What is Seasonal Affective Disorder?

Articles | Master of Science in Nursing |

Seasonal affective disorder (SAD) is a type of depression that changes with the seasons. SAD tends to begin in the late fall and early winter before improving during the spring and summer. Even though depressive episodes associated with SAD can occur in the summer, they are far less common than winter episodes.

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An Overview of Seasonal Affective Disorder

How Many Are Affected

An estimated 5 percent of the U.S. population experiences seasonal affective disorder over the course of any given year. Approximately 10 to 20 percent of cases of recurrent depression have a seasonal pattern, and symptoms of SAD first appear most often in people entering their 20s.

There are two types of seasonal affective disorder: winter onset and spring onset. With winter-onset SAD, symptoms start in the fall or winter and fade in the summer. However, symptoms of spring-onset SAD start appearing in the spring or summer instead.

SAD’s prevalence changes based on proximity to the equator. People living farther from the equator tend to be more susceptible overall. While 9 percent of Alaskans experience SAD, only 1 percent of Floridians experience this condition.

Females are also more likely to be impacted by seasonal affective disorder. There are approximately three females for every male who is affected by SAD. People with a family history of SAD are more prone to being affected by it as well.

What Causes Seasonal Affective Disorder

Lower serotonin levels caused by a lack of sunlight can lead to depression. Melatonin levels can be impacted by the changing of seasons, which has an effect on sleep patterns and mood.
The body’s biological clock or circadian rhythm can be interrupted by a decreased amount of sunlight and could contribute to depression.

Symptoms of SAD

Seasonal affective disorder is connected to a plethora of symptoms, including anxiety, depression, difficulty concentrating, fatigue and low energy. SAD is also associated with a hypersensitivity to rejection, sleep problems and suicidal thoughts.

Changes in weight can appear in people affected by seasonal affective disorder as well. However, these symptoms tend to appear differently for people with spring-onset and winter-onset SAD.
Spring and summer SAD is connected to weight loss and poor appetite, while fall and winter SAD is connected to appetite changes, increased cravings for carbohydrates and weight gain.
Seeing a medical professional is critical for people experiencing symptoms of seasonal affective disorder.

Diagnosis and Treatment Options

The Diagnostic Process

Health care providers should ask patients in-depth questions about their symptoms, feelings, thoughts and behavioral patterns while performing a physical exam. Questions about self-care behavior, nutrition, stress, sleep patterns and suicidal ideation are common.

Even though there are no diagnostic tests for seasonal affective disorder, a complete blood count (CBC) to check a patient’s thyroid condition is often ordered to rule out other problems relating to physical health.

Treatment Options

Pharmacological intervention in the form of medication is one treatment option that doctors may discuss with their patients.
Psychotherapy is another option that can help patients better manage stress, learn healthier coping strategies, and recognize negative thoughts and behaviors while making an effort to change them.

Light therapy can also help treat SAD by exposing patients to full-spectrum light via a light therapy box, visor or lamp for a period of 15 minutes to 1.5 hours. This treatment mimics natural outdoor light, which has the ability to affect brain chemicals related to mood.

Alternative Treatment Options

Dawn simulators work by gradually increasing light 30 minutes before an alarm clock is set to go off. Among study participants, 42 percent reported a reduced occurrence of symptoms related to seasonal depression while using dawn simulators, and an increase in alertness, cognitive performance, reaction time and sleep quality coincided with their use.

Studies have also shown oils containing omega-3 fatty acids, also known as n-3 polyunsaturated fatty acids (PUFAs), to be capable of relieving major depression symptoms.
Exercising regularly can help lessen the effects of seasonal affective disorder as well. It can be as effective as cognitive behavior therapy or pharmacology for treating symptoms of depression.

Yoga therapy can also be used to treat SAD. According to an eight-week study, depression scores decreased by 9.47 points among participants performing hatha yoga regularly, while a decrease of only 2.99 points was reported for a control group over the same time period.

Likewise, meditation and guided imagery techniques have been shown by numerous studies to reduce stress and decrease depressive symptoms.

Additional Steps Patients Can Take to Treat SAD

While medical and alternative treatment options may mitigate the effects of seasonal affective disorder, there are additional steps that can be taken to prevent and treat SAD.
Here are a few strategies for helping patients cope with this condition:
1. Spending as much time outside as possible.
2. Taking vacations in warm and sunny climates.
3. Increasing natural light indoors by opening curtains and trimming sunlight-blocking branches.
4. Painting interior walls lighter and brighter colors.