So, as the clocks “spring” forward an hour, are you suddenly feeling energised, full of cheer and zing again after a winter of sluggishness, depression and sleepiness? If so, you may be amongst the three per cent of the population who are known to suffer from winter depression, also known as Seasonal Affective Disorder (SAD). Many of us feel more tired, sleep more and put on weight in the winter but SAD mimics symptoms of depression with low mood, lack of energy, lack of interest in things and irritability characteristic of the condition. In addition (and unlike typical symptoms of depression), those with SAD sleep and eat more not less. They crave chocolate and high carbohydrate foods and feel inordinately drowsy. The comparison with a state of hibernation is striking.
SAD is thought to be caused by a lack of daylight, particularly sunlight, affecting serotonin levels in the brain. It is three times as common in women as in men, and particularly affects women during childbearing years. It is recurrent and characteristically the symptoms return each autumn and winter with symptoms peaking in November and January.
SAD can be managed with self-help measures, light therapy (phototherapy), medication and psychological treatments. Self-help measures include staying outside as much as possible during the winter, continuing to exercise regularly and holidaying abroad for some winter sun. Light therapy involves using a light box delivering at least 10,000 lux (equivalent to the amount of sunlight from summer sun) absorbed through the retina for 30 minutes each day. Unlike sunlight, phototherapy does not include harmful ultraviolet rays. Medication in the form of SSRI antidepressants can be helpful and used in conjunction with phototherapy. There is some evidence that cognitive behavioural therapy can be helpful not only in treating an episode but in preventing future episodes.
It is important to receive an accurate diagnosis for SAD so that appropriate treatment can be recommended. LPP Consulting can provide specialist assessments and treatment so as to optimise mental health and performance for those suffering from this disabling and recurrent condition.
For severe symptoms, the first choice will usually be between a lightbox and antidepressants. The choice will depend on what is available, what is convenient and what each person prefers. Only a few studies have compared phototherapy and antidepressants, but it seems that both treatments work equally well. When one treatment is not enough, phototherapy and antidepressants can be used together.
Further reading and information:
Seasonal Affective Disorders Association (SADA) at PO Box 989, Steyning, BN44 3HG www.sada.org.uk
Royal College of Psychiatrists Public Education Leaflet – Seasonal Affective Disorder http://www.rcpsych.ac.uk/mentalhealthinfo
Winter Blues, Revised Edition: Everything you need to know to beat Seasonal Affective Disorder by Norman E. Rosenthal, Guilford Press, New York, 2006
Suppliers of lightboxes and related devices include:
Lumie, 3 The Links, Trafalgar Way, Bar Hill, Cambridge, CB23 8UD
Lightbox UK, 49 Dalsetter Avenue, Glasgow, G15 8TE