Seasonal Affective Disorder

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"Health is a state of Body. Wellness is a state of being." -J. Stanford

Volume 1, Issue 4

Julie Teuber, MD

Have you noticed that your mood is a little worse when then sun hasn’t made an appearance in a few weeks to months?  If so, you may be suffering from SAD or seasonal affective disorder.  According to the Mayo Clinic, SAD is a type of depression that starts and ends around the same time each year that occurs in colder months, sapping your energy and causing depression-like symptoms.  Approximately 3 million people suffer from this annually in all age groups over 18 years of age. Women are more affected than men usually, and this rarely occurs in people within 30 degrees of the equator.  While the cause of SAD is unknown, it may be related to circadian rhythm. With a decrease in light during a 24 hour period, the suprachiasmatic nucleus (SCN), the part of the hypothalamus that is the master biological clock in the brain will see a decrease in the vital neurotransmitters that assist in mood.  Serotonin, dopamine and norepinephrine are all neurotransmitters that depend on the SCN or biological clock of the brain for their pattern of excretion.

DSM-5 criteria for SAD diagnosis (must have for at least 2 years): 1)depression that begins during a specific season each year 2) depression that ends during a specific season each year 3) no episodes of depression during other seasons 4)many more seasons of depression than seasons without depression over the lifetime of your illness

Treatments: First line treatments are lifestyle changes including (but not limited to):

  1. Physical exercise of any kind

  2. Spending time outside (even in the cold and cloudy environment)

  3. Light therapy (also known as phototherapy, which includes spending around 4 hours per day in bright light 4x the intensity of normal household lighting)

  4. Cognitive behavioral therapy (a formal psychotherapy that is completed with professional mentalhealth care providers)

  5. Some people find it necessary to take medications for significant symptoms. Medications include SSRIs (ie sertraline or fluoxetine) or buproprion.

Remember: If you are having signs of symptoms of depression, please consider talking to someone - friends, colleagues, Chief Residents, and/or the Program Director. If you are having signs and symptoms of depression please call 585-6100 for counseling and support services.

References

  1. Seasonal Affective Disorder. http://www.mentalhealthamerica.net/conditions/sad.2002
  2. Seasonal Affective Disorder. http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/basics/definition/con-20021047. 2014
  3. Hewitt, Sarah, Mount Royal University. Seasonal Affective Disorder and Circadian Rhythms. http://goo.gl/xHc8ZS