shown that CBT produces the longest-lasting effects of any treatment approach.
  • Antidepressant medication: Sometimes, providers recommend medication for depression, either alone or with light therapy.
  • Spending time outdoors: Getting more sunlight can help improve symptoms. Try to get out during the day. Also increase the amount of sunlight that enters your home or office.
  • Vitamin D: A vitamin D supplement may help improve symptoms.

How does light therapy work?

To use light therapy, or phototherapy, you get a special lamp. It has white fluorescent light tubes covered with a plastic screen to block ultraviolet rays. The light is about 20 times brighter than regular indoor light. The intensity of light emitted should be 10,000 lux.

To use phototherapy, don’t look directly into the light. Place the lamp about 2 or 3 feet away while you read, eat or do other activities.

What time of day should I use light therapy?

When you use light therapy may impact how effective it is. Morning light therapy seems to work better. Plus, using it later in the day may cause insomnia. Many health professionals recommend 10,000 lux for 15 to 30 minutes every morning.

How long will it take light therapy to work?

People who use a lamp for SAD often see results within two to four days. It may take about two weeks to reach the full benefits.

How long do I use light therapy for?

Healthcare providers often recommend using light therapy through the entire winter. SAD symptoms can return quickly after stopping light therapy. Continuing to use the therapy can help you feel your best throughout the season.

Is light therapy safe?

Light therapy is typically safe and well-tolerated. But you may need to avoid light therapy if you:

  • Have diabetes or retinopathies: If you have diabetes or a retina condition, there’s a potential risk of damaging the retina, the back of your eye.
  • Take some medications: Certain antibiotics and anti-inflammatories can make you more sensitive to sunlight. Light therapy can then cause harm.
  • Have bipolar disorder: Bright light therapy can trigger hypomania or mania, uncontrolled boosts in mood and energy level. People with bipolar disorder need medical supervision to use light therapy.

You may experience:

  • Eyestrain.
  • Fatigue.
  • Headaches.
  • Insomnia.
  • Irritability.

Can I use a tanning bed instead of light therapy to treat seasonal affective disorder (SAD)?

Don’t use tanning beds to treat SAD. Tanning beds do generate enough light, but they can cause other harm. They produce a high amount of UV rays that can hurt your skin and eyes.

What type of antidepressants can help with seasonal affective disorder (SAD)?

Medications called selective serotonin reuptake inhibitors (SSRIs) can treat SAD. They improve mood by regulating serotonin levels in your body.

Another approved antidepressant called bupropion comes as an extended-release tablet. It can prevent seasonal depression episodes when people take it daily from fall to early spring.

You may not be able to prevent the first episode of SAD. But once your provider has diagnosed you with seasonal depression, you can take steps to help keep it from coming back:

  • Use your light box: Start using light therapy at the beginning of fall, before you feel SAD symptoms.
  • Get out: Spend time outside every day, even if it’s cloudy. Daylight can help you feel better.
  • Eat a well-balanced diet: Even though your body may crave starchy and sweet foods, stick to nutritious choices. A healthy diet with enough vitamins and minerals can give you the energy you need.
  • Exercise: Try to get 30 minutes of exercise, three times a week.
  • See friends: Stay involved with your social circle and regular activities. They can provide support during the winter months.
  • Find help: Consider seeing a mental health professional who’s trained in CBT. This treatment can be very effective for seasonal affective disorder.
  • Consider medications: Talk to your healthcare provider about taking an antidepressant. Medications can help if your symptoms are severe or if they continue after other treatments. In some cases, taking the medication before SAD begins can prevent episodes.

Talk to your healthcare provider to find out if starting treatment early, as a preventive measure, is right for you.

The outlook is positive. Treatments are available for SAD. People who get the right diagnosis and combination of treatments can find relief from symptoms. Talk to your healthcare provider to figure out the treatment that will work best for you.

Can seasonal affective disorder (SAD) come back?

People who are prone to seasonal affective disorder can get it every year. But you can take steps to prevent or lessen symptoms.

Talk to your healthcare provider. By planning ahead, you can manage your symptoms and feel your best.

Do:

  • Stick to your treatment plan: If you have medications or a lamp for SAD, use them as directed. Follow up with your healthcare provider if you don’t see an improvement in your symptoms.
  • Care for yourself: Eat a well-balanced diet. Get enough sleep. Exercise regularly. Try to manage stress, perhaps by talking to a counselor or therapist.
  • Plan ahead: Make a plan for what you’ll do if your symptoms get worse. If you notice signs of depression, take action. It might help to plan a lot of activities during these months. Having a busy schedule keeps you from hunkering down at home.
  • Start treatment early: Talk to your healthcare provider about preventive treatment. If you know your symptoms start in October, consider starting treatment in September.

Don’t:

  • Isolate yourself: Being alone can make your symptoms worse. Even though you may not feel going out or being social, try to reach out to friends and loved ones.
  • Use alcohol or drugs: They might make symptoms worse. And they can interact negatively with antidepressants.

When should I see my healthcare provider about seasonal affective disorder (SAD)?

