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Seasonal affective disorder (SAD) affects so many people this time of year, which is doubly impactful as often the holidays are a time of anxiety and stress. Who needs the additional depressive effects from not getting enough sunlight, coupled with anxiousness brought on by the season? Double -whammy.

SAD is temporary depression (winter blues) that occur when the days get shorter, typically in the late fall, early winter (and just happens to coincide with some of our most fraught family rituals, Thanksgiving, Christmas, Hanukah, am I right?).

Although the cause is unknown, it is suggested that as the days get darker, we produce more melatonin, leaving us sleepy and lethargic. However, some people can also get this episodic depression in the summer (yes, summer SAD).

Symptoms of SAD, which is a type of depression, may include some or all of the following symptoms, according to DSM-5:

  • Major depression symptoms:

  • 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

To be diagnosed with SAD, a thorough evaluation would include a physical exam, lab tests to test the thyroid, along with a CBC blood test, and a psychological evaluation. SAD can be misdiagnosed with some misdiagnoses being hypothyroidism, hypoglycemia or even a viral infection.

What causes SAD?

Some research suggests that people who have SAD have trouble with their levels of serotonin, and are unable to regulate this neurotransmitter which influences mood. These same folks also produce less vitamin D, which suggests that it may play a role in serotonin regulation. Insufficient levels of vitamin D correlate to depressive symptoms, in clinical environments.

I don’t know about you, but I know that two years ago when I was found to have low vitamin D, I felt depressed, tired and lethargic. Once I got my vitamin D levels back up, I felt different, more energetic, and now keep to a regimen of supplements (Vitamin D3 + K) to maintain my levels of this important nutrient. I will be tested again in the next few months to see how I am doing; however, I feel great.

Another factor known to increase one’s chance of developing SAD are location, location, location. The further you live from the equator the more frequent the likelihood of developing SAD.

If your family has a history of depression, you may be more likely to be seasonally depressed. If a close relative has a psychiatric disorder, particularly severe depression or alcohol abuse, your chances of SAD increase.

The number people affected by SAD is estimated to be about 10 million, and is four times more common for women than men. The age of onset is anywhere between 18 and 30 years of age. Fortunately, SAD is episodic, lasting a short period of time, and diagnosis of SAD is based on at least two years of experiencing depression with a seasonal change.

What can I do to manage SAD?

There are many ways to treat SAD, of which increasing vitamin D is one. Other treatments that are effective are light therapy, medication, and counseling, sometimes a combination.

Light therapy is exposure to bright artificial light to mimic outdoor light, using a lightbox or light visor. It generally takes place in the morning, for a period of 30 to 60 minutes at a time. It is recommended to continue the light therapy until spring, and you no longer feel depressed or lethargic. Too soon and the symptoms can return.

There is a minimum of side effects, the biggest one being doing the light therapy too late in the day, which could cause an inability to go to sleep. People with bipolar disorder, skin that is sensitive to light or other conditions that may make your eyes vulnerable to damage from the light should steer clear.

Often people are also treated with anti-depressants and therapy, usually cognitive behavioral therapy (CBT).

And I would be remiss if I didn’t offer some self-care activities that can help when you are affected by winter blues, such as:

  • Taking advantage of sunlight when you can by getting out at lunch for a brisk walk

  • Exercise of any kind helps lift your spirits and gets the endorphins boosted (endorphins are also boosted by massage, food and sex too)

  • Go to bed and wake up at regularly scheduled times

  • Make your space sunnier, brighter and cheerier

If you or someone you know is experiencing SAD, it is a form of depression and is something you don’t want to ignore. Get help when needed. Resources below:

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