Understanding Seasonal Affective Disorder (SAD) and Its Impact on Mental Wellbeing
Seasonal Affective Disorder (SAD) is a type of depression that occurs at a specific time of year, typically during the winter months when daylight hours are shorter. This condition can significantly impact an individual’s mood, energy levels, and overall wellbeing. Understanding SAD is crucial for recognising its symptoms and seeking effective treatment. This article explores the symptoms, causes, and treatment options for Seasonal Affective Disorder, supported by scientific research.
What is Seasonal Affective Disorder?
Seasonal Affective Disorder is a recurrent major depressive disorder that follows a seasonal pattern, most commonly beginning in late autumn and continuing through winter. It is more prevalent in regions with significant seasonal variations in daylight hours. While the exact prevalence in Australia is not well-documented, studies suggest it affects about 1-2% of the population in higher latitudes, with milder forms affecting up to 10% (Lam et al., 2001).
Symptoms of Seasonal Affective Disorder
SAD symptoms can vary in severity and often resemble those of other forms of depression. Key symptoms include:
Depressive Symptoms
Persistent Low Mood: Feeling sad, tearful, or hopeless most of the day, nearly every day.
Loss of Interest: Reduced interest or pleasure in activities once enjoyed (Melrose, 2015).
Physical Symptoms
Low Energy and Fatigue: Persistent tiredness and lack of energy despite adequate rest.
Changes in Sleep Patterns: Oversleeping (hypersomnia) and difficulty waking up in the morning.
Cognitive Symptoms
Difficulty Concentrating: Trouble focusing or making decisions.
Negative Thought Patterns: Increased feelings of worthlessness or guilt (Melrose, 2015).
Changes in Appetite and Weight
Increased Appetite: Cravings for carbohydrates and subsequent weight gain.
Weight Gain: Due to overeating, especially carbohydrate-rich foods (Rosen et al., 1990).
Causes and Risk Factors
The exact cause of SAD is not fully understood, but several factors are believed to contribute:
Reduced Sunlight Exposure
Circadian Rhythm Disruption: Shorter daylight hours can disrupt the body’s internal clock, leading to feelings of depression (Partonen & Lönnqvist, 1998).
Melatonin Levels: Increased production of melatonin, a sleep-related hormone, in the dark can contribute to lethargy and mood changes.
Serotonin Levels
Serotonin Dysregulation: Reduced sunlight can lower serotonin levels, affecting mood and emotional regulation (Lam et al., 2001).
Genetic Factors
Family History: Individuals with a family history of SAD or other forms of depression are at higher risk (Partonen & Lönnqvist, 1998).
Diagnosis of Seasonal Affective Disorder
Diagnosis typically involves a thorough evaluation by a mental health professional. The process includes:
Clinical Interview: Discussion of symptoms, their duration, and their seasonal pattern.
Medical History: Examination of personal and family medical history.
Questionnaires: Use of standardized screening tools like the Seasonal Pattern Assessment Questionnaire (SPAQ) (Rosenthal et al., 1984).
Treatment Options
Effective treatments for SAD focus on alleviating symptoms and regulating mood. Common treatments include:
Light Therapy
Bright Light Therapy: Exposure to a light box that mimics natural sunlight can help reset circadian rhythms and boost serotonin levels. Typically, patients use the light box for 30 minutes to an hour each morning (Terman et al., 1998).
Psychotherapy
Cognitive Behavioural Therapy (CBT): Helps individuals identify and change negative thought patterns and behaviours. CBT tailored for SAD (CBT-SAD) can be particularly effective (Rohan et al., 2007).
Medication
Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) can help manage symptoms by increasing serotonin levels in the brain. Commonly prescribed SSRIs include fluoxetine and sertraline (Lam et al., 2006).
Lifestyle Modifications
Regular Exercise: Physical activity can improve mood and energy levels.
Healthy Diet: Eating a balanced diet can help manage weight and energy levels.
Increased Sunlight Exposure: Spending more time outdoors during daylight hours can alleviate symptoms (Melrose, 2015).
Conclusion
Seasonal Affective Disorder is a significant mental health condition that can impact quality of life during certain times of the year. Recognising the symptoms and seeking appropriate treatment is crucial for managing SAD. Light therapy, psychotherapy, medication, and lifestyle changes are effective strategies for alleviating symptoms and improving overall wellbeing. If you or someone you know is experiencing symptoms of SAD, consulting with a mental health professional is an important step towards recovery.
References
Lam, R. W., Tam, E. M., Yatham, L. N., Shiah, I. S., & Zis, A. P. (2001). Seasonal depression: the dual vulnerability hypothesis revisited. Journal of Affective Disorders, 63(1-3), 123-132.
Lam, R. W., Levitt, A. J., Levitan, R. D., Enns, M. W., Morehouse, R., Michalak, E. E., & Tam, E. M. (2006). The CAN-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder. The American Journal of Psychiatry, 163(5), 805-812.
Melrose, S. (2015). Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression Research and Treatment, 2015, 1-6.
Partonen, T., & Lönnqvist, J. (1998). Seasonal affective disorder. The Lancet, 352(9137), 1369-1374.
Rohan, K. J., Roecklein, K. A., Lacy, T. J., & Vacek, P. M. (2007). Winter depression recurrence one year after cognitive-behavioral therapy, light therapy, or combination treatment. Behavior Therapy, 38(3), 225-238.
Rosen, L. N., Targum, S. D., Terman, M., Bryant, M. J., Hoffman, H., Kasper, S. F., … & Rosenthal, N. E. (1990). Prevalence of seasonal affective disorder at four latitudes. Psychiatry Research, 31(2), 131-144.
Rosenthal, N. E., Bradt, G. H., & Wehr, T. A. (1984). Seasonal Pattern Assessment Questionnaire. National Institute of Mental Health, Bethesda, MD.
Shapiro, F. (2014). Eye Movement Desensitization and Reprocessing (EMDR) Therapy, Third Edition: Basic Principles, Protocols, and Procedures. Guilford Publications.
Terman, M., Terman, J. S., & Ross, D. C. (1998). A controlled trial of timed bright light and negative air ionization for treatment of winter depression. Archives of General Psychiatry, 55(10), 875-882.