Seasonal
Affective
Disorder
JB Leiknes
Seasonal Affective Disorder


Mood disorder
People who are normally happy experience
depressive symptoms during winter months

“Winter-blues” or “winter depression”

More prevalent in nordic countries


First described by scholar Jordanes in the 6th
century in his book Getica1
Most prevalent during winter months but can
occur during other seasons [Reverse Seasonal
Affective Disorder]
Classification of SAD

In order to qualify as SAD a diagnosis must
meet 4 criteria2:

Depressive periods at a particular time of year

Relapse into depression or mania/hypomania at a
particular time of year

Pattern of depression lasting two or more years with
no nonseasonal major depressive episodes during
the same period

The instances of depression following a seasonal
pattern must outnumber other instances of
depression throughout patient's life
Etiology

Believed to be light-related


Serotonin polymorphisms4


Evidence: effectiveness of light-therapy3
Association between SAD and the shorter allele of
the serotonin transporter promoter repeat length
polymorphism (5-HTTLPR)
Mutation in the gene expressing melanopsin

Photopigment found in retina, participates in
circadian rhythm
Treatment

Primarily concerning winter-based SAD

Light therapy


Bright light therapy/dawn simulation5

Medication

Timed administration of the hormone melatonin
Main theory behind treatment is adjustment of
circadian rhythm via use of light or
hormones/medicaments to mimic or induce the
body's own mechanisms of circadian rhythm
Cultural Impact


Light cafés
Commercially available
bright-lights
Sources
1 – [Wikipedia] Jordanes' Getica – http://en.wikipedia.org/wiki/Getica_(Jordanes)
2 – [Mayo Clinic] Depression - Seasonal Affective Disorder (SAD) –
http://www.mayoclinic.com/health/seasonal-affective-disorder/DS00195/DSECTION=symptoms
3 – [American Journal of Psychiatry] The Can-SAD Study: A Randomized Controlled Trial of
the Effectiveness of Light Therapy and Fluoxetine in Patients With Winter Seasonal
Affective Disorder – http://ajp.psychiatryonline.org/cgi/content/abstract/163/5/805
4 – [Neurobiology of Disease] Seasonal Affective Disorder and Serotonin-Related
Polymorphisms – http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WNK457VFDV13&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=
1&_urlVersion=0&_userid=10&md5=cdf40c7c01f51290364ab7709dbeacf4
5 – [Biological Psychiatry] Dawn simulation and bright light in the treatment of SAD: a
controlled study – http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T4S43RJ7CF8&_coverDate=08%2F01%2F2001&_alid=509264218&_rdoc=1&_fmt=&_orig=search&_qd=1&_
cdi=4982&_sort=d&view=c&_acct=C000022721&_version=1&_urlVersion=0&_userid=489256&
md5=c2dc9bcba4a21f35f9482ab0fd10cd1a