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Seasonal Affective Disorder

Seasonal Affective Disorder

Seasonal Affective Disorder (SAD) is a type of depression that occurs at the same time every year, usually starting in the fall and may continue through the winter months.  Prevalence increases with latitude.  For example, in Florida 1.4 percent of the population may experience symptoms, whereas, in New Hampshire, the number rises to 9.7 percent. The average age of onset is 23.  Incidence decreases with age.

Symptoms:  Fall onset SAD - Hopelessness, anxiety, oversleeping, heavy feeling in arms and legs, craving foods high in carbs, weight gain, social withdrawal.  Summer onset – Weight loss, insomnia, irritability

Causes:  In some people, the body’s biological clock can be disrupted due to reduced sunlight and hours of daylight.  This causes a decrease in Serotonin levels, which can influence mood.  Also, a family history of depression may be a factor.

Treatment:   The treatment of choice is Light Therapy and/or Medication Management.

  • Light Therapy  is the first line of treatment as it starts working within 2-4 days and has few side effects.  Many insurance companies will cover the cost if prescribed by a physician.  A light box typically costs $70 - $200.  Treatments are generally 30 minutes per day.
  • Medication Management  involves taking an antidepressant, typically an SSRI such as Paxil, Zoloft or Prozac.  It can take 4-6 weeks to notice symptom reduction. Side effects such as nausea, headache, dizziness may be experienced briefly.  If you have a history of SAD, the doctor may start the antidepressant before the onset of symptoms in the fall.

 Warning! Both treatments can trigger a manic episode in people with bipolar.

 Lifestyle Measures can be effective if symptoms are mild to moderate. For example, brighten the home environment (open blinds, sit closer to windows, add skylights, trim tree branches); get outdoors within 2 hours of getting up in the morning (take a long walk, sit on a bench and soak up the sun, have lunch in the park) and exercise regularly.

 SEE A DOCTOR IMMEDIATELY IF YOU HAVE THOUGHTS OF SELF-HARM