After many years of conjecture, mental health experts are gaining a deeper understanding of Seasonal Affective Disorder (SAD,) a condition that affects many adults. SAD is characterized by episodes of major depression, mania, or hypomania that regularly occur in particular seasons.
SAD is Triggered by a Transition in the Season and Not Necessarily a Particular Season
The two recognized patterns of SAD are fall/winter onset and spring/summer onset. Most people who experience SAD have depression symptoms in the winter that generally lift in the spring or summer. SAD is not classified as a separate mood disorder, but as a subset of major depressive disorder.
People who suffer from fall/winter onset SAD can experience multiple symptoms, including increased appetite, reduced energy, weight gain, increased sleep, and carbohydrate craving. The symptoms mirror those for people suffering from major depressive disorder.
Spring/summer onset SAD, also known as summer depression, is also characterized by typical depression symptoms such as decreased appetite, weight loss and insomnia.
Assessment of and Treatment of SAD
In order to assess the severity of SAD, a Patient Health Questionnaire (PHQ) is administered. Patients with severe major depression often score 20 or more points on the questionnaire and often have suicidal thoughts. Patients who score less than 20 points often have mild-to moderate cases of SAD a do not have generally have suicidal thoughts.
Medical practitioners have developed a roster of modalities to alleviate SAD symptoms, including:
· Antidepressants
· Light therapy
· Sleep hygiene
· Daily outdoor walks
· Aerobic exercise
· Enhanced indoor lighting
First-Line Treatment of SAD
The recommended first line treatment for patients with severe SAD is antidepressants combined with light therapy, although antidepressants alone may be sufficient. For patients with less severe cases, light therapy alone is considered to be a reasonable first line treatment alternative.
Sleep regulation is particularly important for treating AD, since insomnia and hypersomnia are common symptoms of the disorder. SAD therapy includes focusing on the sleep-wake cycle and minimizing blue light exposure from electronic devices within two hours of going to bed.
Second-Line and Third-Line Treatments for More Extreme Cases of SAD
For patients who are unresponsive to first line therapies, additional steps may be required. Second line therapies involve modifying a patient’s medication and incorporating the form and amount of light therapy used. Third line therapies can incorporate psychotherapy into the equation.
It is important to realize the symptoms of SAD if you or a loved one experience recurring, seasonal depression. Seeking out a qualified mental health professional is an essential first step towards regaining your mental well-being.
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