What is seasonal affective disorder? Seasonal affective disorder (SAD) is a type of depression that tends to occur (and recur) as the days grow shorter in the fall and winter. It is believed that affected people react adversely to the decreasing amounts of sunlight and the colder temperatures as the fall and winter progress. It is important to note that although seasonal affective disorder usually presents in the fall and winter there are those who suffer from this condition during the summer instead of, or in addition to, during the fall or winter. Seasonal affective disorder has not been long recognized as an official diagnosis. The term first appeared in print in 1985. Seasonal affective disorder is also sometimes called winter depression, winter blues, or the hibernation reaction. The incidence of seasonal affective disorder increases in people who are living farther away from the equator. Statistics on seasonal affective disorder in the United States include that this disorder occurs in 1% to 10% of adults, and its prevalance is dependent on geographical location. Seasonal affective disorder is less common where there is snow on the ground. Seasonal affective disorder is about four times more common in women than men, and the average age of people when they first develop this illness is 23 years of age. People of all ages can develop seasonal affective disorder. What causes seasonal affective disorder? Seasonal affective disorder seems to develop from inadequate bright light during the winter months. Researchers have found that bright light changes the chemicals in the brain. Exactly how this occurs and the details of its effects are being studied. While those specific mechanisms remain undetermined, factors like low vitamin D levels in the blood are found to be associated with a higher occurrence of seasonal affective disorder and some other depressive disorders. What are the symptoms of seasonal affective disorder? Although there is no specific diagnostic test for the illness, it is understood that symptoms of seasonal affective disorder include tiredness, fatigue , depression, crying spells, irritability, trouble concentrating, body aches, loss of sex drive, poor sleep, decreased activity level, and overeating, especially of carbohydrates, with associated weight gain. When the condition presents in the summer, the symptoms are more commonly insomnia , poor appetite, and weight loss, in addition to irritability, difficulty concentrating, and crying spells. In severe instances, seasonal affective disorder can be associated with thoughts of suicide. The symptoms of seasonal affective disorder typically tend to begin in the fall each year, lasting until spring. The symptoms are more intense during the darkest months. Therefore, the more common months of symptoms will vary depending on how far away from the equator one lives. What is the treatment for seasonal affective disorder? In addition to being key in the prevention of seasonal affective disorder, regular exposure to light that is bright, particularly fluorescent lights, significantly improves depression in people with this disorder when it presents during the fall and winter. The light treatment is used daily in the morning and evening for best results. Temporarily changing locations to a climate that is characterized by bright light (such as the Caribbean) can achieve similar results. Light treatment has also been called phototherapy. Individuals who suffer from seasonal affective disorder will also likely benefit from increased social support during vulnerable times of the year. Phototherapy is commercially available in the form of light boxes, which are used for approximately 30 minutes daily. The light required must be of sufficient brightness, approximately 25 times as bright as a normal living room light. Contrary to prior theories, the light does not need to be actual daylight from the sun. It seems that it is quantity, not necessarily quality of light that matters in the light therapy of seasonal affective disorder. The most common possible side effects associated with phototherapy include irritability, insomnia, headaches, and eyestrain. Antidepressant medications, particularly those from the serotonin selective reuptake inhibitor family (SSRI) family, have been found effective treatment for seasonal affective disorder that presents during summer as well as that which tends to occur during the fall or winter. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa). Common side effects for this class of medications include insomnia, nausea, diarrhea, and decreased sex drive or performance. As with any other mood disorder, psychotherapy tends to accentuate the effectiveness of medical treatment and therefore should be included in the approach to addressing this disorder. In individuals who are perhaps vulnerable to the development of bipolar disorder, either light therapy or antidepressant medication can cause a manic episode as a side effect. Since stimulant medications like modafinil (Provigil) may be a helpful addition to other treatments for seasonal affective disorder, other stimulants like methylphenidate (Ritalin) may play a future role in addressing this disorder. Acupuncture may be a viable alternative intervention to antidepressant medications, particularly in pregnant women, for whom medications should be used with particular caution. Source: http://www.medicinenet.com/script/main/mobileart.asp?articlekey=11009
