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  • Writer's pictureMarie Whelan

Shedding Light on Seasonal Affective Disorder


Fall back…spring forward. It’s time for the seasonal time change that throws everyone off. Darkness comes earlier and some people may not see vibrant sunlight for months. For these individuals, the lack of once abundant natural light brings on symptoms of depression that only occur seasonally. This type of depression is called seasonal affective disorder or SAD. Of those diagnosed with SAD, 90% have fall/winter onset SAD and the remaining 10% have spring/summer SAD.


SAD is considered a subcategory under the umbrella of overall depression. In order to be be officially diagnosed with SAD, an individual must have experienced the repeating seasonal symptoms for at least two years. According to the American Academy of Family Physicians, 4% - 6% of the American populace is diagnosed with Seasonal Affective Disorder.


WHAT ARE THE RISK FACTORS FOR SAD?

For every five individuals diagnosed with SAD, four of those people are women. Equatorial residents have less episodes of SAD than those above or below the Tropics of Cancer or Capricorn. The National Institutes of Health says that only 1% of Floridians are diagnosed with SAD, but up to 9% of New Englanders or Alaskans have SAD.


According to Dr. Joseph Allen of Premier Health, the average presenting age for SAD is 20-years old, with it most commonly occurring between 18-30, but it can effect any age. It most commonly appears in those with a history of family depression where the individual has an existing diagnosis of depression themselves.


WHAT ARE THE SYMPTOMS OF SAD?

According to the National Institutes of Health, the symptoms of SAD include:

  • Low energy, feeling sluggish

  • Loss of interest in things you once enjoyed

  • Trouble sleeping

  • Feeling hopeless, worthless

  • Difficulty concentrating

  • Appetite changes - weight gain or loss

  • Daytime fatigue - increased sleepiness

  • Lowered sex drive

For individuals that have a winter pattern SAD, they commonly have increased incidence of the following:

  • Hypersomnia (excessive time feeling sleepy or sleeping)

  • Social withdrawal – hibernating

  • Cravings for carb-filled “comfort food”


MEDICAL TREATMENT OF SAD

As Seasonal Affective Disorder is a form of depression, your first step should always be seeing your personal physician. Your physician may recommend talk therapy with a certified clinician. Counseling has been very effective for depression, particularly cognitive behavioral therapy (CBT) with a therapist. If depression is really overwhelming, a physician may recommend antidepressant medication to allow your depressant thoughts the chance to calm down and your mind the space to heal and move forward. Most anti-depressants take 4-weeks to reach maximum efficacy, and your physician can work with you to find the medication most effective for you. In addition, the following holistic treatments might alleviate symptoms in the interim or be sufficient in milder cases of SAD.


HOLISTIC TREATMENT OF SAD

A multi-pronged approach is necessary for non-pharmaceutical, holistic treatment of SAD.


NUTRITIONAL

Watch Your Vitamin D Levels – A study out of the University of Georgia has shown that lower levels of Vitamin D is common in those diagnosed with SAD. It is recommended that you have your doctor do a simple blood test to determine your Vitamin D levels as over supplementation can cause serious negative effects. In addition to supplements, Harvard recommends foods higher in vitamin D like fatty fish (salmon, swordfish, tuna, sardines), milks and orange juice fortified with vitamin D, and eggs.


Avoid excessive alcohol and caffeine - Excessive caffeine consumption tends to lead to sleep disturbances and the lack of sleep can exacerbate depressive symptoms. A 2019 study showed that caffeine disrupts critical neurotransmitters like dopamine and gamma-aminobutyric acid (GABA), triggering irritability, anxiety, low-motivation and self-criticism.


The same depressant effect occurs on the central nervous system with the over consumption of alcohol. Additionally, over indulgence in alcohol can lead to the depressive shame spiral where the individual feels poorly, drinks to feel better, but the alcohol only makes them feel worse.


Resist urge to eat nutritionally empty carbohydrates or sugary foods - Does a tiring day at the office or the emotional tension of a stressful family gathering make you want to race to the cookie jar or curl up with a huge platter of mac and cheese? Well you aren't alone. Simple carbohydrates are an easy way for the body to convert food into fuel through easily digestible sugars. While these sugars may give a short-term energy boost, the subsequent crash creates a depressive rebound.


