A B C D E F G H I J K L M N O P R S T U V W

SEASONAL AFFECTIVE DISORDER (SAD)

What is Seasonal Affective Disorder ?

It has been known for a long time that people's mood may change according to the season. Usually it is mild "winter blues" and does not cause too much suffering. There are others who can become quite disabled and depressed during the winter months. They often become better when spring arrives. This seems to follow a regular pattern every year. Seasonal affective disorder or SAD affects an estimated half a million people every winter, especially between December and February. It can appear at any age. The depression may start between September and November and continue until March or April. It will follow a pattern of occurring every winter. You may feel irritable and very tired. This will affect your sleep. Most people with SAD tend to sleep more and have difficulty staying awake. Some have disturbed sleep and may wake up early in the morning. In other depressions, appetite is decreased but in SAD it appears to be increased. There is a craving for carbohydrate food and you may put on weight. The depression will leave you feeling sad and withdrawn. Feelings of guilt and worthlessness together with extreme changes of mood may occur. You may lose your sexual desire. There can be episodes of increased activity, especially in the spring and autumn.

How does Seasonal Affective Disorder occur ?

The cause of SAD is not known. It is thought that there may be a biochemical imbalance or a lack of certain chemicals in a particular part of your brain called the hypothalamus. The shortening daylight hours and the lack of sunlight in winter seems to cause the problem.

Why does Seasonal Affective Disorder occur ?

The majority of sufferers often have at least one family member who has had a history of depression or mental problem. In some people SAD may be triggered by events such as depression after pregnancy, the menopause or hysterectomy. It may also be triggered by other life events such as retirement, loss of job or bereavement.

Treatment involved for Seasonal Affective Disorder

SAD may be diagnosed from your history, but sometimes, a questionnaire is given for you to complete. This helps confirm the diagnosis. PHOTOTHERAPY Treatment with light seems to work in over three-quarters of sufferers. A light box will need to be purchased (this is not available on the NHS), and treatment is carried out at home. The light box provides light at least ten times stronger than your lights at home. The intensity of light is usually set at 2500 lux. There are some even stronger light boxes. These would mean you would need to spend less time in front of the light. Treatment is usually started at the onset of the symptoms. It will need to be continued throughout the winter months. To begin with, two hours per day of light exposure is recommended. After 2 or 3 weeks, it is possible to adjust the treatment according to the response. Each individual will vary and some may be able to decrease the treatment, whilst others may need to maintain or even increase the treatment. There is no best time to have the light treatment, but it is usually recommended first thing in the morning. You will need to sit about two or three feet away from the light box. The light will need to shine into your eyes, although you need not look at the light. You should not wear sun glasses or block out the light with a visor. You can read, work or eat whilst in front of the box. Treatment usually works within a few days. ANTIDEPRESSANT DRUGS There are different types of antidepressant drugs. Tricyclic antidepressant drugs are not usually very effective for people with SAD. The newer drugs (5HT inhibitors or SSRI drugs) such as Prozac (fluoxetine) have fewer side-effects and can be effective. When first taken, they may cause headaches and feelings of anxiety. These side-effects usually improve. Other drugs have not been shown to be helpful. OTHER TREATMENTS Regular exposure to sunlight is important. So whenever it is sunny, try to get out. Psychotherapy ("talking treatment") or counselling may be helpful. It may help you cope with the day to day living and help you come to terms with your illness. Different complementary therapies such as massage and acupuncture may help you relax and cope better.

During Treatment

Light treatment is safe. The ultraviolet light is small and not harmful. However, some people do get headaches or sore eyes after light treatment. If you are sensitive to light in this way, this treatment may not suit you.

If Seasonal Affective Disorder is left untreated

Most people with depression do seek professional help. In some ways, this is the first and most important step towards recovery. Most people with SAD manage to cope quite well, although their quality of life may be lessened.

Effects on the family of Seasonal Affective Disorder

People with SAD can find it difficult to live a normal life. They will need constant support. Sometimes no great expertise is needed: a person who will listen, a shoulder to cry on and someone to be there may be all that is needed.