Seasonal affective disorder (SAD)
Seasonal affective disorder (SAD)
Seasonal affective disorder (also called SAD) is a type of depression that occurs at the same time every year. If you're like most people with seasonal affective disorder, your symptoms start in the fall and may continue into the winter months, sapping your energy and making you feel moody. Less often, seasonal affective disorder causes depression in the spring or early summer.
Treatment for seasonal affective disorder includes light therapy (phototherapy), psychotherapy and medications. Don't brush off that yearly feeling as simply a case of the "winter blues" or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year.
In most cases, seasonal affective disorder symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer. However, some people with the opposite pattern have symptoms that begin in spring or summer. In either case, symptoms may start out mild and become more severe as the season progresses.
Fall and winter seasonal affective disorder (winter depression)
Spring and summer seasonal affective disorder (summer depression)
Seasonal changes in bipolar disorder
When to see a doctor
The specific cause of seasonal affective disorder remains unknown. It's likely, as with many mental health conditions, that genetics, age and, perhaps most importantly, your body's natural chemical makeup all play a role in developing the condition. A few specific factors that may come into play include:
Factors that may increase your risk of seasonal affective disorder include:
Take signs and symptoms of seasonal affective disorder seriously. As with other types of depression, seasonal affective disorder can get worse and lead to problems if it's not treated. These can include:
Treatment can help prevent complications, especially if seasonal affective disorder is diagnosed and treated before symptoms get bad.
Preparing for your appointment
You're likely to start by seeing your family doctor or primary care provider. Or, you may start by seeing a mental health provider such as a psychiatrist or psychologist.
Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do:
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For seasonal affective disorder, some basic questions to ask include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions at any time during your appointment.
What to expect from your doctor
Your doctor may also ask other questions depending on your individual situation.
Tests and diagnosis
To help diagnose seasonal affective disorder, your doctor or mental health provider will do a thorough evaluation, which generally includes:
Seasonal affective disorder is considered a subtype of depression or bipolar disorder. Even with a thorough evaluation, it can sometimes be difficult for your doctor or mental health provider to diagnose seasonal affective disorder because other types of depression or other mental health conditions can cause similar symptoms.
To be diagnosed with seasonal affective disorder, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.
The following criteria must be met for a diagnosis of seasonal affective disorder:
Treatments and drugs
Treatment for seasonal affective disorder may include light therapy, medications and psychotherapy. If you have bipolar disorder, your doctor will be careful when prescribing light therapy or an antidepressant. Both treatments can potentially trigger a manic episode.
Light therapy is one of the first line treatments for seasonal affective disorder. It generally starts working in two to four days and causes few side effects. Research on light therapy is limited, but it appears to be effective for most people in relieving seasonal affective disorder symptoms.
Before you purchase a light therapy box or consider light therapy, talk to your doctor or mental health provider to make sure it's a good idea and to make sure you're getting a high-quality light therapy box.
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.
Your doctor may recommend starting treatment with an antidepressant before your symptoms typically begin each year. He or she may also recommend that you continue to take antidepressant medication beyond the time your symptoms normally go away.
Keep in mind that it may take several weeks to notice full benefits from an antidepressant. In addition, you may have to try different medications before you find one that works well for you and has the fewest side effects.
Light therapy is often an effective treatment for seasonal affective disorder. You can usually do routine activities, such as reading, while having light therapy. ...
Lifestyle and home remedies
If your seasonal depression symptoms are severe, you may need medications, light therapy or other treatments to manage seasonal affective disorder. However, there are some measures you can take on your own that may help. Try the following:
Several herbal remedies, supplements and mind-body techniques are commonly used to relieve depression symptoms. It's not clear how effective these treatments are for seasonal affective disorder, but there are several that may help. Keep in mind, alternative treatments alone may not be enough to relieve your symptoms. Some alternative treatments may not be safe if you have other health conditions or take certain medications.
Supplements used to treat depression include:
SAMe and St. John's wort can interact with medications for other conditions, especially antidepressants. Talk to your doctor before trying either of these remedies to make sure they're safe for you.
Mind-body therapies that may help relieve depression symptoms include:
Coping and support
Following these steps can help you manage seasonal affective disorder:
There's no known way to prevent the development of seasonal affective disorder. However, if you take steps early on to manage symptoms, you may be able to prevent them from getting worse over time. Some people find it helpful to begin treatment before symptoms would normally start in the fall or winter, and then continue treatment past the time symptoms would normally go away. If you can get control of your symptoms before they get worse, you may be able to head off serious changes in mood, appetite and energy levels.
Last Updated: 2011-09-22
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