Sad because of SAD…

Dr. Seema Das
Dr. Seema Das

Dr. Seema Das has been a professor of Life Sciences for more than 20 years. Her ability to write stems from authoring academic texts, and is displayed in her articles. A positive and empathetic person of cheerful disposition, she would love to see a world full of happy and empowered people. This translates into her dream of becoming a practising counsellor: something which she’s currently studying for.

 

Did the clock setback on 29th October 2017 also set your mood back? Have you been feeling anxious, guilty and worthless since then? Are you more stressed, fatigued, irritable and finding it difficult to concentrate and take decisions? Do you feel like crying for no reason and have a general feeling of despair? Are you eating more and gaining weight? Has your libido gone down and you don’t feel like interacting with people?

Do you feel this way every year at this time and then switch back to your normal, energetic, cheerful self when the clocks are reset again in March?

If your answer is in the affirmative to all the above, science may be able to explain your ‘winter blues’. You are sad in the winter months because you might be having SAD, Seasonal Affective Disorder, also known as winter depression.

Seasonal Affective Disorder is a type of recurrent major depressive disorder in which episodes of depression occur during the same season each year. These episodes begin in the fall and lessen as spring approaches. A less common type of SAD, known as summer depression, usually begins in the late spring or early summer. Seasonal affective disorder has not been recognised for long, the term having first appeared only in 1985.

SAD is not considered a separate disorder, but rather a type of depression with a recurring seasonal pattern. To be diagnosed with SAD, an individual must have had major depression coinciding with specific seasons for at least two years. Additionally, these seasonal depressions should have been much more frequent than any non-seasonal ones.

SAD could also be a product of the modern, urbanized society. As compared to 75% of the population working outdoors in natural light a few years back, only 10% do so presently. Concentrated city environments are more likely to have a higher number of sufferers due to high office hours and less time spent outdoors.

SAD occurs four times more in women than in men, with the age of onset between 20 and 30 years. Symptoms, however, can appear earlier; cases of SAD have been reported even in children and teens. Some people experience symptoms severe enough to affect quality of life, and up to six percent require hospitalization. The prevalence of seasonal depression is anywhere from 0 -10 percent of the population, depending on the geographic region. Typically, the further one is from the equator, the more at risk they are for seasonal depression. Seasonal effective disorder is seen to be less common where there is snow on the ground.

The map of winter depression: Between the 30th parallels winter depression is almost unknown: rates increase towards the poles

Seasonal affective disorder is estimated to affect 10 million Americans. Another 10 to 20 percent may have mild SAD. Estimates in the UK vary between 1 in every 3 people – a figure supported by the Royal College Of Psychiatrists – up to approximately 1 in every 15 people every year.

Many people don’t know they have SAD — or that there are treatments available.

Although the causes of SAD are not fully known, research has linked its’s occurrence to certain biological factors. The risk of developing SAD could be attributed to how a person responds to changes in daylight during the autumn and winter. In people suffering from SAD, reduced daylight may alter the body clock, affecting sleep, hormone levels and mood.

People with SAD may have trouble regulating serotonin, one of the key neurotransmitters involved in mood, having abnormally low levels of serotonin in winter.  They may overproduce the hormone melatonin as well, which regulates sleep. As winter days become shorter, melatonin production increases, leaving people with SAD more lethargic and sleepier. Research also suggests an underproduction of Vitamin D in patients. This may be playing a role in serotonin activity and clinically significant depression symptoms.

The National Institute for Health and Care Excellence (NICE) in the UK recommends that SAD should be treated in the same way as other types of depression. This includes using treatments such as cognitive behavioural therapy (CBT) or medication such as antidepressants. Selective serotonin reuptake inhibitors (SSRIs) are the preferred type of antidepressant for treating SAD, which increase the level of serotonin in the brain, helping elevate mood.

St John’s wort is a herbal remedy used to treat mental health problems. Scientifically known as Hypericum perforatum, it contains the ingredients hypericin and hyperforin, that have antidepressant properties. Research suggests that it increases the activity of brain chemicals such as serotonin and noradrenaline that are thought to play an important part in regulating mood.

Light therapy is also a popular treatment for SAD. This involves sitting by a special lamp called a light box for around 30 minutes to an hour each morning. The light produced from the lamp simulates sunlight that’s missing during the darker, winter months. Light boxes filter harmful ultraviolet (UV) rays as well, eliminating any risk of skin or eye damage. Better results have been obtained with light of shorter wavelength (blue). While the usefulness of this treatment is questionable, it remains both accessible and safe. Dawn-stimulating alarm clocks, which gradually light up the bedroom as one wakes up, may also be useful for some people.

Simple lifestyle measures can help in the self-management of SAD. These include: trying to get as much natural sunlight as possible (even a brief lunchtime walk can be beneficial), making work and home environments brighter and airy, exercising regularly, and eating a healthy, balanced diet. Talking to family and friends and joining a support group can offer great comfort.

While these changes are very difficult to deal with, one must keep in mind that winter doesn’t last forever. When the clocks turn back to normal on Sunday, the 25th of March, you would too! If you want to know more about the disorder and how to treat it, the NHS website is a reliable resource.