It is that time of year again when we must confront the cyclic moods we call Seasonal Affective Disorder, or S.A.D. Each year during the winter months, some individuals experience depression that is cyclic and predictable. This mood change usually starts sometime around October or November and subsides around March or April. Symptoms may include:
- A drop in energy level
- Difficulty concentrating
- Becoming increasingly irritable
- Experiencing a change in appetite, craving sweets or carbs
- Increased fatigue
- Weight gain
While depression can be caused by major life changes, certain medications, or alcohol and other drugs, S.A.D. is believed to be caused by a change in circadian rhythm. The circadian rhythm is the repeating cycle that regulates day and night activities and is fueled by the secretion of melatonin from the pineal gland in response to darkness. Whereas melatonin induces sleep, the hormone serotonin produces energy and feelings of happiness, and increases with exposure to bright light.
Individuals who have Seasonal Affective Disorder show a longer duration of melatonin release during nights and winter months, due to shorter daylight hours. Circadian rhythm is a 24-hour repeating rhythm in the human brain that regulates day and night activities. Between midnight and 2 a.m., melatonin levels peak and then fall gradually until morning. Sunlight informs the brain of a new day, suppresses melatonin and increases serotonin. During the winter months, there is later morning light, causing melatonin levels to peak later and remain elevated two or more hours longer than during the summer months. When this occurs the body thinks it needs more sleep.
There are several options available in treating S.A.D. If an individual is experiencing mild symptoms that do not interfere too much with their activities of daily living, light therapy can be effective. Light therapy is used to synchronize the circadian rhythm and sleep/awake cycle with a special lamp that is 10-20 times brighter than ordinary indoor bulbs, for about 30 minutes each day. Typical light therapy is generated at 10,000 lux using a light box, and is most effective if used in the morning. These boxes are available through durable medical equipment programs, or can be found by shopping online.
Other effective treatments of S.A.D include medications and talk therapy. Antidepressants can be used to treat symptoms of seasonal affective disorder. Talk therapy can be successful in identifying and modifying negative thoughts and behaviors and increasing coping skills to manage stress. All persons affected by S.A.D. regardless of their choice of treatment should engage in activities such as walking or other exercise, eating a well-balanced diet, establishing regular sleep/wake times, and participating in winter sports or hobbies that will lead to productive use of time.
An important thing to remember about Seasonal Affective Disorder is that it only lasts a few months during the year and that treatment is available to lessen the symptoms. For more information about Seasonal Affective Disorder there are many books, such as Winter Blues: Seasonal Affective Disorder—What It Is and how to Overcome It by Norman Rosenthal, M.D., or websites from reputable experts, such as the National Institute of Health’s www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder or the National Institute of Mental Health’s www.nimh.nih.gov.
For those who need more intense treatment for S.A.D. or other mental health conditions MidMichigan Health provides an intensive outpatient program called Psychiatric Partial Hospitalization Program at MidMichigan Medical Center – Gratiot. Those interested in more information about the PPH program may call (989) 466-3253. Those interested in more information on MidMichigan’s comprehensive behavioral health programs may visit www.midmichigan.org/mentalhealth.