Is this why you’re lacking energy?
All your friends are excited about the season change and the upcoming holidays every Fall. You dread this time of year because you feel depressed, lose interest in activities, and have low energy. This lasts until sometime in the Spring. When you explain this to your doctor, she says you might have seasonal affective disorder. What is this? How is it treated? Are there ways to prevent it?
Definition
Seasonal affective disorder (SAD) is a type of depression that’s related to changes in the season. This means it starts and ends at about the same time every year. For most people, it begins in the Fall, lasts throughout the Winter, and goes away in the Spring/early Summer. This is often called Winter depression. Other individuals experience the opposite pattern and have symptoms during the Spring and Summer. This is known as Summer depression.
The cause of SAD isn’t known but thought to be related to your biological clock (circadian rhythm), decreased serotonin levels, or alteration to melatonin levels. In Fall and Winter, the reduced sunlight might disrupt your circadian rhythm, leading to the condition. Reduced sunlight can also cause your serotonin levels to drop, and since it plays a vital role in mood regulation, this can have an impact. These changes can also affect the amount of melatonin in your body, which is vital in regulating sleep patterns.
Symptoms of SAD usually start out as mild and become more severe as the season progresses. General symptoms include feeling depressed most of the day (nearly every day), losing interest in activities you once enjoyed, having low energy, having problems with sleeping, experiencing changes in your appetite or weight, feeling sluggish or agitated, having difficulty concentrating, feeling hopeless/worthless/guilty, and having frequent thoughts of death or suicide. Symptoms related specifically to winter depression are oversleeping, appetite changes (especially a craving for foods high in carbohydrates), weight gain, and tiredness/low energy. Symptoms seen primarily in summer depression are trouble sleeping (insomnia), poor appetite, weight loss, and agitation/anxiety.
Certain factors can increase your chances of developing SAD. It’s more likely to occur if you’re female and a young adult. The odds are also higher if you have a family history of the condition or other form of depression, you have major depression or bipolar disorder, or you live far from the equator. The condition seems to be more common in individuals who live farther away from the equator due to the decreased sunlight during Winter. SAD can lead to many complications if not treated, such as social withdrawal, school/work problems, substance abuse, other mental health disorders (ex. anxiety or eating disorders), and suicidal thoughts/behavior. To lessen the chances of these, you should see your doctor if you feel down for days at a time and you can’t get motivated to do activities you usually enjoy. This is especially true if your sleep patterns and appetite have changed, you turn to alcohol for comfort or relaxation, feel hopeless, or think about suicide.
Treatment
There are many different treatment options when it comes to seasonal affective disorder. The first choice is light therapy (or phototherapy). It involves you sitting a few feet from a special box that exposes you to a bright light that mimics natural outdoor light. You do this every morning within the first hour of waking. It helps to cause changes in brain chemicals. It takes a few days to weeks to start noticing a difference. Before you buy a lightbox, ask your doctor what features and options you need so you can select a high-quality product that’s safe and effective.
If you have severe SAD, your doctor may recommend taking antidepressant medication. The most common is an extended-release form of bupropion, but other drugs can be used. It can take several weeks before you notice the full benefits, so your doctor might suggest that you start taking them before your symptoms typically begin each year and continuing them after your symptoms usually go away. Your doctor may also advise that you participate in psychotherapy (talk therapy) because it can help you to identify/change negative thoughts/behaviors that may be making you feel worse, learn healthy ways to cope (ex. reducing avoidance behavior and scheduling activities you enjoy), and learn how to manage stress.
There are some other steps you can take to improve your condition. The first is to stick to your treatment plan. Next, you want to make your environment sunnier and brighter by opening blinds, trimming tree branches that block sunlight, or adding skylights to your home. Whenever possible, sit closer to bright windows. Make time to get outside by taking a long walk, eating lunch at a nearby park, or sitting on a bench. Keep in mind that even on cold or cloudy days, outdoor light can help. This is true any time of day, but especially within two hours of getting up in the morning. You also want to exercise regularly because it helps relieve stress and anxiety. Make sure you get enough sleep to feel rested but don’t get too much sleep. Choose healthy meals and snacks. Don’t turn to alcohol or recreational drugs for relief. Try to connect with people you enjoy being around because they can offer support. Take winter vacations in sunny, warm locations and take summer vacations to cooler places.
Prevention
The key to preventing seasonal affective disorder is being aware that you have the condition and then following the treatment plan you and your doctor created. Start managing your symptoms before they appear each year. Maintain a healthy lifestyle throughout the year to encourage overall good health.
Seasonal affective disorder can disrupt your life, but by managing it to the best of your ability, you’ll be able to have the life you want! If you have any questions or concerns about seasonal affective disorder, please speak with your doctor. If you would like more information, please visit the National Institute of Mental Health’s seasonal affective disorder page at https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder