Seasonal Affective Disorder SAD

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    Well into the fall season, many practitioners in the field of psychology and psychiatry notice an increase of referrals this time of year. This increase tends to be for patients presenting complaints of depression, fatigue, and the blues. The change of seasons, which also signals a decrease in daylight, is responsible for a form of depression called Seasonal Affective Disorder or SAD. Those who suffer SAD tend to experience an onset of depression with the shortening of available daylight during the the fall or winter months.

    SAD tends to be recurrent, in that it returns year after year. The depression tends to lift or diminish in the spring. Some common symptoms include: fatigue, hypersomnia, weight gain, a craving for carbohydrates, and, of course, depressive feelings. There is a tendency for the person to feel more and more down as the day progresses. The latter tends to be the opposite of what is seen in major depressions. For individuals who suffer year round depression a seasonal component can mean a worsening of symptoms during the fall and winter.

    SAD tends to be more common as we get further north or south from the equator. Younger people are at a higher risk for the disorder and there is some suggestion that greater numbers of females VS males are afflicted.

    SAD is not related to seasonal factors such as unemployment, the start of school, or unhappiness about the weather. The cause of SAD is felt to be due to chemical changes which occur in the brain as a result of reduced light stimulation to the retina of the eye. The levels of the neurotransmitter Seratonin (5HT), and the hormone Melatonin, are partially regulated by photic (light) stimulation, but in opposite ways. light increases Seratonin but decreases Melatonin. Lower amounts of light hitting the eyes means lower levels of Seratonin and higher levels of Melatonin in brain regions. Lower Seratonin levels result in depression, whereas higher levels of Melatonin result in fatigue and a desire to sleep. The latter are the core symptoms of SAD.

    Treatment of SAD involves utilizing interventions which attempt to reverse the chemical changes that lowed daylight cause in the brain. The most common interventions for mild cases of the disorder involve lifestyle changes which allow more opportunity for light to stimulate the eyes. In more serious cases light boxes, which attempt to replicate the intensity of natural sunlight, are used to stimulate the eyes. In the most severe cases of SAD medications which increase seratonin levels in the brain (SSRI's) are used with good results.