Feeling SAD :: Emotional and Mental Health :: Seasonal Affective Disorder (SAD)

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Feeling SAD?
by author Timothy Burns

It’s the middle of November, and Carol is beginning to get moody and a little depressed. She’s not looking forward to another long northern winter throughout which she will feel irritable, sleep in, and gain weight–just like every winter for the last five years.

These feelings happen the same time every year and always disappear in late winter or early spring–as soon as the sun returns from hibernation. Carol discussed her problem with a friend who told her about a condition called SAD. These three letters pretty well summed up Carol’s feelings about winter.

What is SAD?

Carol’s symptoms are typical of someone who suffers from seasonal affective disorder (SAD), a form of depression that follows the seasons. The most common form is associated with the winter months, beginning in the fall and ending in the late winter to early spring. More cases of SAD are reported in northern countries and higher latitudes, with twice as many women diagnosed as men.

The symptoms of SAD are similar to other forms of depression, generally including feelings of irritability, discomfort in social situations, and low energy. More specific symptoms include a tendency to sleep in and cravings for sweets and carbohydrates followed by a commensurate winter weight gain. The key to diagnosis is the seasonal nature of the condition. Unlike other forms of depression, SAD is not triggered by external circumstances such as job stress or other social factors. Seniors will be happy to learn that it rarely affects their age group.

Individuals diagnosed with SAD appear to have either low levels of the neurotransmitter serotonin during periods of prolonged low light and/or some inability to metabolize serotonin properly.

Drug Therapy

Antidepressants including d-fenfluramine, sertraline, and fluoxetine, which impact serotonin metabolism, are effective treatments for SAD. The question, though, is not whether they’re effective, but whether it makes sense to use pharmaceuticals to alter your brain chemistry for a few months every year in order to treat a seasonal disorder.

Lifestyle Strategies

Learn to recognize the onsets of symptoms–they occur at about the same time every year. Stimulate your endorphins through regular exercise; maintain a balanced diet; eat sufficient protein; and control your sugar intake. Take part in social events and keep your mind active. Energy-based therapies such as acupuncture and cognitive therapy, a form of psychotherapy, may also be useful.

Natural Therapies

St. John’s wort is a potential alternative to antidepressant drugs. Numerous studies have shown its benefits in mild to moderate depression. One study involving SAD sufferers found that 300 mg of a standardized St. John’s wort extract taken three times daily significantly reduced symptoms. However, St. John’s wort should not be taken in conjunction with light therapy, as it can make some individuals more sensitive to light.

Adding foods rich in tryptophan, a precursor of serotonin, or supplements such as 5-HTP or B complex to your daily diet, may be beneficial as well.

Light as Therapy

Studies indicate that light therapy is effective in approximately 65 percent of individuals. The subjects are exposed to a light box, normally a unit with minimum light output of at least 10,000 lux, for at least 30 minutes per day. Any time of day will work, but for some, morning light is better, while others benefit from daily morning and evening sessions. Light boxes are available in some medical supply stores and natural food stores.

Light therapy is generally safe, but mild to moderate side-effects occur in up to 27 percent of subjects. They include eye strain, headache, nausea, agitation, sweating, and sleepiness. Normally these side-effects subside with continued use, as the body adapts to higher light levels. It’s advisable to consult a practitioner if you suffer from diseases that affect the retina, conditions such as glaucoma, or if you are taking medications or supplements that affect photosensitivity, such as lithium, phenothiazines, chloroquine, hematoporphyrins, 8-methoxypsoralens, melatonin, or St. John’s wort.

Take winter head-on–don’t be SAD!

Timothy Burns writes about health and lifestyle issues.

Source: alive #289, November 2006

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