Dr. Ducharme’s Blog October 2, 2017 Seasonal Affective Disorder

It is that time of year again. The days are getting shorter. The nights, if not always the days, are cooling down. I have begun to get up in the dark and leave the office in the dark. I definitely prefer the hot weather and when I am cold I can get a bit cranky. Although my husband continues to wear shorts around the house, it is not unusual to find me in a sweatshirt snuggled under a blanket…with a heating pad and a hot drink! Clearly I have not completed adapted to moving north!

For some people, however, these weather changes are a major trigger for what is called Seasonal Affective Disorder. This is very different than the “winter blahs” and generally responds very well to treatment.

Seasonal affective disorder (SAD) is a type of depression that’s related to changes in seasons. SAD begins and ends at about the same times every year. If you’re like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. Less often, SAD causes depression in the spring or early summer.
Treatment for SAD may include broad spectrum light therapy (phototherapy), psychotherapy and medications. If someone is using light therapy, which is often recommended, it is important to start these treatments in the fall rather than wait till mid-winter when symptoms of SAD are peaking.

Symptoms specific to winter-onset SAD, sometimes called winter depression, may include:
• Irritability
• Tiredness or low energy
• Problems getting along with other people
• Hypersensitivity to rejection
• Heavy, “leaden” feeling in the arms or legs
• Oversleeping
• Appetite changes, especially a craving for foods high in carbohydrates
• Weight gain

For some individuals who suffer from Bi-Polar Disorders spring and summer can bring on symptoms of mania or a less intense form of mania (hypomania), and fall and winter can be a time of depression.

The specific cause of seasonal affective disorder remains unknown. Some factors that may come into play include:
• Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may cause winter-onset SAD. This decrease in sunlight may disrupt your body’s internal clock and lead to feelings of depression.
• Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression.
• Melatonin levels. The change in season can disrupt the balance of the body’s level of melatonin, which plays a role in sleep patterns and mood.

Factors that may increase your risk of seasonal affective disorder include:
• Being female. SAD is diagnosed more often in women than in men, but men may have more-severe symptoms.
• Age. Young people have a higher risk of winter SAD, and winter SAD is less likely to occur in older adults.
• Family history. People with SAD may be more likely to have blood relatives with SAD or another form of depression.
• Having clinical depression or bipolar disorder. Symptoms of depression may worsen seasonally if you have one of these conditions.
• Living far from the equator. SAD appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter and longer days during the summer months.

It’s normal to have some days when you feel down. But if you feel down for days at a time and you can’t get motivated to do activities you normally enjoy, it is important to discuss this with a psychologist or other medical provider who understands SAD. This is especially important if your sleep patterns and appetite have changed or if you feel hopeless, think about suicide, or turn to alcohol for comfort or relaxation. As healthier means of coping, try working our with a friend, listening to music, learning yoga or meditation and eating healthier meals. Also, whenever possible, go outdoors for a walk and sit by a window with good light exposure.

Additional information about SAD can be found on the Mayo Clinic’s website:
http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/basics/definition/con-20021047

More from Dr. Elaine Ducharme
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