Seasonal Depression

WHAT EXACTLY IS SEASON AFFECTIVE DISORDER?

Many people Have had experiences of time where we feel sad and don't feel like our usual selves. Sometimes, these types of mood changes begin and end when the seasons change. People May start to feel sad when the days get shorter in the fall and winter( Also known as " winter Blues") and begin to cheer up in the spring, with longer daylight hours. in some occurrences, these mood changes are more severe and can affect a person's state of mind and Deal with daily activities. if you have ever noticed mood changes whenever the seasons change, you more than likely may be suffering from seasonal affective disorder. SAD usually occurs in the late fall or early winter and goes away during the spring and summer; this is known as " winter- pattern SAD". Some people may experience depression swings during the spring and summer months; this is called " Summer pattern SAD" and is less likely to occur.

WHAT ARE THE SIGNS OF SAD?

SAD has not been officially recognized as a separate order but as a type of depression characterized by its recurring seasonal pattern, with symptoms lasting usually 4 to 5 months per year. Therefore the Symptoms of SAD include those associated with severe depression, and some other symptoms that alter for winter season and summer season. The symptoms of SAD are Different for everyone So the symptoms below is not guaranteed for everyone Symptoms of major depression may include:

● Feeling depressed most of the day, nearly every day

● Losing interest in activities you once enjoyed

● Experiencing changes in appetite or weight

● Having problems with sleep

● Feeling sluggish or agitated

● Having low energy

● Feeling hopeless or worthless

● Having difficulty concentrating

● Having frequent thoughts of death or suicide For winter-pattern SAD, additional specific symptoms may include:

● Oversleeping (hypersomnia)

● Overeating, particularly with a craving for carbohydrates

● Weight gain

● Social withdrawal (feeling like “hibernating”) Specific symptoms for summer-pattern SAD may include:

● Trouble sleeping (insomnia)

● Poor appetite, leading to weight loss

● Restlessness and agitation

● Anxiety

● Episodes of violent behavior Season depression If you think you are suffering from SAD, talk to your health care provider or a mental health specialist. They usually have you fill out specific questionnaires to determine if your symptoms meet the criteria for SAD. To be diagnosed with SAD, a person must meet the following criteria:

● They must have symptoms of major depression or the more specific symptoms listed above.

● The depressive episodes must occur during specific seasons (i.e., only during the winter months or the summer months) for at least 2 consecutive years. However, not all people with SAD do experience symptoms every year.

● The episodes must be much more frequent than other depressive episodes that the person may have had at other times of the year during their lifetime. WHAT CAUSES SAD?: Doctors Have not fully determined what causes SAD: Some scientists Theorized That people with SAD may have reduced and low levels of the brain chemical serotonin which assists in regulating mood. Research findings also suggest that sunlight controls the levels of molecules that help regulate normal serotonin levels, but in people with SAD, this regulation does not function properly, resulting in low serotonin levels in the winter. Others theorize that people with SAD produce too much melatonin a hormone that is extremely important for maintaining the normal sleep- wake cycle. Too much melatonin can cause sleepiness. Both serotonin and melatonin help maintain the body's rhythm that is tied to the seasonal night day cycle. in people with SAD, the changes in serotonin and melatonin levels can interrupt the normal daily rhythms. As a result, they will no longer adapt to the seasonal changes in day, length, leading to sleep, and mood changes. A Low amount of vitamin D may worsen these problems because vitamin D is believed to produce serotonin activity. In addition to Vitamin D consumed with diet, the body produces Vitamin D when the skin is exposed to sunlight. with less daylight in the winter, People with SAD may have low Vitamin D amounts, which will slow down serotonin activity. Bad thoughts and feelings about the winter and its associated limitation and stresses are common people with SAD. it is unknown whether these are the causes or effects of the mood disorder, but it can be used as a primary focus of treatment. Who develops SAD? Millions of Americans suffer from SAD, although many may be completely oblivious they even have the condition. SAD is much more common in women than men, and it is more common in those farther north, where there are shorter daylight hours in the winter. People living in places like Alaska or New England may be more likely to develop SAD than people living in hotter places like Florida. SAD is more likely to begin in young adulthood. SAD is more common in people with severe depression and bipolar Season depression disorder. Also, People with SAD tend to have other mental disorders like ADHD, eating disorders, panic disorders, and anxiety. SAD usually runs in families. SAD is more common in people who have relatives with other mental illnesses, such as depression or schizophrenia.

HOW IS SAD TREATED?

There are treatments available that help people with SAD. there are 4 types that may be used alone or in combination.

● Light therapy

● Psychotherapy

● Antidepressant medications

● Vitamin D

Talk to your doctor about which treatment, or combination of treatments is best for you. LIGHT THERAPY: Since the 80s, light therapy has been the centerpiece for treatment of SAD. it aims to expose people to a bright light every day to make up for the lack of sunlight in the darker months. for this treatment, the person sits in front of a bright light box everyday for approximately 30 to 45 minutes, usually the first thing in the morning. from fall to spring. The light boxes are 20 times brighter than ordinary indoor light filters out the damaging UV light making the treatment safe. However, people with eye diseases or people taking medications that increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision. PSYCHOTHERAPY: Cognitive behavioral therapy is a type of talk therapy which is focused on helping people learn how to cope with difficult situations; CBT has been adapted for people with SAD( CBT-SAD). it is usually conducted in two weekly group sessions for 6 weeks and focuses on replacing negative thoughts related to the winter season with more positive thoughts. CBT-SAD also uses a process called " behavioral activation", which helps individuals and schedule more pleasant, engaging indoor and or outdoor activities to combat the loss of interest they typically experience in the winter. When researchers compared CBT with light therapy, both treatments were very effective in improving SAD systems. some symptoms seemed to get better faster with light therapy than CBT. However, a long term study showed that the SAD patients for two winters found that the positive effects of CBT lasted longer over time.

MEDICATIONS

Because SAD, like other types of depression, is linked with disturbances in serotonin activity, antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are also used to treat SAD when symptoms occur. These agents can significantly enhance patients’ moods. Commonly used SSRIs include fluoxetine, citalopram, sertraline, paroxetine, and escitalopram. The U.S. Food and Drug Administration (FDA) also has Season depression approved another type of antidepressant, bupropion, in an extended-release form, that can prevent recurrence of seasonal major depressive episodes when taken daily from the fall until the following early spring. All medications can have side effects. Talk to your doctor about the possible risk of using these medications for your condition. You may need to try several different antidepressant medications before finding one that improves your symptoms without causing problematic side effects. Because SAD, like other types of depression, is associated with disturbances in serotonin activity, antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are also used to treat SAD when symptoms occur. These agents can significantly enhance patients’ moods. Commonly used SSRIs include fluoxetine, citalopram, sertraline, paroxetine, and escitalopram. The U.S. Food and Drug Administration (FDA) also has approved another type of antidepressant, bupropion, in an extended-release form, that can prevent recurrence of seasonal major depressive episodes when taken daily from the fall until the following early spring. All medications can have side effects. Talk to your doctor about the possible risk of using these medications for your condition. You may need to try several different antidepressant medications before finding one that improves your symptoms without causing problematic side effects. Vitamin D: Because people With SAD usually have Low amounts of vitamin D, nutritional supplements can help improve their symptoms. However, Studies have found mixed results, with some indicating that it is as effective as light therapy but others detecting no effect.

Source: The National Institute of mental health