Seasonal Affective Disorder

Seasonal Affective Disorder (SAD) Which is also known as ‘Winter Blues’ is a type of depression which affects many people seasonally, especially during the winter months due to reduced exposure to bright light (it is also typical in people who work night shifts and sleep during the day).  People who suffer from this condition, tend to feel excessive fatigue and increase in appetite (especially for carbohydrates, leading to weight gain). Additional symptoms include:

  • Sleep problems, finding it hard to stay awake during the day, but having

  • disturbed nights

  • Loss of libido, not interested in physical contact

  • Anxiety, inability to cope

  • Social problems, irritability, not wanting to see people

  • Depression, feelings of gloom and despondency for no apparent reason

SAD is a sub category of depression and is not considered a different disorder. The key difference is that the symptoms of SAD occur seasonally, as the name suggest. The symptoms of SAS often parallel mild depression, including mood, sleep patterns and general feelings of disrupted wellbeing. If you regularly feel down mainly in the winter months, it is likely that you suffer from SAD and your condition should be treated as such.

Treatments for SAD and depression are not entirely similar.  One of the most common treatments for SAD is light therapy. Research shows that the changes in the amount of light per day (photoperiod) causes chemical changes in the brain which can ignite depressive symptoms.  Light therapy attempts to ‘reboot’ the circadian clock (our body’s clock) by exposure to a SAD lamp for a certain amount of time per day (usually 30-60 minutes, depending on the strength of the lamp).  This triggers the body to correct its chemical imbalance in a natural way, and is usually as effective as antidepressants but without the side effects.   In cases where the symptoms are severe, professional help should be sought based on other empirically based treatments for depression, such as cognitive behavioural therapypsychotropic medication etc.

In mild case of SAD, where professional help is not required self-help can go a long way.  A good place to start would be to ask yourself if you’re physically healthy because there’s a well establish link between physical and mental health.  For example, you should ask yourself if you exercise regularly.   There is an abundance of studies that demonstrate how physical exercise is a natural anti-depressant. It produces endorphins and a good mood, both of which help promote better choices regarding food and nutrition and increase the ability to cope with stressors.  It’s recommended to adopt routines that promote positive health practices such as early rising, showering, eating regularly and balanced etc. We call these ‘behavioural activation’ strategies.  Another ‘remedy’ is to avoid social isolation because social interaction with friends and family can really help.  It is important, however, to set realistic goals. When not met, unrealistic goals tend to trigger in some people a sense of defeat, discouragement and depression. In order to help mild or moderate depression it is often a good idea to break up the goals into smaller, more achievable ones that is likely to promote more confidence and less distress. 

When confronted with a situation where a friend or a member or the family is exhibiting signs of SAD it is very important to be supportive.  You should act patiently and offer emotional support, understanding and encouragement.  Be a good listener and do not disparage the emotions which are being expressed. Certainly, do not ever ignore comments about suicide.  You might want to conceptualise yourself as a coach and suggest engaging in physical activities (preferably together) as well as suggest breaking down unrealistic expectations or goals or offer alternative strategies to reach realistic goals.  If there is no noticeable change in symptoms, encourage them to see a health professional who specialise in this condition.   You should take into account that there is no set time frame for determining if the symptoms have persisted for a length of time which requires professional intervention.  Some people will reach for professional help almost immediately whereas others might wait for years before seeking help.  The trigger for reaching out for professional help should be the point where the depressive symptoms are impairing their quality of life or are interfering with daily activities and functions. 

In addition to (and sometimes in lieu of) light and emotional therapy there are several supplements to consider:

  • St. John’s wart: has been shown to benefit people who suffer from mild or moderate depression.  Dosage recommendations.

  • Omega 3: Some researches have demonstrated significant improvement when compared with placebo.  Omega 3 appears to interact with neurotransmitters and allow increased serotonin and dopamine transmission. Recommended daily dosage 2000mg.

  • SAM-e: In some countries, this can be purchased over the counter. It can work as well as antidepressants but without the side effects. Daily recommendation is 400-1600mg.  Read more about SAM-E.

  • Vitamin B9- Also known as folate or folic acid. Deficiency of this vitamin has been correlated with depression. Recommended daily dosage is 500 micrograms.

  • L-Tryptophan: is another natural remedy which is a precursor to serotonin (the calming, mood-elevating neurotransmitter). Recommended dosage 500-1000mg.

  • Vitamin B12 - Important note for Vegans and Vegetarians. People who have vegetarian diets, and particularly vegans, are at increased risk for vitamin B12 deficiency because they don't consume the animal-based foods that are rich sources of B12. Amongst other symptoms, vitamin B12 deficiency is known to cause depression and cognitive impairment.

  • Vitamin D: Some studies suggest an association between low vitamin D levels in the blood and various mood disorders, including depression, seasonal affective disorder (SAD), and premenstrual syndrome (PMS).  Vitamin D supplementation may improve symptoms of depression associated with SAD. More research is needed before a conclusion can be made. Recommended daily dosage 400-800 IU.

For any of the above or any other depression remedies, I suggest consulting

your healthcare professional who has knowledge about how these remedies

may interfere with other medications you maybe taking.  Please note that

St. John’s Wort can interfere with HIV medications. Certain other

supplements can interfere with contraceptives. For obvious reasons, it is

essential to consult professionals with any form of treatment you are

undertaking for SAD and/or any other mental health disorder.

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