What is Seasonal Affective Disorder/Winter Depression? By Martin Downs, MPH From the WebMD Archives A wistful feeling comes over us in late autumn, as the last remaining leaves drop, morning frosts cover the ground, and the sun sets earlier each day. Hot cider and the warmth of a favorite old coat may be all you need to face the coming winter with good cheer, but for many people, fall melancholy deepens to winter depression . Winter depression is still a mystery to scientists who study it. Many things, including brain chemicals, ions in the air, and genetics seem to be involved. But researchers agree that people who suffer from winter depression -- also known as " seasonal affective disorder ," a term that produces the cute acronym SAD -- have one thing in common. They're particularly sensitive to light, or the lack of it. Many studies have shown that people with seasonal affective disorder feel better after exposure to bright light. It seems simple enough: In higher latitudes, winter days are shorter, so you get less exposure to sunlight. Replace lost sunlight with bright artificial light, and your mood improves. But it's actually far more complex.

Alfred Lewy, MD, a seasonal affective disorder researcher at the Oregon Health & Science University, says it's not only a matter of getting light, but also getting it at the right time. "The most important time to get light is in the morning," he says. He thinks seasonal affective disorder is due to a "phase-shift" of the circadian rhythm. The wall clock may tell you it's time to get up and at 'em, but your body's internal clock says you should be resting. Bright light in the morning resets your circadian clock. This is relevant to the "fall back" time change, which happens in places that observe Daylight Saving Time. You might think that setting back the clock one hour would make seasonal affective disorder symptoms worse, because the sun sets one hour earlier. "Actually, I think it's the opposite," Lewy says. "The problem is waking up before dawn." Lewy says he suspects that "true winter depressives," the people whose problem is biological and not related to other factors, might feel better after the time change. But the improvement would only be temporary, as days continue to shorten.

Continued Arctic Winters In Fairbanks, Alaska, in the dead of winter, less than four hours separate sunrise and sunset. With so little sunlight, it seems like no one could escape winter depression ; but in fact, many Alaskans fare just fine. One study found that about 9% of Fairbanks residents had seasonal affective disorder. That's about the same percentage another study found in New Hampshire. Mark D., who lives near Fairbanks, says he doesn't suffer from seasonal affective disorder, even though he rarely sees the sun. He pulls 12-hour shifts working in a power plant. He stays active in winter, so "cabin fever" isn't a problem for him, either. "If you sit around the house and do nothing all day I suppose it could eat at you," he says. "But there is always something for me to do -- snow-machine, cut firewood ... or just going into town and have a cup of coffee with friends at the cafe. "There are people, though, that will have a ten-yard stare in a five-yard room," he says. Some seek comfort from a bottle, too. "In lots of the smaller villages, that does happen.

Drinking is a big problem." Seasonal affective disorder researcher Michael Terman, PhD, at the Columbia Presbyterian Medical Center in New York, offers some possible explanations for why seasonal affective disorder isn't more common in the arctic. For one, people with seasonal affective disorder may be genetically predisposed to clinical depression and light sensitivity . Most people, in any place, wouldn't have both genetic traits. "Another way to look at it is that those are the people who are still in Alaska," he says. People who can't cope might not stay. But not everyone affected by seasonal changes has full-blown seasonal affective disorder, so estimates of how many people do have it may be low. "Winter depression is a spectrum of severity," Lewy says. You may have trouble getting up, have bouts of fatigue during the day, or feel compelled to overeat, without feeling depressed. These symptoms can be treated with the same therapy given to seasonal affective disorder patients. Bright light -- generated by a special light box that's much brighter than a normal lamp -- is the first option. It's proven to work, but not for everyone. Also, the right time for it differs from person to person, Terman says.

For a night owl, taking light therapy too early could make seasonal affective disorder worse. Continued New Ideas om Wehr, researcher at the National Institute of Mental Health , has proposed a new explanation for seasonal affective disorder: It may stem from too much melatonin . When the brain 's pineal gland starts pumping out melatonin , we get sleepy. During winter, animals secrete melatonin for longer periods than they do at other times of the year. Wehr discovered that people do, too -- but only those who suffer from seasonal affective disorder. Light therapy would still work if melatonin were the main culprit, because light controls melatonin levels. Researchers are also testing a drug called propranalol, which they hope will improve seasonal affective disorder symptoms by curtailing melatonin flow in the morning hours. Lewy is studying the effects of small melatonin doses given in the afternoon, hoping that they will adjust circadian rhythms. Raymond Lam , MD, researcher at the University of British Columbia, Canada, and others are studying the role of brain chemicals like serotonin and dopamine. "We know there are interactions between the serotonin system and the circadian system," Lam says.

Some antidepressants like Paxil and Prozac work for some seasonal affective disorder sufferers. But Lewy says he prefers light therapy to antidepressants , which he says "are probably more of a Band-Aid," because they're not specific to winter depression. Terman has been testing yet another new way to treat seasonal affective disorder. This therapy involves aiming a stream of negatively charged ions at a person sleeping on a special conductive bed sheet. The discovery that high-density negative ions (not the same ions produced by home air filters) helped people with seasonal affective disorder came accidentally from a previous study. A second study, which will end later this year, has also found a beneficial effect. The air is full of negative ions in springtime, and not in the winter. But that doesn't explain how ion therapy works. "We don't yet have an answer to that question," Terman says; nevertheless, "We're now convinced that it's real." Seasonal affective disorder (SAD) - Mayo Clinic Seasonal affective disorder (SAD) By Mayo Clinic Staff Seasonal affective disorder (SAD) is a type of depression that's related to changes in seasons — SAD begins and ends at about the same times every year.

If you're like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. Less often, SAD causes depression in the spring or early summer. Treatment for SAD may include light therapy (phototherapy), psychotherapy and medications. Don't brush off that yearly feeling as simply a case of the "winter blues" or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year. References Saeed SA, et al. Seasonal affective disorder. Accessed Aug. 13, 2014. Specifiers for depressive disorders: With seasonal pattern. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. Accessed Aug. 13, 2014. Seasonal affective disorder. National Alliance on Mental Illness. Accessed Aug. 13, 2014. Seasonal-affective disorder. American Psychiatric Association. Accessed Aug. 13, 2014. Varteresian T, et al.

Natural products and supplements for geriatric depression and cognitive disorders: An evaluation of the research. Current Psychiatry Reports. 2014;16:456. Sanassi LA. Seasonal affective disorder: Is there light at the end of the tunnel? Journal of the American Academy of Physician Assistants. 2014;27:18. Melatonin. Natural Medicines Comprehensive Database. Accessed Aug. 13, 2014. Depression. National Institute of Mental Health. Accessed Aug. 13, 2014. Ravindran AV, et al. Complementary and alternative therapies as add-on to pharmacotherapy for mood and anxiety disorders: A systematic review. Journal of Affective Disorders. 2013;150:707. Stress and relaxation techniques. NCCAM Clinical Digest. Accessed Aug. 13, 2014. Massage therapy for health purposes. NCCAM Clinical Digest. Accessed Aug. 13, 2014. Kung S (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 29, 2014.

Products and Services Seasonal Depression (SAD) | Cleveland Clinic Seasonal Depression Share Facebook Twitter Linkedin Email Print What is Seasonal Depression? Seasonal depression, often called seasonal affective disorder (SAD), is a depression that occurs each year at the same time, usually starting in fall, worsening in winter, and ending in spring. It is more than just "the winter blues" or "cabin fever." A rare form of SAD, known as "summer depression," begins in late spring or early summer and ends in fall. What are the symptoms of seasonal affective disorder? People who suffer from SAD have many of the common signs of depression, including: Sadness loss of interest in usual activities withdrawal from social activities extreme fatigue and lack of energy a “leaden” sensation in the limbs increased need for sleep craving for carbohydrates, and weight gain. Symptoms of summer SAD include: weight loss decreased appetite How common is seasonal affective disorder? Approximately half a million people in the United States suffer from winter SAD, while 10 to 20 percent may suffer from a more mild form of winter blues. Three-quarters of the sufferers are women, and the depression usually starts in early adulthood.

SAD also can occur in children and adolescents. Older adults are less likely to experience SAD. This illness is more commonly seen in people who live in cloudy regions or at high latitudes (locations farther north or south of the equator). Individuals who relocate to higher latitudes are more likely to be affected by SAD. What causes seasonal affective disorder? The exact cause of this condition is not known, but evidence strongly suggests that, for those who are vulnerable to it, SAD is set off by changes in the availability of sunlight. One theory is that with less exposure to sunlight, the internal biological clock that regulates mood, sleep, and hormones is shifted. Exposure to light may reset the biological clock. Another theory is that brain chemicals (neurotransmitters, such as serotonin) that transmit information between nerves may be changed in people with SAD. It is believed that exposure to light can correct these imbalances. Melatonin, a chemical known to affect sleep patterns, may also play a role in seasonal affective disorder. Some have suggested that the lack of sunlight stimulates the production of melatonin in some individuals. This may be a factor in the symptoms of sluggishness and sleepiness.

How can I tell if I have seasonal affective disorder? It is very important that you do not diagnose yourself. If you have symptoms of depression, see your doctor for a thorough assessment. Sometimes physical problems can cause depression. But other times, symptoms of SAD are part of a more complex psychiatric problem. A mental health professional typically can evaluate your pattern of symptoms and identify whether you have SAD or another type of mood disorder. How is seasonal affective disorder treated? Research now shows that phototherapy, also known as bright light therapy, is an effective treatment for SAD. Sometimes antidepressant medicine is used alone or in combination with light therapy. Spending time outdoors during the day can be helpful, as well as increasing the amount of sunlight you're exposed to at home and in the office. Cognitive-behavioral therapy (CBT) is a very effective psychotherapeutic approach to seasonal affective disorder. A recent study demonstrated that CBT produced the longest-lasting effects of any treatment approach. What is light therapy? Is it safe? Light therapy, sometimes called phototherapy, is provided by a device that contains white fluorescent light tubes covered with a plastic screen to block ultraviolet rays.

The intensity of light emitted (Lux) should be 10,000 Lux. The patient does not need to look directly into the light, but reads or eats while sitting in front of the device at a distance of two to three feet. Light therapy is generally safe and well-tolerated. However, there are some situations in which it cannot be used (for example, conditions such as diabetes or retinopathies, certain medications) because of the potential risk of damage to the retina of the eye. Bright light therapy can cause hypomanic or manic symptoms; therefore, individuals with bipolar affective disorder need to have medical supervision in order to use light therapy. Side effects of light therapy include: eye strain insomnia At what time of the day should I use light therapy? For how long? The timing of light therapy appears to affect the response. Recent studies suggest that morning light therapy is more effective than evening treatments. Using this treatment too late in the day may cause insomnia. Many health professionals prefer to treat SAD with 10,000 Lux for 15 to 30 minutes every morning. Patients often see improvement within two to four days, and reach full benefits within two weeks.

The symptoms of SAD return quickly after light therapy is stopped, so light treatment should be continued throughout the entire season of low sunlight. Even though they generate enough light, tanning beds should not be used to treat SAD. The amount of ultraviolet (UV) rays they produce is harmful to the skin and eyes. Can I prevent seasonal affective disorder? If you think you have symptoms of SAD, see your doctor for a thorough examination. Your doctor will want to make sure that these symptoms are not caused by another psychiatric condition or major medical illness. If you have been diagnosed with SAD, here are some things you can do to help keep it from coming back: Begin using a light box at the start of the fall season, even before you feel winter SAD coming on. Try to spend some amount of time outside every day, even when it's very cloudy. The effects of daylight are still helpful. Eat a well-balanced diet and include sufficient amounts of vitamins and minerals as recommended by the FDA. This will help you have more energy even though your body is craving starchy and sweet foods. Try exercising for 30 minutes a day, three times a week. Stay involved with your social circle and regular activities.

This can be a tremendous means of support during winter months. Consider consulting a mental health professional trained in cognitive behavior therapy, which has been demonstrated as an effective treatment for SAD. Talk to your doctor about antidepressant medication if your symptoms are severe or continue even after treatments such as bright light therapy. If your symptoms become severe and you or someone you know, are having thoughts of suicide, call your doctor right away or go to the nearest emergency room. References National Institute of Mental Health. Seasonal Affective Disorder Accessed 12/8/2016. American Academy of Family Physicians. Seasonal Affective Disorder Accessed 12/8/2016. © Copyright 1995-2017 The Cleveland Clinic Foundation. All rights reserved This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

This document was last reviewed on: 2/4/2013...#9293 Seasonal Affective Disorder Products & Info from Verilux, Philips, Sunbox & Litebook - SADTherapyLamps.com lack of interest in friends and family excessive weight gain no motivation Like any other mood disorder the causes can be complex and there may be more than one method for resolving the problem. SAD MINI QUIZ:DO YOU HAVE SAD? If you’re trying to ﬁgure out whether what you have is the winter blues or SAD (seasonal affective disorder), ask yourself a few questions: Are your feelings about the weather actively inhibiting your life? Are you so unhappy that you’re unable to perform basic tasks? Are you sleeping signiﬁcantly more hours per night, and do you still have trouble waking in the morning? Has your spouse or your boss complained about your change in behavior? Do you feel seriously depressed (as opposed to simply grumpy or out of sorts)? If you answered yes to most of these questions, it’s possible what you’re experiencing is SAD. The encouraging news is that there are cures for SAD.

In fact there are multiple ways to alleviate SAD and bring energy and light back into your life. SAD TREATMENTS Treatments include psychotherapy, drugs and SAD light therapy. By far the most effective and least invasive treatment for SAD found thus far is light therapy, which is thankfully both affordable and easy to self-administer. Because SAD light therapy has been shown to be so effective, we have created this site devoted to discussing how to use light therapy properly, what you should look for in light therapy boxes to treat SAD specifically and screen the best light therapy boxes for you to purchase. Some of the best and most popular models include: Seasonal affective disorder (SAD) - NHS Choices Seasonal affective disorder (SAD) Introduction Seasonal affective disorder (SAD) is a type of depression that comes and goes in a seasonal pattern. SAD is sometimes known as "winter depression " because the symptoms are more apparent and tend to be more severe during the winter. The symptoms often begin in the autumn as the days start getting shorter. They're typically most severe during December, January and February. SAD often improves and disappears in the spring and summer, although it may return each autumn and winter in a repetitive pattern.

Symptoms of SAD Symptoms of SAD can include: a persistent low mood a loss of pleasure or interest in normal everyday activities irritability feelings of despair, guilt and worthlessness feeling lethargic (lacking in energy) and sleepy during the day sleeping for longer than normal and finding it hard to get up in the morning craving carbohydrates and gaining weight For some people, these symptoms can be severe and have a significant impact on their day-to-day activities. Read more about the symptoms of SAD . When to see your GP You should consider seeing your GP if you think you might have SAD and you're struggling to cope. Your GP can carry out an assessment to check your mental health. They may ask you about your mood, lifestyle, eating habits and sleeping patterns, plus any seasonal changes in your thoughts and behaviour. Read more about diagnosing SAD . What causes SAD? The exact cause of SAD isn't fully understood, but it's often linked to reduced exposure to sunlight during the shorter autumn and winter days.

The main theory is that a lack of sunlight might stop a part of the brain called the hypothalamus working properly, which may affect the: production of melatonin – melatonin is a hormone that makes you feel sleepy; in people with SAD, the body may produce it in higher than normal levels production of serotonin – serotonin is a hormone that affects your mood, appetite and sleep; a lack of sunlight may lead to lower serotonin levels, which is linked to feelings of depression body's internal clock (circadian rhythm) – your body uses sunlight to time various important functions, such as when you wake up, so lower light levels during the winter may disrupt your body clock and lead to symptoms of SAD It's also possible that some people are more vulnerable to SAD as a result of their genes, as some cases appear to run in families. Treatments for SAD A range of treatments are available for SAD. Your GP will recommend the most suitable treatment programme for you.

The main treatments are: lifestyle measures, including getting as much natural sunlight as possible, exercising regularly and managing your stress levels light therapy – where a special lamp called a light box is used to simulate exposure to sunlight Seasonal Affective Disorder | Psych Central Home » Library » Seasonal Affective Disorder Seasonal Affective Disorder By John M. Grohol, Psy.D. ~ 2 min read Winter depression (or winter blues) is a common affliction for those who live in our northern climate. Its clinical name is seasonal affective disorder (SAD) and up to 5 percent of the population (especially in northern states) may suffer from it. Seasonal affective disorder is characterized by feelings of sadness and depression that occur in the fall or winter months when the temperatures being to drop and the days grow shorter. The depressive episode is often associated with excessive eating, sleeping, and weight gain. Depressive symptoms begin in the fall or winter and persist until the spring. Women are twice to three times more likely to suffer from the winter blues than men. Seasonal affective disorder can also impact people during the summer months (“the summer blues”), too, but it is less common.

People suffering from SAD either are unable to function or function minimally during the season in which their disorder occurs. Seasonal affective disorder shares several symptoms with other forms of depression including lethargy, sadness, hopelessness, anxiety and social withdrawal. Strategies to Help Seasonal Affective Disorder There are many effective treatments for winter depression , some of which you can do to help yourself. Increasing your daily exposure to as much natural light as possible can be helpful to many. Any time that you have the opportunity to gain access to more sunlight in the winter months, you should try to do so. Taking a walk throughout the day (even if you don’t normally do so), sitting next to a south-facing window at your office, in a classroom, or at home will increase your sunlight exposure. Exercising next to a window or outdoors (when possible) is another activity that can help. Although it may be difficult to do, maintaining your schedule and lifestyle will help to keep the depression at bay. A regular pattern of sleep is the most important thing to maintain. It may be helpful, for instance, to have your bedroom lights on a timer to turn on a half-hour before you wake.

This may help in waking at a regular time every morning, when it is still dark outside in the winter months. Light therapy has shown to be an effective treatment for seasonal affective disorder. While you can purchase expensive, specialized light therapy lighting fixtures for your home or office, some inexpensive alternatives are also available. Another lighting technique to try is to replace commonly used light bulbs in your home with brighter full spectrum (also known as broad spectrum) light bulbs. While more expensive than regular light bulbs, these bulbs provide light that is similar to natural sunlight. Seasonal Affective Disorder: Winter Depression - Northern County Psychiatric Associates Northern County Psychiatric Associates You are here: Home / Depression / Seasonal Affective Disorder: Winter Depression Seasonal Affective Disorder: Winter Depression December 2004 By Carol Watkins MD Seasonal Affective Disorder and Light Therapy Other issues What is SAD? Throughout the centuries, poets have described a sense of sadness, loss and lethargy which can accompany the shortening days of fall and winter. Many cultures and religions have winter festivals associated with candles or fire. Many of us notice tiredness, a bit of weight gain, difficulty getting out of bed and bouts of “the blues” as fall turns to winter.

However some people experience an exaggerated form of these symptoms. Their depression and lack of energy become debilitating. Work and relationships suffer. This condition, known as Seasonal Affective Disorder (SAD) may affect over 10 million Americans while the milder, “Winter Blues” may affect a larger number of individuals. The typical symptoms of SAD include depression, lack of energy, increased need for sleep, a craving for sweets and weight gain. Symptoms begin in the fall, peak in the winter and usually resolve in the spring. Some individuals experience great bursts of energy and creativity in the spring or early summer. Susceptible individuals who work in buildings without windows may experience SAD-type symptoms at any time of year. Some people with SAD have mild or occasionally severe periods of mania during the spring or summer. If the symptoms are mild, no treatment may be necessary. If they are problematic, then a mood stabilizer such as Lithium might be considered. There is a smaller group of individuals who suffer from summer depression. SAD is recognized in the DSM-IV (The American Psychiatric Association’s diagnostic manual) as a subtype of major depressive episode. The classic major depression involves decreased appetite, decreased sleep, and often, poor appetite and weight loss.

It has long been recognized that some depressed individuals had a “atypical depression” with increased sleep and appetite along with decreased energy. Some, but not all of these atypical individuals also had a seasonal pattern. Some people with winter depression also have mild or occasionally severe manic mood swings in the spring and summer. If these episodes are severe, the individual might be diagnosed with Bipolar Disorder (formerly called manic depressive illness). Epidemiology of SAD About 70-80% of those with SAD are women. The most common age of onset is in one’s thirties, but cases of childhood SAD have been reported and successfully treated. For every individual with full blown SAD, there are many more with milder “Winter Blues”. The incidence of SAD increases with increasing latitude up to a point, but does not continue increasing all the way to the poles. There seems to be interplay between an individual’s innate vulnerability and her degree of light exposure. For instance, one person might feel fine all year in Maryland but develop SAD when she moves to Toronto. Another individual may be symptomatic in Baltimore, but have few symptoms in Miami. Some individuals who work long hours inside office buildings with few windows may experience symptoms all year round.

Some very sensitive individuals may note changes in mood during long stretches of cloudy weather. Theories About How Light Affects Mood and Sleep In 1984, a psychiatrist at NIMH, Norman Rosenthal, published a paper on the use of bright light therapy in patients with this disorder. Since then, a large number of well-designed studies have confirmed and refined these findings. Researchers are still investigating mode by which bright light can lift depression or reset a sleep cycle. One theory is that an area of the brain, near the visual pathway, the suprachiasmatic nucleus responds to light by sending out a signal to suppress the secretion of a hormone called melatonin. Brain studies suggest that there is impairment serotonin function in neurons leading to the suprachiasmatic nucleus. Initial theories suggested a pathway from the retina to the suprachiasmatic nucleus. However some recent research indicated that bright light applied to the back of an individual’s knee could shift human circadian rhythms (Daily sleep-wake cycle). This suggests that the bloodstream, not just the neurons of the visual pathways, might mediate the biological clock. How the Light Box is Used Before embarking on a course of light treatment, it is best to have a complete psychiatric evaluation.

Sometimes a medical illness or another psychiatric condition can masquerade as depression. Discuss various treatment alternatives with your doctor. Light therapy does take time, and regular use. Like exercise, not everyone who would benefit from it will actually do it on a regular basis. Your doctor will discuss the various types of light boxes or visors available. The time spent in front of the light is related to the intensity of the light source and the distance one sits from the light. The light devices cost about $250 to $500 and often are not covered by insurance. I will often lend out a box for a month so that the individual can see whether it helps before purchasing a box. Some individuals who use a 10,000-lux box may only need 30 minutes of daily light treatment. However, the amount of light needed varies widely from individual to individual. The light treatment is most often done in the morning, but studies have suggested that either morning or evening light can help SAD. Some people may get insomnia when they use the light in the evening. Initially, researchers felt that one needed full spectrum light. Now, studies suggest that regular fluorescent lights will work as well.

UV (ultraviolet) light can damage eyes and skin, so it must be filtered out. It is best to buy a commercially built light box to be sure of the exact amount of light and to be sure that there are no isolated “hot spots” which could damage eyes. Many people still prefer full spectrum (minus UV) light because it is closest to natural lighting. The individual measures the distance from her face to the light source. This measurement is important, and should be repeated daily for several days and occasionally after that. The light needs to strike one’s eyes, but one does not need to look directly into the light source. It is fine to occasionally glance directly into the light. Many people read a book or eat breakfast while using the lights. Sitting still for 30 minutes to several hours is not an option for some people. For these people, the light visor is an option. Others are able to take one of the compact light boxes to work and use it for several hours. It is best to use the light source in an uninterrupted time block, but it can be helpful even with some interruptions. Long term treatment compliance is often more difficult than one might initially anticipate. This is an important reason to have a professional monitoring.

Having to account for your regular use (or the lack thereof) is a powerful motivator. It is also helpful to have an outside objective individual to help monitor your response to the treatment. Since one of the symptoms of SAD can be difficulty awakening in the morning, some find it helpful to have the light turn on just before they are supposed to wake up. Some individuals like to use a Dawn Simulator. This is a bright light that is programmed to gradually increase its intensity such that it reaches its full intensity a set period before the individual is scheduled to awaken. Although it is less gentle, some people will put their light box beside their bed and hook it up to a timer set to turn on shortly before awakening. Some people like to use full spectrum light bulbs for everyday household use. There is no evidence that these low intensity bulbs affect mood or sleep phase. Your plant light will not cure your SAD. Your 10,000-lux light however, may be nice for some of your plants. Other Treatments Outdoor light, even when the sky is overcast, provides as much or more light than a light box. There has been a study showing improvement in SAD symptoms when individuals took a one-hour daily walk outside.

Outside light is often brighter than the light boxes. Spending an hour outside each day can often produce beneficial results in some individuals. However, one cannot get early morning outside light in the winter. Not everyone’s job will allow for an hour-long outside walk. Only highly motivated people will continue their daily walk when it the rains or snows. SSRI (Selective Serotonin Reuptake Inhibitors–Paxil, Zoloft etc.) have been shown to be effective in SAD and in some cases of PMS. Some people prefer to take a pill because it is less time consuming than sitting in front of a light box. Some individuals need a combination of light therapy, medication, and psychotherapy. For those with winter depression and spring-summer mania, a mood stabilizer such as Lithium may be useful. Daily exercise has been shown to be helpful, particularly when done outdoors. For those who tend to crave sweets during the winter, eating a balanced diet may help one’s mood. Conversely, as the mood improves, craving for sweets may abate. Psychotherapy can help the depressed individual look at her depressive assumptions and negative expectations. It can also help one identify relationship difficulties so that interpersonal mistakes might not be repeated.

Research has shown that cognitive psychotherapy does help relieve depression faster and more completely than no therapy. Some individuals continue to have a certain amount of energy fluctuation with the seasons. If one is aware of this, one can plan for it and work the expected fluctuations into one’s life plans. Side Effects of Light Therapy Potential side effects of light therapy are rare and most often include jitteriness, a feeling of eyestrain and headache. Light therapy, like antidepressant medications, occasionally will cause someone to switch into a manic state. There has been debate on whether there might be long term retinal effects, but none have been documented when lights with proper screening of UV wavelengths are used. Individuals taking certain medications such as Lithium, tricyclic antidepressants, and neuroleptics and individuals with conditions such as diabetes or retinal degeneration should be monitored by an ophthalmologist. Because this form of treatment is fairly new, many doctors recommend a baseline eye exam and annual monitoring. Sleep Disorders Humans and animals generally have innate sleep-wake cycles close to but not exactly 24 hours. They depend on the daily light-dark cycle to keep their circadian rhythms to a regular 24 hours.

If a human is left in a room with no light-dark cues, he or she will gradually shift into a sleep-wake cycle that is not exactly 24 hours long. Body temperature and the secretion of the hormone melatonin follow the daily cycle. Other factors, such as work schedule can modify the sleep-wake cycle in humans. The autonomous cycle length varies at different periods in the life span. Adolescents often have an innate cycle longer than 24 hours so that they have the desire to stay up late and sleep in when it is time to get up. The innate cycle then shifts closer to 24 hours for adults, but for the elderly, the autonomous sleep-wake cycle may be shorter than 24 hours resulting in evening tiredness, sleep difficulty and waking too early. Individuals who have more severe difficulty with the timing of their sleep-wake cycle may have either Delayed Sleep Phase Disorder (difficulty falling sleep and the urge to sleep late) or Advanced Sleep Phase Disorder (tiring too early and waking too early) Both conditions can be treated with bright light. However, the proper timing of the exposure to light and darkness is more critical than it is for SAD.

In these conditions, improperly timed light and dark exposure can make the problem worse, not better. Jet Lag and Shift Work In the cases of jet lag or shift work, the individual does not have a disorder, but is reacting to externally induced changes in the sleep-wake cycle. Traveling west to east over three or more time zones is the most difficult shift. Large forced changes in the timing of sleep periods can lead to irritability and decreased alertness. Many people can deal with this by getting extra rest while traveling or by switching to a job with a more regular schedule. However, for those who must deal with frequent sleep timing changes, one may use a special calculator to help determine the timing for exposure to light and darkness just before and during travel or shift change. If one calculates the timing wrong, one may actually make the time phase shift worse instead of better. A travel kit can consist of a calculator, a light visor and wrap-around dark glasses. Some use small timed doses of Melatonin to achieve the same purpose. Other Uses of Bright Light Therapy There has been research using light therapy for PMS, obesity and non-seasonal depression. The results have not been as striking as the results for SAD. More research needs to be done.

However, it may make sense to use light therapy as an augmentation of other depression treatments or in cases in which the individual is unable to use other forms of treatment. The study on obesity was small and needs to be repeated with a larger, more carefully selected group. The obese individuals may have lost weight because their depression was better. Individuals whose PMS was worse in the winter responded better to light therapy than individuals with PMS without a seasonal variation. References: Winter Blues by Norman Rosenthal 1993, Guilford Press Seasonal Affective Disorder and Phototherapy edited by Rosenthal and Blehar 1989 Guilford Press Copyright 2002 Please do not reproduce without permission No related posts. Northern County Psychiatric Associates Our practice has experience in the treatment of Attention Deficit disorder (ADD or AD/HD), Depression, Separation Anxiety Disorder, Obsessive-Compulsive Disorder, and other psychiatric conditions. We are located in Northern Baltimore County and serve the Baltimore County, Carroll County and Harford County areas in Maryland. Since we are near the Pennsylvania border, we also serve the York County area. Our services include psychotherapy, psychiatric evaluations, medication management, and family therapy. We treat children, adults, and the elderly.

Featured Posts Overview - Light therapy - Mayo Clinic Light therapy Print Light therapy is a way to treat seasonal affective disorder (SAD) and certain other conditions by exposure to artificial light. SAD is a type of depression that occurs at a certain time each year, usually in the fall or winter. During light therapy, you sit or work near a device called a light therapy box. The box gives off bright light that mimics natural outdoor light. Light therapy is thought to affect brain chemicals linked to mood and sleep, easing SAD symptoms. Using a light therapy box may also help with other types of depression, sleep disorders and other conditions. Light therapy is also known as bright light therapy or phototherapy. References AskMayoExpert. Seasonal affective disorder (SAD). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015. Martensson B, et al. Bright white light therapy in depression: A critical review of the evidence. Journal of Affective Disorders. 2015;182:1. Lam RW, et al. Efficacy of bright light treatment, fluoxetine, and the combination in patients with nonseasonal major depressive disorder: A randomized clinical trial.

JAMA Psychiatry. 2016;73:56. Racz E, et al. Phototherapy and photochemotherapy for psoriasis. Dermatologic Clinics. 2015;33:79. Van Maanen A, et al. The effects of light therapy on sleep problems: A systematic review and meta-analysis. Sleep Medicine Reviews. 2016;29:52. Avery D. Seasonal affective disorder: Treatment. Accessed Feb. 8, 2016. Sanassi LA. Seasonal affective disorder: Is there light at the end of the tunnel? JAAPA. 2014;27:18. Melrose S. Seasonal affective disorder: An overview of assessment and treatment approaches. Depression Research and Treatment. Accessed Feb. 8, 2016. Kurlansik SL, et al. Seasonal affective disorder. American Family Physician. 2012;86:1037. O'Leary RE, et al. Update on tanning: More risks, fewer benefits. Journal of the American Academy of Dermatology.

2014;70:562. Seasonal affective disorders (SAD) — Treatment. NHS Choices. Accessed Feb. 15, 2016. Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 15, 2016. Related

Question: Also known as winter depression, what is the full form of S.A.D.?
Answer: SEASONAL AFFECTIVE