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Seasonal Depression

Is that miserable feeling simply a case of the winter blues or could it be something more serious?

Seasonal affective disorder (SAD) is an actual disorder that results in a seasonal depression due to a lack of daylight exposure that throws off one’s biological clock (or circadian rhythms). It can cause a drop in serotonin, a brain chemical that affects mood, and a disruption in the body’s level of melatonin, which plays a role in sleep patterns and mood. Once spring hits, the symptoms disappear.

The symptoms of SAD typically include sadness, fatigue, irritability, sleeping more and concentrating less. Instead of experiencing a loss of appetite as you’ll find with depression, SAD sufferers crave carbohydrates like pasta and bread, which can result in weight gain.

SAD is more common among women. Family history can play a role. The disorder needs to be addressed by a medical professional because complications can include thoughts of suicide, substance abuse and social withdrawal.

To determine if you have SAD, doctors will look to see if there is a pattern. If the symptoms have occurred before at this time of year and get better once the season changes, it’s an indication that this could be the problem.

TREATMENT

Light therapy (phototherapy), which is believed to reset the patient’s biological clock, is the primary treatment. There are two types:

• Bright light treatment, where a light box is placed a certain distance away on a desk or table while the patient eats, reads or works.

• Dawn stimulation, where a dim light goes on in the morning while the patient sleeps, getting brighter over time like a sunrise.

Light therapy is usually prescribed for 30 minutes to two hours a day. Most people start to feel better within a week or so, but it is recommended they stay with it until the season changes.

Antidepressant medicines alone or along with light therapy may also be prescribed. SSRIs like Paxil and Zoloft are usually tried first. Other antidepressants may include Wellbutrin and Effexor. Psychotherapy may also help by teaching patients how to manage their symptoms and prevent future episodes.

Another recommendation is outside exercise. This will energize patients and make them feel less depressed, as well as expose them to sunlight.

Certain herbal supplements like St. John’s have sometimes been used, although there is no scientific evidence supporting them. The same goes for melatonin, a dietary supplement that is a synthetic form of the hormone that occurs naturally in the body to regulate mood.

Written by Jamie MacPherson

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