Healthy You Article – January 2, 2009

Is Seasonal Affective Disorder Getting You Down?
By Mary Perkins, Wellness Center Manager

Winter blues, holiday slump, cabin fever, winter doldrums…do you have feelings of depression every year at this time? Do these feelings begin in the late fall, intensify in winter, and ease up as spring approaches? If so, you may be suffering from Seasonal Affective Disorder. Estimates are that as many as ten percent of the population suffer from some degree of SAD. It is more common among women living in northern latitudes, but may affect men and children as well. Research continues around this often-misunderstood affliction and new therapies are being developed to help ease the symptoms.

Symptoms of Seasonal Affective Disorder usually begin in late fall when the daylight in the Northern Hemisphere is the shortest and dimmest of the year. This light deprivation causes a slow down of the production of serotonin, which is a “feel good” chemical in the brain. These symptoms often intensify in January and February and begin to taper off as spring approaches and the amount of daylight increases.

Symptoms of Seasonal Affective Disorder
Symptoms of SAD may vary from mild to severe but may still challenge the quality of life during this time and may include:

-Depressed mood.
-Fatigue and lack of energy.
-Sleeping much more than usual, increased need for sleep, or difficulty awakening in the morning.
-Increased appetite, often including carbohydrate cravings (sweets, pasta, breads).
-Reduced work productivity.
-Loss of interest or pleasure in every day activities.
-Withdrawal from family or friends.
-Loss of interest in sex.
-Irritability.
-Anxiety.
-Unusual heaviness in arms and legs.
-Weight gain.
-Loss of concentration.
-Inability to make decisions.
-Feelings of worthlessness, guilt, or thoughts of death.

It is important that people suffering from SAD have support from others during this time. Patience and understanding from family, friends and coworkers is crucial. Following are tips for people suffering from SAD to better help themselves keep symptoms under control.

1) Learn all you can about Seasonal Affective Disorder. As research continues, more and more information is becoming available about SAD. Arm yourself with information, let others know you need their support right now, and keep in touch with your doctor.
One online source is: http://depression.about.com/od/sad. This website is affiliated with the New York Times and offers advice from Dr. Michael Terman – Professor of Clinical Psychology and Psychiatry at Columbia University who heads the Winter Depression Program there.

2) See your doctor. If you suspect that you may be suffering from SAD, write down your symptoms and have a discussion with your doctor. He/She may be able to offer advice, support, and suggest available therapies, which may include bright light therapy, dawn simulation therapy, high-density negative ion therapy, anti-depressants, or a combination of therapies.

Bright Light Therapy attempts to imitate the brightness of being outdoors on a sunny day. It consists of sitting under a high-intensity light for 30 minutes every morning.

Dawn Simulation Therapy is a treatment that simulates the sunrise in the middle of May. This takes place while you sleep and may be an alternative to someone who cannot be exposed to bright lights or does not have the thirty minutes to sit under the high-intensity light. This therapy is still being tested for effectiveness.

Anti-depressants are prescribed by the doctor in the more severe cases of SAD. The most commonly prescribed anti-depressants include Prozac, Zoloft, and Wellbutrin.

3) Eat A Well-Balanced Diet. Stick to a diet rich with proteins, fruits, and vegetables, trying to avoid sugars, excess carbohydrates, and caffeine. This will regulate insulin levels, lessen the feelings of exhaustion, and help to avoid weight gain.

4) Stay Active. Remaining active, particularly outside activities, will help to increase levels of energy. Going for walks will increase heart rate and allow exposure to light.

5) Increase lighting in the home. For mild cases of SAD, keeping lights on rather than shutting them off to lower the utility bill may help.

Winter can be long and stormy for those suffering from Seasonal Affective Disorder. It can be devastating for the sufferer and difficult for loved ones. If you have symptoms and suspect that SAD may be the cause, discuss it with your doctor. There may be light at the end of the tunnel.

"HEALTHY YOU” is a weekly column prepared by health care providers and staff at North Country Hospital and Health System. For information or to suggest a topic for this column, please call Mary Perkins, Wellness Center Manager, 334-3226, or email mperkins@nchsi.org.