What is Seasonal Affective Disorder? (SAD)
• It is a form of depression connected with varying daylight hours
• Typically happens in the fall and winter months, but can happen in the summer months
• SAD is different from ‘holiday stress’ or seasonal adjustments dealing with school or work schedules
What Causes SAD?
Although the cause of SAD remains a mystery the following is known
• Daylight impacts two chemicals in the brain serotonin and melatonin
• During sunny days the brain increases its creation of serotonin
• Increased amounts of serotonin lead to feeling more happiness and overall well-being
• On the other hand a decrease in serotonin leads to feelings of depression
• When there is a lack of sunlight the brain is charged with creating melatonin
• Increased melatonin promotes sleepy feelings and in turn, the body has a deficit of energy
• Shorter days combined with an increase in hours of darkness in the fall and winter may impact the two chemicals decreasing serotonin and increasing melatonin
• This altering of chemical distribution promotes the likelihood of depression
Who is Affected by SAD?
• Mostly people in winter climates. But don’t confuse this with “holiday blues or “winter blues”
• Women
• Teenagers and Children
• Did you know:
• Studies show at least one million children in North America cope with SAD each year
• There is a Winter SAD and a Summer SAD, Although Winter SAD is most common
• Winter SAD is at its peak during January and February
• Typically emerges in young adulthood
• On average 5% of the adult population suffers from SAD
• Women get SAD more than Men
• 3 out of 4 of the SAD population are Women
• SAD usually emerges around 20-30 years of age
• As people age they are less likely to have SAD
• Seniors are less likely to have it
• Unfortunately few follow through with treatment
• Millions of Americans who have SAD may not even know they have it
• Winter SAD peaks during January and February months
• To be diagnosed someone must have the symptoms for two back-to-back years
Symptoms of Winter SAD
• Oversleeping during the Winter months; on average 2.5 hours more versus the Summer
• Overwhelming feeling of sadness for more than half a year
• Weight gain; in winter months people with SAD binge on carbohydrates and sugary treats as a source of comfort foods
• Become more self-critical, likely to complain, find fault, and focus on their problems versus other times during the season
Younger Children:
• Symptoms are associated with behavior
• Irritable, cry more often, and may have temper tantrums
• May be challenging to put to bed
• Complain of headaches and stomaches
• Children who have ADD or Attention Deficit Disorder are more susceptible to SAD
Pre-Teen and Teenagers:
• Schoolwork suffers from homework not being completed or tuned in late grades drop increasingly
• Challenging waking up and going to school and is often late
• Challenging to concentrate and recall details
• Making decisions is a struggle
• Loses interest in activities, possibly including avoiding friends, family, and social activities
Symptoms of Summer SAD
• Surprisingly 10% of the SAD population experiences Summer SAD (Reverse SAD). This depression occurs during the Spring and Summer months
• It's unknown why Summer SAD occurs but the longer days, high temperatures, and humidity might be a factor
• Summer SAD symptoms include loss of appetite, loss of weight, difficulty sleeping anxiety, and possible violence
How is SAD Diagnosed?
• Someone must have the symptoms for two back-to-back years
• Have a lab test measuring blood count
• Have a psychological evaluation to determine it is SAD
• Complete a questionnaire called a SPAQ Seasonal Pattern Assessment Questionnaire
Therapies to Lessen the Effects of Winter SAD
There are four therapies used when treating Winter SAD. They can be used individually or in combination. It is always best to consult a therapist, psychologist, or medical professional before starting any therapy.
• Medication
• Medical doctors and psychiatrists can prescribe antidepressants
• Antidepressants may have side effects
• Consult a doctor before taking any medication
• Light Therapy
• Light therapy effectively reduces the light deficiency experienced in the winter months
• Mimics sunlight by dispersing 10,000 lux or higher of fluorescent light (Lux = the measure of light hitting a surface)
• A bright sunny day is approximately 10,000 lux
• An overcast day is approximately 1,000 lux
• Need approx. 20 - 60 minutes of light exposure each morning
• Keep in mind there are risk factors so consult a doctor before use.
• Psychotherapy
• Cognitive Behavioral Therapy (CBT)
• Beneficial for many psychological disorders besides SADs
• Distinguishing and reducing negative thoughts
• Replacing those negative thoughts with positive ones
• Leading to a better outlook for those suffering
• Dialectical Behavioral Therapy (DBT)
• Children and teens are encouraged to participate
• Guides those participating to live in the moment and deal with stressors in a healthy way
• Results in emotional balance and to partake in healthy relationships
• Dialectical Behavioral Therapy Restructured (DBT-C)
• Effective for kids and teens
• Focuses on the developmental levels of children and matches effective treatment methods
• Encourages coping skills according to the child or teen’s current developmental circumstances
• Effective for kids and teens who have been unresponsive to other forms of therapy
Vitamin D
• Not recommended for treating severe SAD
• More research is needed to prove the effectiveness of taking vitamin D alone
• If already vitamin D deficient, taking vitamin D will reduce the vitamin deficiency
• Psychotherapy or light therapy are far more effective treatments for SAD.
• Benefits of vitamin D:
• Inexpensive
• safe if taken in the correct dosage
• Approved treatment combined with other treatments
Left Unattended SAD Can Turn Severe
• When SAD is recognized, take it seriously
• Reach out for help
• Ask a doctor about treatment.
• Unattended may create consequences that challenge a happy healthy life.
• When family and friends are being pushed away, never stop trying because isolation for someone coping with SAD is not healthy.
• It is better for them to be doing something active and not feel like themselves than to be isolated with their negative thoughts.
• Movement and exercise are key.
• Exercising produces endorphins and reduces depression even just for that moment.
• Don’t rule out Therapy
• A benefit of CBT (Cognitive Behavioral Therapy) is it encourages parent-child interaction because homework is embedded in the therapy.
• Homework gives the teen or child an obligation to complete the assignment even when they are feeling down.
• However for a child or teen to meet this obligation in addition to their regular schoolwork they may need extra nudging.
To learn more about SAD, check out the following website sites:
National Institute of Mental Health (General SAD overview )
https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder
Psychology Today (General SAD overview )
https://www.psychologytoday.com/us/conditions/seasonal-affective-disorder#:~:text=Winter%20or%20summer%20seasonal%20affective,such%20as%20headaches%20and%20stomachaches.
Hillside Atlanta Foundation (General SAD overview)
https://hside.org/does-winter-make-you-depressed/
Newport Academy (General SAD overview for teens)
https://www.newportacademy.com/resources/mental-health/teens-seasonal-affective-disorder/#block_e7f1e96a2bf0c3ad18e9371f1cc0501b-5
Nemours Children’s Health (General SAD overview for teens)
https://kidshealth.org/en/teens/sad.html
Destination for teens (General SAD overview for teens)
https://www.destinationsforteens.com/destinations-blog/do-teens-experience-seasonal-depression/
Mayo Clinic ( Teen depression)
https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985
Children National Hospital (General SAD overview for kids)
https://riseandshine.childrensnational.org/could-your-child-have-seasonal-affective-disorder/#:~:text=Each%20year%2C%20more%20than%201,that%20follows%20a%20seasonal%20pattern.
Renown Health (10 facts about SAD)
https://www.renown.org/blog/10-facts-about-seasonal-affective-disorder
Mayo Clinic (choosing correct the lightbox)
https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298