The symptoms of SAD are often misdiagnosed as clinical because of the
many shared characteristics. However, the key factor in diagnosing SAD
is it's seasonal reappearance. Many physicians use a the criteria of
two episodes of fall or winter onset depression in a three year period
as a guide toward diagnosing SAD. The diagnosis of Seasonal Affective
Disorder should only be made after an evaluation by a psychiatrist,
psychologist or social worker. Self-diagnosis can be harmful, as it is
easy to misinterpret symptoms and their severity. Self-diagnosis can
also keep a patient from seeking appropriate medical attention.
What causes SAD?
Though no definite causes of Seasonal Affective Disorder have been
identified, several theories have been offered. Many believe that the
winter season causes changes in the brain chemistry, specifically
serotonin and dopamine production and balance. One of the
characteristics of SAD, the strong craving for foods high in
carbohydrates, gives credence to this theory, since these foods increase
levels of serotonin in the brain.
Many professionals credit a disturbance in the "biological clock" of the
brain, that regulates hormones, sleep and mood. It is believed that
the shorter days and lack of bright sunlight and the ability to be
outside contribute these disturbances. In Florida for example, less
than 1% of people are believed to suffer from winter depression, whereas
10% or more suffer from SAD in Alaska.
Is SAD treatable?
The good news is that Seasonal Affective Disorder is treatable!
Exciting research is finding that many patients with SAD improve with
exposure to bright artificial light, commonly called light therapy, or
photo therapy. Exercise and diet are also critical elements of
Recommended light therapy systems consist of a set of fluorescent bulbs
installed in a box with a diffusing screen. Patients are instructed to
sit in front of the light box for a prescribed amount of time, with the
lights on and their eyes open. It's not necessary, nor recommended that
patients look directly at the lights. Treatment sessions can be as
short as 15 minutes, or as long as 3 hours, once or twice a day. What
appears to be critical is that the intensity of the light is comparable
to natural sunlight shortly after sunrise or before sunset. It is also
believed that the best results are achieved by patients who do their
light therapy immediately upon rising in the morning. Some patients
find additional benefits in giving themselves an additional treatment in
the early evening hours.
There are very few side effects from light therapy. Some people who are
extremely sensitive to light, may experience some redness, mimicking a
sunburn type reaction. Changing the distance between themselves and
the lightbox, or using a sunscreen or sunblock can help. This won't
affect the therapy, as the benefits of light therapy come from the light
entering the eyes. A few patients report eye irritation. Using eye
drops, or sitting farther from the light box usually relieves this side
effect. Occasionally, some patients experience nausea, but this is
usually mild and eventually disappears after repeated treatment.
Though a physician's order, or prescription is not required by the Food
and Drug Administration for light therapy, it is best to work with a
physician to determine your individual needs. It is important to have a
physician supervise your light therapy. Patients with certain physical
conditions are not advised to use light therapy. It is not recommended
that individuals build their own light boxes. Output must be carefully
calibrated for the proper treatment value. The danger of creating heat
or electrical hazard is also possible. Currently, a commercially
manufactured light box can be purchased for approximately $300-500, with
new models coming out each year.
Diet, Exercise and Medication
Regular exercise, combined with good sleep hygiene and good nutrition
are also valuable treatment options. Daily, light exercise, such as a
brisk walk is more valuable than sporadic heavy workouts. It is
believed that the daily light routine helps the body maintain a healthy
body clock, and assists the body in maintaining higher levels of
serotonin. Experts caution against exercising in the late evening
hours, as this may adversely affect the body's natural winding down
mechanism before bed and can cause fragmented sleep.
New studies are indicating that SAD patients can benefit from increasing
their intake of foods high in carbohydrates and proteins. Carbohydrates
increase serotonin levels in the brain, as well as give added energy.
The important thing about diet is to keep it balanced.
Several medications have been found to be effective in battling SAD.
Most particularly medications in the SSRI family such as Prozac and
Most importantly, anyone experiencing significant symptoms of clinical
depression should be assessed by their family doctor. Some physical
problems can show up as depression. A family doctor can also make a
referral to a psychiatrist who is aware of SAD and other forms of
clinical depression. All forms of depression are treatable. If you
suspect you, or someone you love is suffering from SAD, or another form
of clinical depression, tell them there's help out there! It does get
Copyright by Terre Seuss
Reprinted with Permission
Dedicated to all those travelers
who share in the one journey
that can never be made alone
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