Seasonal Affective Disorder (SAD)

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Seasonal Affective Disorder in WinterSimply put – Seasonal Affective Disorder (SAD) is a reaction to the changing season that causes problems with mood and behavior.  These mood and behavior changes tend to start around September and may last until April.  According to S.A. Saeed in the March 1998 issue of American Family Physician, 4-6% of the general population experiences winter depression and an additional 10-20% have low-level features of the disorder. In the Journal for the Academy of Child and Adolescent Psychiatry (February 1998) J. Giedd reported that 3-5% of students in the 4th through 6th grade meet the criteria for SAD.  Women are 4 times more likely to be diagnosed with SAD and the average age of onset is 23.  Giedd reported that 9% of adults with SAD had an onset prior to 11 and 33% reported an onset prior to age 19.

The symptoms of SAD include sleep problems, overeating, depressed mood, family problems, lethargy, physical complaints, and behavioral problems.  Individuals experiencing sleep problems associated with SAD are most likely to report oversleeping, but not feeling refreshed when they awaken.  Then may report difficulty getting out of bed, or the need for frequent naps in the after.  (Think hibernation)

Overeating tends to be a problem in several ways.  First, people with SAD often crave and eat carbohydrates.  This generally leads to weight gain.  (Again, think hibernation).  Weight gain then contributes to depression.  In addition, ingestion of carbohydrates can cause rapid blood sugar fluctuations when also impact mood.

Persons with SAD typically aren’t much fun to be around.  They will often avoid company or when they are with other people they may be highly irritable.  Loss of sexual interest is also common.  In general, folks with SAD feel too tired to cope with daily living.  Everything feels like a tremendous effort.  Normal tasks become difficult.  Joint pain and stomach problems become more frequent and they may have lowered resistance to infection.  As if that isn’t enough, people with SAD are depressed.  They may use words like despair, misery, guilt, anxiety, or hopelessness to describe their mood.

By this time you may be wondering what causes this disorder.  My witty reply would be “living in Ohio.”  Actually, where you live can be part of the problem.  There is a structure in the brain called the pineal gland, and during night/darkness, this gland produces melatonin that makes us drowsy.  Bright light is the off switch for the melatonin production.  On dull winter days (there are a lot of those in Dayton) there is not enough light to trigger the pineal gland.  Bright light has also been associated with another brain chemical – serotonin.  You know about that one because it is associated with depression.

Using sunshine to treat seasonal affective disorderBoth the American Medical Association and the American Psychiatric Association recommend light therapy as the primary treatment strategy for SAD.  This isn’t ordinary reading light.  For this type of treatment the light must be at least 2500 lux.  That’s five times brighter than the well-lit office.  Believe it or not, light therapy does have some side effects for a few people including a jittery feeling, excitability, mild nausea, or burning of the eyes.

What can you do if you are one of the mild, moderate, or severe sufferers of SAD?

  1. See your primary care physician.  The diagnosis deserves careful attention since the symptoms overlap with other disorders.
  2. Increase your exposure to natural sunlight, if not medically contraindicated.
  3. Decrease consumption of carbohydrates.  Again, check this out with your physician before making a big dietary change.
  4. Ask your physician about light therapy.

I’ve used it.   And it works!


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