One 2015 study showed increased sucrose levels lead to brain inflammation common in individuals with major depressive disorder and reducing those blood sugar levels reduces the inflammation and the potential for depression. A further 2015 study added eating a balanced, nutritious diet of fibrous vegetables correlated with lower odds of depression and refined grain consumption increased that risk.


DUPLICATE THE SUN

Lightboxes – While medical science doesn't have a definitive explanation of what causes SAD, we do know it could be changes in biological circadian rhythms triggered by the reduction of natural light. These seasonal changes may also disrupt hormones like serotonin and melatonin thereby disrupting sleep, mood, and overall well-being.


The first line of treatment for SAD is to replace this light loss through the use of light therapy boxes, or lightboxes. Lightboxes are twenty times brighter than normal indoor light and operate without damaging ultraviolet (UV) light. When selecting a lightbox, choose one that is made for light therapy and provides a minimum of 10,000 lux of light. With consistent use, over 60-80% of people that use lightboxes see improvement with only 30-min a day use.


Use your lightbox within the first hour of awakening to provide your circadian rhythm the jumpstart needed to re-regulate your system. Simply position your lightbox about 16-24 inches away from the side of your face, perhaps while drinking your coffee at the counter or brushing your teeth in the morning. Do not look directly into the light, but have your eyes open while using it for 20-30 minutes...then go on with your day


A 2010 study found that the effect of light therapy led to an improvement in mood as soon as 20 minutes into the first session, but there is no need to overdo it. More lightbox time doesn't lead to faster improvement. Researchers found that 40 minutes of exposure led to more of an improvement than 20 minutes, but 60 minutes was not more effective than 40 minutes.


There are literally 100's of light therapy boxes available on Amazon or at other retail vendors. The items selected below are unique and highly rated and wont look like the standard "white brick" most light boxes look like.


Dawn-Simulation Lamps - Also called "sunrise lights," dawn simulator lamps or clocks are not anywhere near as bright as the lightboxes. They are meant to be placed on your night stand and emit a gradually increasing light to replicate a normal dawn sunrise. This allows you to wake up slowly and naturally and some have found that this was all that is needed to get their circadian rhythms back on track during the winter months.


Full-Spectrum Light Therapy Devices - And finally, there are some unique situation lamps for use when you are driving, reading or resting. However you can bring this light to your life will alleviate your SAD symptoms and improve your life.



PHYSICAL CARE

And finally, there is physical care for the body to fend off illness, exhaustion and depression. Aerobic exercise has been documented to raise endorphins to banish those winter blues. A 30-minute walk outside brings all the benefits of cardio as well as bring you closer to nature. Be certain to bundle up as people with SAD tend to frequently say they are unable to get and stay warm. Below are some non-caloric ways to keep warm and provide the comfort that is usually found in carb-heavy foods.



MENTAL CARE

Mental care is sometimes the hardest to do because we cannot see any external evidence of recovery like we can with a physical injury. But taking time to really explore your emotions will allow you to get more familiar of when you need additional tenderness, compassion and self-care during this season.


Journal - Journaling is an outstanding way not only to track your emotions and recovery, but also to discern symptoms of improvement or relapse to take care of yourself. For some, the blank page is daunting. So in addition to finding one of the many wonderful notebooks and journals available with blank pages, the books below provide outstanding prompts to get you thinking about what you really need to survive and thrive while getting through your seasonal depression.

Aromatherapy - Almost all brain functions - seeing, hearing, touching, and tasting - enter the brain and are routed through the thalamus where they are appropriately channeled to the areas of the brain most apt to deal with them, such as the amygdala for emotions and the hippocampus for memory. But scent is different. It bypasses the thalamus and goes right into the amygdala and hippocampus which may explain why the scent of your grandmothers baking transports you immediately into your childhood.


Aromatherapy uses natural plant extracts distilled down into their essential oils to evoke emotional regulation of our minds and bodies. In research studies, the exposure to and the use of lavender, chamomile, sweet orange, rosemary, and lemongrass oils have been shown to reduce stress, anxiety and symptoms of depression.


Although the name of aromatherapy implies inhaling the scents, it can also be massaged into the skin. Below are multiple products that provide you the benefits of essential oils without using an oil-infused humidifier. Use it on your linens, as jewelry, perfume on pulse-points, shower steamers, relaxation therapeutics or pocket inhalers.

Seasonal Affective Disorder doesn't need to knock you out for months. Once you have spotted this pattern, use these tips to prepare for the weeks to come and take care of your mental health. You've got this!



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