Just the thought of winter makes you tired and sad? Do you lose interest in almost everything during winter? If that sounds like you, you may have the seasonal affective disorder (SAD).
Seasonal affective disorder (SAD) is a type of depression that occurs during a specific season. The most common feature of SAD is that the symptoms typically exist during winters and gradually diminish during the spring.
According to the American Psychiatric Association, and Diagnostic and Statistical Manual of Mental Disorders DSM-5, SAD is officially classified as a recurrent type of major depressive disorder with seasonal patterns that begins and ends during a specific season. It is more common in young adults and women than men.
Since the days of winter are shorter, with the decrease in sunlight, the combination of low serotonin and high melatonin impacts your energy and mood. SAD can coincide with other depressive disorders like bipolar, ADHD, alcoholism, and eating disorders, making it difficult to diagnose. So it's essential to understand what causes SAD.
Causes of Seasonal Affective Disorder (SAD)
Though the exact cause of SAD is not known. Seasonal fluctuations in mood and behavior are hypothesized to be caused by changes in monoaminergic neurotransmission in the brain. Some experts presume that SAD is associated with some hormonal changes. Some of the major causes of SAD are :
Vitamin D Deficiency
When you are exposed to the sun and get vitamin D, the serotonin hormone (5-hydroxytryptamine or 5-HT), also known as the happy hormone, boosts your mood and makes you happier. But during winters and fall, less sunlight steers the brain to produce less serotonin. Low serotonin levels result in symptoms like depression, fatigue, and weight gain.
Chemical Imbalance in Brain
The neurotransmitters ( chemical messengers in the brain) help communicate between the nerve cells. One of these chemicals includes serotonin or happy hormone. Since sunlight helps in regulating serotonin activity, people with SAD experience less serotonin activity due to the lack of sunlight in winters. This falling level of serotonin leads to depression and anxiety disorder.
Circadian Rhythm
Your body’s circadian rhythm or biological clock is maintained by both serotonin and melatonin levels, which are associated with the seasonal day-night cycle. Due to the lack of enough sunlight during winters, the body starts producing too much melatonin and less serotonin, and hence, your normal sleep-wake cycle gets disrupted.
Further, you can no longer adjust to the seasonal changes during the day and night, which leads to increased sleepiness, sudden mood swings, behavioral fluctuations, and lethargic tendency during winters.
Melatonin Levels
In winters, the lack of sunlight helps to produce too much melatonin in your body. As a result, you may experience sleep disorders like delayed sleep, insomnia, an abnormal sleep-wake cycle, and depressed mood.
Living far From the Equator
If you are living far north and south of the equator, you may suffer from SAD. This may be due to decreased sunlight during winters in those parts of the world.
Family History
It has been observed that people with a family history of any kind of depression or anxiety disorder are more likely to be vulnerable to SAD.
Symptoms of SAD
Since we know that SAD is considered a significant depressive disorder with seasonal patterns, the symptoms may include:-
- A feeling of discouragement and hopelessness
- Losing interest in activities that you enjoyed earlier
- Increased food cravings and weight gain
- Sluggishness, fatigue, and low energy
- Frequent mood swings and irritation
- A sleeping disorder like oversleeping (Hypersomnia)
- Lack of concentration and frustration
- Withdrawal symptoms and frequent suicidal thoughts
Diagnosis :
Sometimes seasonal affective disorder can be difficult to diagnose because its symptoms can be similar to other types of depression or mental disorders. Hence, if you have mood swings, feel depressed or crabby, are fatigued, are low on energy, or if you feel hopeless, which appears to be seasonal, immediately seek your doctor’s attention and discuss your issues.
So to diagnose SAD, your doctor may advise you to go through the evaluations like physical routine checkups, blood tests like complete blood count (CBC), and thyroid function test (TFT), to ensure that there is no hormonal abnormality in your body. Your doctor may take a structured clinical interview (SCI) to examine the symptoms like your feelings, thoughts and behavior patterns, etc.
Natural Treatment for Seasonal Affective Disorder
There are a number of simple things that can be tried by self to help improve the condition of SAD, which include :
- Exposure to natural sunlight as much as possible
- Do regular exercises 5 days a week, particularly outdoors
- Make your living place bright and well ventilated
- A healthy balanced diet is a must and stay away from alcohol and drugs
- Try different ways to avoid stress, such as talking to family members and friends
- Gardening, writing, book reading, going for a movie, spending time with pets, taking part in social and religious activities may help you feel better
- Do not let negative thoughts affect you, try to think positive instead
- Spend some time on meditation, yoga, and pranayam
- Go on a vacation to spend some time with nature
Treatment :
The treatment for SAD differs from patient to patient. If you have bipolar disorder or any other kind of depression, then you need to speak clearly to your doctor regarding the same to help him understand your exact condition.
If you have SAD, your doctor may treat you with medicine or therapy or a combination of medicine and therapy, depending upon your severity. At first, you may not be able to prevent the occurrence of SAD but with your doctor’s proper advice and attention, you can manage it better or even prevent it from recurring. The treatment of SAD may include
Therapy Lights for Seasonal Affective Disorder
In phototherapy, the patient is made to sit near a lightbox that emits bright light. The light produced by the lightbox simulates the sunlight that is required during the winter months. Within a few days, it helps relieve the SAD symptoms and starts elevating the mood of the patient.
Psychotherapy
Psychotherapy includes both cognitive behavioral therapy and counseling. Cognitive behavioral therapy or CBT is a form of psychotherapy that focuses on how thoughts, beliefs, and attitudes affect feelings and behaviors. It helps to learn to cope with SAD, how to manage stress, and establish good conduct like increasing physical activity and improving sleep patterns.
According to the American Psychiatric Association, several research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been proven to be more effective than any other form of psychological therapy or psychiatric medication.
Medications
When the symptoms of SAD are severe, the patient needs to be treated with antidepressants. Antidepressants like bupropion (Wellbutrin XL, Aplenzin) are often used to treat SAD. These drugs have helped the patients to recover from depressive episodes of SAD.
In addition, Selective serotonin reuptake inhibitors (SSRIs) are also preferred by healthcare professionals to treat SAD. The SSRIs improve the serotonin level in the brain, which can help uplift the patient’s mood. Agomelatine (Valdoxan) is a novel antidepressant with melatonergic (MT1/MT2) agonist and serotonin 5HT2C antagonist properties. It shows a primary action on circadian rhythms and therefore helps in the treatment of SAD.
Conclusion :
The seasonal affective disorder is a mental condition that strikes at the same time every year, causing significant distress. The exact cause of SAD remains unknown, and research is continuing. Seek help if you are experiencing SAD symptoms like low energy and mood swings that are affecting the quality of your life. Certain lifestyle modifications, medications, and therapies can help you feel better.