Seasonal Affective Disorder
Reflection: Seasonal Affective Disorder
Shannon N. Phifer
Moraine Park Technical College
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Seasonal Affective Disorder
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Seasonal affective disorder, also known as SAD, is a mood disorder similar to depression,
which occurs around the same time of the year, usually in the winter. There is a less common
form of SAD that involves depression in the summer. SAD tends to last about 5 months in those
who live in the northern part of the U.S. The disorder seems to affect women more often than
men, especially in the reproductive years of a woman’s life (Encyclopedia, 2012). The causes of
depression are not fully known; most likely a combination of genetic, biologic, and
environmental factors play a role.
Because depression often runs in families, it may have a genetic component. Data from
family, twin, adoption, and genetic studies strongly indicate a genetic factor. Studies have found
that close relatives of patients with depression are two to six times more likely to develop the
problem than individuals without a family history. Since SAD is a form of depression, it makes
sense that those who have family members that suffer from depression can acquire SAD, even if
they do not qualify for the typical diagnosis of classic depression. There are also biological
factors that may contribute to SAD. Evidence supports the theory that depression has a biologic
basis. The basic biologic causes of depression are strongly linked to abnormalities in the delivery
of certain key neurotransmitters, chemical messengers in the brain. These neurotransmitters
include serotonin, acetylcholine and catecholamines. Serotonin is one of the most influential
factors that contribute to depression; it is important for feelings of well-being. Imbalances in the
brain’s serotonin levels can trigger depression and other mood disorders. Acetylcholine and
catecholamines are a group of neurotransmitters that consists of dopamine, norepinephrine, and
epinephrine (also called adrenaline). Corticotrophin-releasing factor (CRF), a stress hormone and
neurotransmitter, may be involved in depression and anxiety disorders. The degree to which
these chemical messengers are disturbed may be affected by other factors such as genetic
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susceptibility. For example, researchers have identified a defect in the gene known as SERT,
which regulates serotonin and has been linked to depression. Environmental factors include
certain types of medications. Many prescription drugs can affect brain chemicals and trigger
depression. These medications include certain types of drugs used for acne, high blood pressure,
contraception, Parkinson’s disease, inflammation, gastrointestinal relief, and other conditions.
There are specific signs and symptoms associated with SAD. Winter-onset seasonal
affective disorder symptoms include:
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Depression
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Hopelessness

Anxiety

Loss of energy

Heavy, "leaden" feeling in the arms or legs
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Social withdrawal
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Oversleeping

Loss of interest in activities you once enjoyed

Appetite changes, especially a craving for foods high in carbohydrates

Weight gain

Difficulty concentrating
Summer-onset seasonal affective disorder symptoms include:

Anxiety

Trouble sleeping (insomnia)

Irritability

Agitation
Seasonal Affective Disorder
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Weight loss
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Poor appetite
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Increased sex drive
In some people with bipolar disorder, spring and summer can bring on symptoms of mania or a
less intense form of mania (hypomania). This is known as reverse seasonal affective disorder.
Signs and symptoms of reverse seasonal affective disorder include:
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Persistently elevated mood
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Hyperactivity
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Agitation
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Unbridled enthusiasm out of proportion to the situation
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Rapid thoughts and speech (Staff M. C., 2011).
There are a variety of treatment options for those affected with SAD. The most common
treatment is light therapy. This consists of sitting in front of a light box that mimics the light
produced by the sun. The individual is advised to sit a few feet away from the light box for at
least 30 minutes a day, preferably in the mornings to replicate a sunrise or early morning sun. It
is best to begin the light treatment in the fall season or early into the winter season to decrease
the symptoms of SAD early on. It is important to note though that the individual must not look
directly at the light and clearance from an eye care professional is advised before beginning
treatment. The side effects of light therapy can include headaches and eye strain, as well as a
less common side effect of mania (Guide, 2007). Typically, SAD resolves itself naturally when
the season changes but light therapy can speed up the process.
Talk therapy is also helpful when dealing with SAD. Cognitive behavioral therapy research
for treating individuals that suffer from SAD has been promising. In fact, Kelly Rohan, a SAD
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expert and assistant professor of psychology at the University of Vermont, states that CBT offers
better outcomes, especially long-term, for those affected then light therapy (Wakefield, 2005).
In a 2005 study involving 61 patients, Rohan treated one group with daily light therapy, another
with 12 sessions of CBT and a third group with a combination of both treatments. A less popular
option, selective serotonin reuptake inhibitors, wasn't used. In addition, the largest percentage of
patients (80 percent) responded in full when CBT and light therapy were combined.
Furthermore, those who underwent CBT, both alone and with light therapy, were less depressed
at the one-year follow-up compared to patients who had been treated with light therapy alone.
Diet has also been recently said to affect SAD. The carbohydrate craving common in people
with this disorder is thought to be caused by decreased levels of the brain neurotransmitter
serotonin. Since tryptophan is a precursor of serotonin, taking in more of this amino acid may
increase the body's production of serotonin and help you feel better. Although there is no solid
research that supports the benefits of eating tryptophan-rich foods, one might want to try eating
more of these foods to see if symptoms improve. Foods rich in tryptophan include turkey, milk,
and egg whites. Other foods include basmati rice, bouillon, cereals and fruit (Guide, 2007).
Caffeine and alcohol consumption should also be monitored and generally reduced, especially
during bouts of SAD. Caffeine can give an immediate energizing effect but also can be
attributed to anxiety, muscle tension and fatigue, once the caffeine effects wear off. Alcohol is a
depressant and can actually increase the signs and symptoms of SAD.
Exercise is a great option to incorporate into the winter months, especially for those suffering
from SAD. Engage in regular aerobic exercise. It is not known for sure if exercise helps people
with SAD, but some evidence suggests that it does. Aim to exercise outdoors in the early
morning hours. Try walking, jogging, biking, swimming; even better, exercise in the sun or near
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a sunny window. Individuals can also keep their body's clock in sync by rising and retiring at the
same time each day, even on weekends or days off from work. Another option is to steep
peppermint or lemon oil in water and inhale. These are stimulating oils and may give a little
extra zip, especially in the early morning hours (Guide, 2007). Other alternative treatment
options include supplements, such as:

