People often describe feeling depressed during the winter. After the beautiful colors of fall, it may feel like everything is gray, from the sky above to the ice and slush covering the ground. Add in more time indoors and a sun that sets an hour earlier and it’s no wonder so many people complain they have the winter blues. For some people, though, the problem goes deeper than that. They have a type of depression known as seasonal affective disorder, or SAD. In this post, we look at the causes, symptoms, risk factors, and treatment of SAD.
What Is Seasonal Affective Disorder?
Seasonal affective disorder is a type of major depression. Patients typically experience it around seasons (hence the name). Symptoms usually begin during late fall and continue throughout winter. Although the majority of sufferers experience seasonal affective disorder during the winter months, the condition strikes some during summer.
To be considered seasonal affective disorder, the patient must meet the criteria for major depression. In addition, the majority of their depressive episodes must align with either winter or summer for two or more years.
What Are the Symptoms of Seasonal Affective Disorder?
Again, the patient must first be diagnosed as having major depression. Symptoms of depression include:
- Feelings of depression most days for the majority of the day
- A lack of energy or sluggish feeling
- Feeling hopeless and/or worthless
- Lack of interest in things you used to love
- Changes in weight and/or appetite
- Change in sleep patterns
- Feeling agitated or having trouble concentrating
Patients also report frequent, recurring thoughts of death or suicide. If this describes you or someone you know, please call 911. Or, you can call the Suicide Prevention Line at 800-273-8255.
There are also symptoms specific to SAD. They differ according to whether the patient has the winter or summer pattern.
Risk Factors for Seasonal Affective Disorder
There are a variety of factors that increase your risk of developing SAD. The first may be whether you’re male or female. According to the National Institute of Mental Health (NIMH), women are four times as likely to receive a SAD diagnosis.
Where you live in relation to the equator also plays a role. For example, around 9 percent of residents in New England and Alaska have seasonal affective disorder. In contrast, only around 1 percent of Floridians do. Researchers think this is due to the sun. Lack of sunlight in winter may be a major contributing factor in SAD.
You’re also more likely to develop seasonal affective disorder if someone in your family has either SAD or another type of depression. In addition, you have a history of depression or bipolar disorder, your risk increases.
Finally, age also plays a role. SAD is most often diagnosed in young adults, but people of any age may experience this disorder.
What Causes Seasonal Affective Disorder?
Although doctors don’t have a definitive answer as to what causes SAD, they have noticed some biological similarities between patients. The first is how their bodies use the hormone serotonin. Although it controls a wide array of bodily functions, we mainly know serotonin for how it affects mood. Patients with SAD produce 5 percent more of the serotonin transmitter protein during winter months. This leaves the patient with lowered levels of the mood-regulating hormone.
Another potential cause is increased melatonin production. Commonly known as the sleep hormone, darkness tells your body to produce melatonin. Fewer daylight hours coupled with reduced sunlight may cause the bodies of SAD patients to produce more melatonin. This throws off the body’s natural circadian rhythms and leaves the patient feeling sleepy and lethargic.
Finally, those who have seasonal affective disorder may have reduced levels of vitamin D. This is natural if they get less sun exposure, as sunlight is the main way our bodies create vitamin D.
Treating Seasonal Affective Disorder
There are a variety of treatment options for seasonal affective disorder. Options include medications, light therapy, psychotherapy, and vitamin D. Your doctor may recommend a single treatment or combining multiple treatments.
Medications to treat SAD include SSRIs (selective serotonin reuptake inhibitors), a type of antidepressant commonly prescribed to treat major depressive disorder. NIMH offers a comprehensive page on SSRIs and other medications to treat depression, including potential side effects.
Light therapy is another common treatment for SAD, as lack of sunlight is seen as a major contributing factor. Patients sit in front of a light box every morning for anywhere from 20 minutes to an hour. The lux emissions of a light box are around 20 times stronger than that of ordinary lighting.
Patients may also undergo cognitive behavioral therapy, where they learn coping techniques. These help them replace negative thoughts with positive ones. Therapy may also include discovering pleasurable activities to help increase feelings of happiness.
Finally, some doctors recommend vitamin D supplementation. As yet, there is no evidence this therapy works. Most doctors believe it likely that SAD patients have deficient vitamin D levels due to reduced sun intake. Your doctor may recommend it anyway, though, to make up for deficiencies.
What Does Medicare Cover?
Medicare covers a variety of mental health screenings. We offer full details in our recent article, Medicare Coverage for Mental Health Issues. You can also get treatment – and help advance the cause of science – by joining a clinical trial. NIMH’s website provides great information on clinical trials. You can also find a study near you at ClinicalTrials.gov.
If you have questions about your Medicare coverage, call us toll-free at 855-350-8101. One of our licensed agents will answer your questions and help you find the best plan and coverage to meet your unique needs.
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