What is Seasonal Affective Disorder?
Seasonal Affective Disorder (SAD), also known as “Winter Blues” or “Winter Depression” occurs when a person experiences depressive symptoms during a specific time of the year, usually in the colder months. Symptoms traditionally begin in the fall when light levels start to diminish, carrying through the end of the winter. SAD is differentiated from other forms of depression because persons with SAD have normal mood throughout the remainder of the year. Persons with SAD experience typical symptoms of depression, including difficulty sleeping, sadness, somatic symptoms, low energy levels, irritability, and an inability to concentrate.
How does PCH treat Seasonal Affective Disorder?
Seasonal Affective Disorder can sometimes be ameliorated with light therapy, melatonin supplements, or antidepressants. However, when symptoms are disabling or refractory to standard treatments, it is time to consider an intensive treatment center. When a client arrives at PCH Treatment Center with seasonal affective disorder or depression, a careful assessment is made to first confirm the diagnosis and then carefully detail the symptoms. A doctoral level psychologist evaluates each client and composes a treatment plan in conjunction with the treatment team. One of the PCH psychiatrists will thoroughly assess the client’s medications, and make appropriate changes in their regimen. The philosophy at PCH is to minimize the amount of medication a client takes, when possible, and to focus on psychotherapy, aerobic excercise and holistic healing. In addition to psychoanalysis, PCH offers Dialectical Behavioral Therapy (DBT), mentalization, mindfulness based stress reduction, anger management, sleep management, psycho-education, and neurofeedback. Holistic adjuncts include yoga, meditation, fitness activities and an arts program. A family weekend is part of the initial treatment plan. Optional family therapy groups are also available. These valuable groups incorporate family members or significant others into the client’s treatment environment.
What causes Seasonal Affective Disorder?
Seasonal Affective Disorder is associated with low light levels that occur during the winter months. SAD may have a genetic basis, as the disorder runs in families. Persons with SAD may have altered melatonin secretion, with increased levels during the winter months causing sluggishness and low energy levels. Additionally, when sunlight is reduced, the body produces less of another hormone, serotonin. Lower levels of serotonin are associated with depression, and the function of some antidepressants is to stabilize serotonin levels. Research has also shown that altered Circadian rhythms occur in people with SAD. One study showed that people with blue eyes have a lower prevalence of SAD, perhaps related to their ability to let in lower levels of light more efficiently. Persons suffering from anxiety disorders, chronic fatigue syndrome and fibromyalgia may be at increased risk for Seasonal Affective Disorder. Furthermore, there is a higher incidence of SAD in colder climates with lower daily light levels.
How is Seasonal Affective Disorder diagnosed?
Seasonal Affective disorder can be clearly diagnosed based on a constellation of depressive symptoms which display a specific pattern, occurring during the fall or winter months. As with any psychological problem, a thorough assessment should determine the nature of the symptoms, and whether or not those symptoms are interfering with daily life at work, school or home. Concomitant substance abuse, alcohol use, or self-medication will complicate both the diagnosis and future treatment of Seasonal Affective Disorder.
Seasonal Affective Disorder can be effectively managed with psychological treatment, aerobic exercise, light therapy, and when necessary, medication. Aerobic exercise has been shown to counteract depression in mood disorders. Exposure to a light therapy device alters circadian rhythms and changes the amount of melatonin secreted, which helps to reduce or control symptoms of SAD. Exposure to a potent light source for at least 30 minutes each morning has been shown to mediate the symptoms of SAD. Melatonin supplements may also be effective in some persons with SAD. Psychotherapy is important to address underlying causes of depression, improve coping skills and resilience, and prevent maladaptive behaviors associated with the depressive symptoms. Antidepressants, when needed, are effective in alleviating Seasonal Affective Disorder. Proper sleep and stress management and psycho-education can significantly improve the wellness of someone with SAD, as well.
Persons with Seasonal Affective Disorder may not be aware they have SAD. Low energy levels, lack of initiative, and feelings of helplessness may prevent them from seeking assistance from a mental health professional. Furthermore, because symptoms cycle, they may not seek treatment expeditiously. Substance abuse is also associated with SAD. Use of alcohol, marijuana, cocaine, or prescription medications will interfere with effective psychological and medical treatment of SAD.