If you think you have symptoms of seasonal depression or another mood disorder, see your healthcare provider. Your provider will want to rule out another condition or illness that may be causing these symptoms.

When should I go to the emergency room?

If you or a loved one has suicidal thoughts, get help. Call your provider, go to an emergency room, call 911 or call the National Suicide Prevention Lifeline, at 800.273.8255. This national network of local crisis centers provides free, confidential emotional support to people in suicidal crisis or emotional distress. It’s available 24/7.

What should I ask my healthcare provider?

If you have SAD, ask your provider:

  • What treatment is best for me?
  • How can I prevent depressive episodes?
  • Will light therapy work?
  • Should I take an antidepressant?
  • When should I start treatment?
  • How long should my treatment continue?
  • What can I eat (or should avoid eating) to improve my symptoms?
  • What else can I do to feel better?

A note from Cleveland Clinic

Seasonal affective disorder (SAD) is a type of depression that happens every year during a specific season, usually winter. Symptoms can include a lack of energy and feelings of hopelessness. Fortunately, there’s treatment for seasonal depression.

Talk to your healthcare provider. The provider may recommend a special lamp for SAD. The lamp emits bright light to improve symptoms. Antidepressants and talk therapy can also provide relief.

If you’ve had seasonal depression in the past, talk to your provider about starting treatment before symptoms begin.

Last reviewed by a Cleveland Clinic medical professional on 12/07/2020.

References

Источник: https://my.clevelandclinic.org/health/diseases/9293-seasonal-depression

Seasonal Affective Disorder

What Is Seasonal Affective Disorder?

Mood Disorders

Seasonal affective disorder, or SAD, is type of depression. It happens during certain seasons of the year—most often fall or winter. It is thought that shorter days and less daylight may trigger a chemical change in the brain leading to symptoms of depression. Light therapy and antidepressants can help treat SAD.

  • Depression is different from feeling sad or unhappy. It is not a sign of personal weakness or a condition that can be willed or wished away.
  • Get help. If you think you may be depressed, see a healthcare provider as soon as possible.
  • Women are affected more often than men.
  • Without treatment, depression can last weeks, months or years, but most people respond well to medication, therapy or a combination of the two.
  • Most people with clinical depression who seek treatment see improvement, usually within weeks.

SAD usually starts during adulthood. The risk of SAD increases with age. It's rare in people under age 20. Women are affected more often than men.

What causes SAD?

Less sunlight and shorter days are thought to be linked to a chemical change in the brain and may be part of the cause of SAD.

Melatonin, a sleep-related hormone, also has been linked to SAD. The body naturally makes more melatonin when it's dark. So, when the days are shorter and darker, more melatonin is made.

There are two types of SAD:

  1. Fall-onset.This is also called «winter depression.» Symptoms of depression begin in the late fall to early winter months and ease during the summer months.

  2. Spring-onset.This is also called «summer depression.» Symptoms of depression begin in late spring to early summer. This type is much less common.

The following are the most common symptoms of SAD:

  • Increased sleep and daytime drowsiness
  • Loss of interest and pleasure in activities formerly enjoyed
  • Social withdrawal and increased sensitivity to rejection
  • Irritability and anxiety
  • Feelings of guilt and hopelessness
  • Fatigue, or low energy level
  • Decreased sex drive
  • Decreased ability to focus or concentrate
  • Trouble thinking clearly
  • Increased appetite, especially for sweets and carbohydrates
  • Weight gain
  • Physical problems, such as headaches

Symptoms tend to come back and then improve at about the same times every year.

The symptoms of SAD may look other mental health conditions. Always see a healthcare provider for a diagnosis.

How is SAD diagnosed?

Depression often happens with other conditions, such as heart disease or cancer. It may also happen with other mood disorders, such as substance abuse or anxiety. For these reasons, early diagnosis and treatment is key to recovery.

A diagnosis of SAD may be made after a careful mental health exam and medical history done by a psychiatrist or other mental health professional.

How is SAD treated?

The treatments for «winter depression» and «summer depression» often differ, and may include any, or a combination, of the following:

  • Exposure to sunlight. Spending time outside or near a window can help relieve symptoms.
  • Light therapy. If increasing sunlight is not possible, exposure to a special light for a specific amount of time each day may help.
  • Psychotherapy. Cognitive-behavioral or interpersonal therapy helps change the distorted views you may have of yourself and the environment around you. It can help you improve interpersonal relationship skills, and identifying things that cause you stress as well as how to manage them.
  • Antidepressants. These prescription medicines can help correct the chemical imbalance that may lead to SAD.

