For people with seasonal affective disorder (SAD), short winter days often mean misery. Symptoms of SAD may include intense mood swings, strong food cravings, overwhelming fatigue, sleeping too much, and general malaise. Other symptoms include anxiety, lethargy, difficulty sleeping, and social and sexual problems. Here's how you can beat seasonal affective disorder this winter.
About half a million people are affected by SAD every winter, most during the winter months. One out of ten people will experience symptoms during the summer. Women are more likely to experience SAD than are men, and they have their first experience when they are between 18 and 35 years old. Geography is a key risk factor for SAD: The further you live from the equator, the greater your risk of the condition -- and the more likely you are to experience a more severe form of the condition.
SAD is frequently misdiagnosed as hypothyroidism, hypoglycemia, infectious mononucleosis, and other infections. Many people with SAD also experience other psychiatric conditions. According to the National Alliance for the Mentally Ill (NAMI), more than half (55 percent) of people with SAD also have severe depressive disorder, and alcoholism affects more than one-third (34 percent).
What Causes SAD?
No one is sure exactly what causes SAD, or why some people are susceptible to it and others aren’t. Seasonal changes in the pattern of sunlight and dark are thought to cause our internal “biological clocks” to shift and become out of synch with the sun and our daily routines. Melatonin is a hormone secreted by the pineal gland in response to darkness. Shorter days lead to greater production of the hormone, which may cause symptoms of depression.
Treatments for SAD
Treatments for SAD focus on ways to reset the brain’s central clock.
- Expose yourself to natural light. People with mild SAD may find relief simply by increasing the amount of natural light. Move your desk near a window. Go for a walk outside at lunch, when the day is brightest. Arrange your schedule to ensure you get outside for a few hours during the brightest time of the day.
- Use artificial light therapy. Standard treatment for SAD involves exposure to bright white fluorescent light between 30 and 90 minutes a day during the winter. Focused light therapy may also help to “reset” the body’s clock and offset SAD symptoms. For most people, this therapy is most effective if it is used in the mornings.
- Ask your physician about melatonin. While researchers are not sure exactly how melatonin is related to sleep and body rhythms, they do know that in people with undisturbed biological clocks, about six hours elapse between the time the pineal gland secretes melatonin and the middle of sleep. Taking melatonin at the right time of day may help to reset the body’s clock. In one study, people with SAD who had “short” sleep cycles showed marked improvement in symptoms when they took melatonin supplements each afternoon. Melatonin should not be taken unless under the guidance of a physician or qualified health-care provider.
- Eat well and take a multivitamin. It’s almost impossible to overcome depression without a healthful diet. Take a good multivitamin every day, and eat a variety of nutritious foods, including fruits and vegetables, whole grains, legumes, and low-fat dairy foods. Minimize sugary foods, including regular sodas and juices. High intake of sugars can lead to rapid fluctuations in blood sugar levels, which, in turn, can negatively affect mood. Eating sugary foods causes the body to release serotonin, the “feel-good hormone.” Some researchers have suggested that eating high-sugar foods is thus an effort to self-medicate depression – which may explain sugar cravings often associated with SAD.
- Exercise. Vigorous exercise enhances overall feelings of well-being, both short and long term. A regular exercise program has many other health benefits, ranging from increased strength to a healthier heart. Feeling better about your body, in turn, can help to alleviate symptoms of depression. Exercise can also be a chance to socialize (for instance, at the gym or with a running or walking group), or to experience some much-needed private time (taking a hike in the woods or swimming laps in a pool). Be sure to check with your doctor before beginning any exercise program.
- Seek professional help. Find a mental health professional who is skilled at treating SAD. Psychotherapy and other forms of talk therapy can be very helpful for people with SAD, especially when used in addition to light therapy. Psychotherapy can help you deal with underlying issues and resolve issues that may have arisen as a result of SAD. People with SAD often experience relationship and career problems, which, in turn, can worsen depression. For people who also struggle with depressive disorder, addictions, or other mental health problems, psychotherapy is essential.
- Medicate. Anti-depressive medications may be helpful for people with severe SAD. Drugs classified as selective serotonin uptake inhibitors (SSRIs) ) are used to increase levels of serotonin – the “feel good hormone.” They are widely prescribed for all types of depression, including SAD. These drugs include fluoxetine (Prozac), paroxetine (Seroxat), and sertraline (Lustral). Tricyclic anti-depressants and monoamine inhibitors are sometimes used to treat SAD, but the side effects may be more difficult to handle.
If you experience suicidal thoughts, seek help immediately. Call 911.
For more information, see
Society for Light Treatment and Biological Rhythm
P.O. Box 591687
174 Cook Street
San Francisco, CA 94159-1687
Center for Environmental Therapeutics
337 West 20th Street, Suite 4M
New York NY 10011
Center for Environmental Therapeutics (European Office)
Lyons P.M., Truswell A.S. (1988). Serotonin precursor influenced by type of carbohydrate meal in healthy adults. Am J Clin Nutr. 47(3):433-9.