What is Seasonal Affective Disorder and how to treat it

By: Aum Aeeman Memon, M.B.B.S., Wayne Health Department of Psychiatry and Behavioral Health

As the daylight hours decrease and days become dark and cloudy, it can be typical for some individuals to experience depressive symptoms. This seasonal predictive change in mood which can occur anytime from September through April with spontaneous remission in the summer months, is called Seasonal Affective Disorder (SAD). Common symptoms can include overeating (carbohydrate craving), over sleepiness (hypersomnia), social withdrawal, weight gain and prominent fatigue along with milder depressive symptoms. SAD occurs more commonly in women and young adults, and it is more common in those living in colder regions.

Light deprivation can lead to changes in circadian rhythm and excess production of Melatonin, a hormone that controls sleep-wake cycle, resulting in sleepiness. In addition, low levels of Serotonin, a neurotransmitter which regulates mood, sleep and digestion, have been noted to occur in winter/fall months. Vitamin D also tends to be low in people with SAD.

Bright light therapy is the first line of treatment for SAD as it helps to ease the symptoms and improve energy. In some cases, antidepressant medications and psychotherapy may be needed. High fluorescent light source of 10,000lux, kept at 30-60 angle from the face, at 16-24inch distance and is used for about 30mins a day. Onset of effect can be seen in 3-7 days and with effect disappearing at discontinuation of therapy. Morning use has shown better results than evening use. Adherence is needed for best treatment response. Low light sources require longer duration for effectiveness.

Light therapy also known as happy light is available in a wide price range with lowest ones starting at 40$. Higher price models may have more cosmetic appeal, but they are not necessarily more effective.

In addition to the above, eating foods rich in antidepressant nutrients (e.g.; seafood, organic meats, leafy greens, lettuce, peppers, and cruciferous vegetables such as broccoli, cauliflower, cabbage, kale, and Brussels sprouts), engaging in social activities, exercising and Vitamin D supplementation can be other ways to improve mood during the winter/fall months.

Additional resource: https://theconversation.com/what-psychiatrists-have-to-say-about-holiday-blues-89210