St. John's Wart. This herb has traditionally been used to treat a variety of problems,
including depression. It may be helpful if you have mild or moderate depression.
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SAMe. This is a synthetic form of a chemical that occurs naturally in the body. SAMe
hasn't been approved by the Food and Drug Administration to treat depression in the
United States. However, it's used in Europe as a prescription drug to treat depression.
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Melatonin. This natural hormone helps regulate mood. A change in the season may
change the level of melatonin in your body.
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Omega-3 fatty acids. Omega-3 fatty acid supplements may help relieve depression
symptoms and have other health benefits. Sources of omega-3s include fish such as
salmon, mackerel and herring. Omega-3s are also found in certain nuts and grains and in
other vegetarian sources, but it isn't clear whether they have the same effect as fish oil.
Mind-body therapies are also suggested to help ease the signs and symptoms of SAD and
include:
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Acupuncture
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Yoga
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Meditation
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Guided imagery
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Massage therapy (Staff, 2011).
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Medications, such as SSRI’s, can also be used in conjunction with other treatment options
like CBT and/or light-therapy. Typically, medications are prescribed to those who are
experiencing severe signs and symptoms of SAD. Antidepressants commonly used to treat
seasonal affective disorder include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac,
Sarafem) and venlafaxine (Effexor). An extended-release version of the antidepressant
bupropion (Wellbutrin XL) may help prevent depressive episodes in people with a history of
seasonal affective disorder. If an individual is feeling the effects of SAD, it is advised to see your
doctor for a physical examination. Other health problems, such as an underactive thyroid, can
cause SAD-like symptoms. The outcome is usually good with treatment. However, some people
have SAD throughout their lives (Encyclopedia, 2012).
I can honestly say that I feel the effects of the long winter months, especially come January
and February. I find myself dragging throughout the day and have a decrease in my energy level
compared to how I feel in the spring and summer months. My father also suffers from marked
SAD. I am assuming that I may fall into the genetic factor associated with SAD. Luckily, I had
realized this year’s back and have taken the necessary steps to help minimize its effects. Every
winter, I reinstate my gym membership so I am able to keep active. I also bought sheer curtains
for my home, so natural light can come in. I have taken Melatonin for the last two years, more
so for sleep but have also found out that it can actually help with minimizing the symptoms of
SAD. I imagine that there are a large number of people that just contribute their feelings of
“winter blues” to the weather and shorter days experienced during the winter months. It is my
hope that SAD is discussed with individuals during check-ups and physician visits. My PCP
never mentioned these symptoms to me when I sought out medical advice and actually stated
that I was suffering from depression. Luckily, I was educated enough to bring up SAD (because
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of my father’s SAD diagnosis) and took measures to help decrease the symptoms. My physician
was ready to place me on an SSRI immediately, which I found disturbing because of the lack of
information they were basing their decision off of. SAD should be made more public and
increased education should be provided to individuals, especially those living in northern parts of
the country. But……that’s just my opinion!
Seasonal Affective Disorder
References
Encyclopedia, A. M. (2012, Febraury 11). Seasonal Affective Disorder. Retrieved March 5,
2013, from PubMed Health: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002499/
Guide, E. o. (2007, January 11). 5 Home Remedies for Seasonal Affective Disorder. Retrieved
March 7 2013, 2013, from Discovery Fit and Health:
http://health.howstuffworks.com/wellness/natural-medicine/home-remedies/homeremedies-for-seasonal-affective-disorder1.htm
Staff, M. C. (2011, September 22). Seasonal Affective Disorder. Retrieved March 6, 2013, from
The Mayo Clinic: http://www.mayoclinic.com/health/seasonal-affectivedisorder/DS00195
Wakefield, J. (2005, October 27). Talk therapy more effective long term treatment for SAD than
light therapy, study finds. Retrieved March 6, 2013, from Eurek Alert:
http://www.eurekalert.org/pub_releases/2005-10/uov-ttm102705.php
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