There are also things you can do for yourself to help relieve symptoms:

  • Get help. If you think you may be depressed, see a healthcare provider as soon as possible.
  • Set realistic goals in light of the depression. Don't take on too much. Break large tasks into small ones, set priorities, and do what you can as you can.
  • Try to be with other people and confide in someone. It is usually better than being alone and secretive.
  • Do things that make you feel better. Going to a movie, gardening, or taking part in religious, social, or other activities may help. Doing something nice for someone else can also help you feel better.
  • Get regular exercise.
  • Expect your mood to get better slowly, not right away. Feeling better takes time.
  • Eat healthy, well-balanced meals.
  • Stay away from alcohol and drugs. These can make depression worse.
  • Delay big decisions until the depression has lifted. Before deciding to make a significant transition—change jobs, get married or divorced—discuss it with others who know you well and have a more objective view of your situation.
  • Remember: People rarely «snap » a depression. But they can feel a little better day-by-day.
  • Try to be patient and focus on the positives. This may help replace the negative thinking that is part of the depression. The negative thoughts will disappear as your depression responds to treatment.
  • Let your family and friends help you.

Key points about SAD

  • SAD is a type of depression that happens during a certain season of the year—most often fall and winter.
  • There is no clear cause of SAD. Less sunlight and shorter days are thought to be linked to a chemical change in the brain and may be part of the cause of seasonal affective disorder (SAD). Melatonin, a sleep-related hormone, also may be linked to SAD.
  • In general, nearly everyone with depression has ongoing feelings of sadness, and may feel helpless, hopeless, and irritable.
  • SAD may be diagnosed after a careful mental health exam and medical history done by a psychiatrist or other mental health professional.
  • Depression is most often treated with light therapy, therapy, and in some cases antidepressants.

Источник: https://www.hopkinsmedicine.org/health/conditions-and-diseases/seasonal-affective-disorder

Light Therapy

Since the 1980s, light therapy has been a mainstay for the treatment of SAD. It aims to expose people with SAD to a bright light every day to make up for the diminished natural sunshine in the darker months.

For this treatment, the person sits in front of a very bright light box (10,000 lux) every day for about 30 to 45 minutes, usually first thing in the morning, from fall to spring.

The light boxes, which are about 20 times brighter than ordinary indoor light, filter out the potentially damaging UV light, making this a safe treatment for most.

However, people with certain eye diseases or people taking certain medications that increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision.

Psychotherapy or “Talk Therapy”

Cognitive behavioral therapy (CBT) is a type of talk therapy aimed at helping people learn how to cope with difficult situations; CBT also has been adapted for people with SAD (CBT-SAD).

It is typically conducted in two weekly group sessions for 6 weeks and focuses on replacing negative thoughts related to the winter season (e.g., about the darkness of winter) with more positive thoughts.

CBT-SAD also uses a process called behavioral activation, which helps individuals identify and schedule pleasant, engaging indoor or outdoor activities to combat the loss of interest they typically experience in the winter.

When researchers directly compared CBT with light therapy, both treatments were equally effective in improving SAD symptoms. Some symptoms seemed to get better a little faster with light therapy than with CBT. However, a long-term study that followed SAD patients for two winters found that the positive effects of CBT seemed to last longer over time.

Medications

Because SAD, other types of depression, is associated with disturbances in serotonin activity, antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are also used to treat SAD when symptoms occur. These agents can significantly enhance patients' moods. Commonly used SSRIs include fluoxetine, citalopram, sertraline, paroxetine, and escitalopram.

The U.S. Food and Drug Administration (FDA) also has approved another type of antidepressant, bupropion, in an extended-release form, that can prevent recurrence of seasonal major depressive episodes when taken daily from the fall until the following early spring.

All medications can have side effects. Talk to your doctor about the possible risk of using these medications for your condition.

You may need to try several different antidepressant medications before finding one that improves your symptoms without causing problematic side effects.

For basic information about SSRIs, bupropion, and other mental health medications, visit the NIMH Mental Health Medications page. Also, visit the FDA website for the most up-to-date information on medications, side effects, and warnings.

Vitamin D

Because many people with SAD often have vitamin D deficiency, nutritional supplements of vitamin D may help improve their symptoms. However, studies testing whether vitamin D is effective in SAD treatment have produced mixed findings, with some results indicating that it is as effective as light therapy but others detecting no effect.

Because the timing of the onset of winter pattern-SAD is so predictable, people with a history of SAD might benefit from starting the treatments mentioned above before the fall to help prevent or reduce the depression.

To date, very few studies have investigated this question, and existing studies have found no convincing evidence that starting light therapy or psychotherapy ahead of time could prevent the onset of depression. Only preventive treatment with the antidepressant bupropion prevented SAD in study participants, but it also had a higher risk of side effects.

Therefore, people with SAD should discuss with their health care providers if they want to initiate treatment early to prevent depressive episodes.

NIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditions—including SAD. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information about clinical research and how to find clinical trials being conducted around the country, visit the NIMH Clinical Trials page.

This publication is in the public domain and may be reproduced or copied without permission from NIMH. Citation of NIMH as a source is appreciated. To learn more about using NIMH publications, refer to our reprint guidelines.

MedlinePlus (En español)

ClinicalTrials.gov (En español)

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESNational Institutes of Health

NIH Publication No. 20-MH-8138

Источник: https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder

Psychologydo
Добавить комментарий

;-) :| :x :twisted: :smile: :shock: :sad: :roll: :razz: :oops: :o :mrgreen: :lol: :idea: :grin: :evil: :cry: :cool: :arrow: :???: :?: :!: