Diagnosed with seasonal affective disorder? Learn about your treatment options
By Miles J. Varn, M.D., Chief Medical Officer at PinnacleCare
If you’ve been diagnosed with seasonal affective disorder (SAD), it’s helpful to have a basic understanding of the condition and what each type of treatment entails so you can make an informed decision. This Q&A provides answers to some common questions.
Q: What is seasonal affective disorder (SAD)?
A: Seasonal affective disorder is a form of major depression with symptoms that return each year during the winter months and stop during the spring and summer. Researchers have not pinpointed specifically what causes SAD, but they believe it’s related to the decrease in daylight, which may cause:
- A disruption of circadian rhythms (your internal biological clock)
- A drop in serotonin levels
- A disruption in the balance of the body’s level of melatonin (a sleep and mood-regulating hormone)
- A vitamin D deficiency
Some studies also suggest there may be a genetic component, with people who have a relative who has been diagnosed with SAD or another form of depression being more likely to develop SAD.
Q: Who is at risk?
A: More women than men are diagnosed with the condition. Seasonal affective disorder also affects younger people in their 20s, 30s and 40s more frequently.
Q: What are the symptoms of SAD?
- Depressed mood or sadness
- Anxiety
- Lack of energy
- Increase in hours spent sleeping
- Insomnia
- Fatigue
- Difficulty concentrating
- Irritability
- Loss of interest in activities and socializing
- Decrease in sexual desire
- Overeating and craving sweet or starchy foods
- Significant weight gain
Q: What treatments are available?
A: First-line treatment usually includes light therapy. You sit in front of a specially designed light box for 30 minutes each day. Doctors recommend spending time outdoors for at least a half hour every day, even on cloudy days, in addition to light therapy.
Dawn simulation is another form of light therapy. Just before you wake up, a device puts out a dim light that grows brighter over time, imitating the sunrise. The goal of this form of treatment is to help reset your body’s circadian rhythms.
Q: What are the potential side effects of light therapy?
A: Some people experience headaches, eyestrain, agitation, nausea and sleep disruptions. If you take medication that makes your skin more sensitive to UV light or have an eye condition that puts your eyes at risk for damage by light, light box therapy may not be appropriate.
Q: What other treatments may be recommended?
A: Doctors often combine cognitive behavior therapy (CBT) with light therapy to treat SAD. CBT helps you identify and change negative thoughts and behaviors and build skills to better manage stress and cope with your symptoms.
In a study conducted at the University of Vermont, researchers found that CBT was more effective than light box therapy alone at relieving symptoms and preventing the recurrence of these symptoms. Two winters after the initial treatment, symptoms returned in 46 percent of the people who used only light therapy. In contrast, symptoms returned for only 27 percent of the people in the CBT group and their symptoms were less severe than those of the people in the light therapy group.
Q: Are there medications to treat SAD?
A: Some physicians include antidepressant medications as part of treatment for SAD. Several studies have found that extended release forms of the anti-depressant bupropion can be effective for some patients.
If a blood test finds that you have low vitamin D levels, your doctor may recommend a supplement to increase your levels and potentially lessen your symptoms.
Q: Are there other steps I can take to manage SAD symptoms?
A: Getting regular exercise and eating a healthy diet may help improve your mood and increase your energy level. It’s also beneficial to stay socially connected and continue to take part in your regular activities, whether that’s meeting friends for a night out, going to an exercise class, or taking part in a book club.
