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Seasonal Affective Disorder

Audrey*, a manager at a busy accounting firm, was fuming. She sat silently at the head of the conference table. Her staff, accustomed to Audrey’s angry outbursts, watched her warily.

“Business is down, and I want answers!” she demanded. Audrey saw her staff visibly wince at the harshness in her voice. Her boss, sitting at the other end of the table, raised an eyebrow.

Back in her office, Audrey remembered something her mother used to say: “You’ll catch more flies with honey than vinegar.” Even as a kid, Audrey felt a certain sadness during winter months. She recalled acting out with tears and defiance. “The Winter Blues,” her mother would say.

As an adult, that black mood was persistent. The darker the sky, the darker Audrey’s mood became.

Audrey’s main support came from her friends, but that winter she felt too sad to reach out and was embarrassed by the weight she had gained. Her isolation grew worse.

Audrey’s boss called her into their office. “I’m worried about your moodiness and lack of focus,” they said. “It’s affecting your work performance and, frankly, it’s affect-ing the entire staff.”

Audrey knew she had to change but didn’t know where to begin. That evening, Audrey burrowed down in bed with a box of chocolates and turned on the TV. That’s when she saw a commercial by an area psychiatrist that changed her life. He was conducting a study on Seasonal Affective Disorder. Audrey recognized she had most of the symp-toms described in the com-mercial. More importantly to Audrey, it was a treatable condition!

She joined the study and, to her relief, began to feel better. To this day, Audrey continues to see a psychiatrist to ensure that Seasonal Affective Dis-order (SAD) never brings her down again.

What is SAD?

SAD is a type of recurrent depression that begins and ends at the same time every year. Contrary to popular belief, SAD doesn’t only occur during the winter months.

SAD comes in two forms: Winter Depression and Summer Depression.

Winter Depression

The most common form of SAD. It usually appears during late fall or early winter and resolves mid to late spring or summer. The symptoms of winter depression typically consist of:

  • Daily feelings of sadness

  • Significant anxiety

  • Feelings of hopelessness

  • Social withdrawal

  • Excessive sleep

  • Increased appetite resulting in weight gain

  • Poor energy or feelings of lethargy

  • Diminished interest and enjoyment in pleasurable activities

  • Poor concentration

  • Significantly impaired daily functioning at home and/or work

Winter Depression vs. Winter Blues

Many of us experience “blue” feelings during the winter months. These are typically transient, mild in nature, and don’t significantly affect our daily functioning.

However, when these “blue” feelings become daily and routine, occur every winter, and significantly affect your daily functioning, you may have SAD.

Summer Depression

A less common form of SAD whereby symptoms of depres-sion appear at the begin-ning of spring or summer. The symptoms of Summer Depression are somewhat different from those of Winter Depression. These typically consist of:

  • Daily feelings of sadness

  • Significant anxiety

  • Agitation or restlessness

  • Decreased appetite, some-times accompanied by weight loss

  • Increased sex drive

  • Significant impairment of functioning

Reverse SAD

Some people who have winter depression experience symptoms of mania or hypomania (a less severe form of mania) during spring and/or summer. These symptoms include feelings of elation, agitation, increased social activity, impulsive behavior, racing thoughts, rapid speech, etc. Reverse SAD is considered a variation of bipolar disorder.

What causes SAD?

As with other neurobiological disorders, the exact cause of SAD is unknown. However, the following points are relevant:

  • Circadian Rhythm: Sunlight serves as an important cue to our biological clock. The reduced level of sunlight in winter and fall causes disruption of the internal clock which could cause depression.

  • Melatonin: Melatonin is a chemical found in our brain that plays a role in regulating sleep and mood. Seasonal cli-mate changes affect melatonin levels and may cause depression.

  • Serotonin: Decreased amount of sunlight during winter months can decrease brain levels of Serotonin, a neurotransmitter that plays a role in the regulation of mood, appetite, sleep, and sex drive.

  • Genetics: There is some evidence that SAD may have a genetic basis.

Treatment of SAD

  • Light Therapy: Regular exposure to certain wavelengths of light during winter has been found to be helpful.

  • Medications: These are typically most effective. Antidepressants such as SSRIs (Selective Serotonin Reuptake Inhibitors) may be helpful. Mood stabilizers are the best options to treat Reverse SAD.

  • Psychotherapy

  • Relaxation Techniques: Yoga and meditation may be helpful adjuncts.

Consult your doctor or a mental health specialist at the earliest signs of any kind of impairments

* Names have been changed to protect privacy. This article is for educational purposes only. It is not intended to diagnose or treat any medical or psychiatric issue. Dr. Rakesh Ranjan is a practicing psychiatrist, a researcher, an author, and an educator. He has been recognized by Ohio NAMI (National Alliance for the Mentally Ill) as a recipient of the Psychiatrist of the Year Award, and by National NAMI as a recipient of the Exemplary Psychiatrist Award. Dr. Ranjan is a national speaker for several organizations and serves on the medical advisory board for the NAMI of Greater Cleveland.

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