Seasonal Affective Disorder

With the hours of daylight shortening and the weather cooling, many of us are already starting to feel anxious about winter settling in. For those who already suffer from Seasonal Affective Disorder (SAD), or for those who may experience SAD symptoms for the first time, it is important to know the signs of seasonal depression and make a plan to overcome the “winter blues.” “If you get the sensation that you feel different in the winter, it’s not your imagination,” says Paul Desan, M.D., Ph.D., and Director of the Psychiatric Consultation Service at Yale New Haven Hospital. Seasonal Affective Disorder symptoms are similar to depression, but occur with a direct correlation to daylight, often presenting during the fall and winter seasons when there are fewer hours of sunlight. Symptoms include poor or depressed mood most of the day, low energy, excessive sleepiness during the day, social withdrawal, loss of interest or pleasure, craving carbohydrates and over-eating and gaining weight.

SAD is more common in women and in people who live far from the equator. For example, it affects an estimated 1% of people in Florida and 9% of those in Alaska. In the Northeast, most studies suggest that SAD affects 3-5% of the population, Dr. Desan says, adding that roughly 15% of people are believed to experience a milder form of seasonal changes in mood, energy, sleep, or appetite. Dealing with SAD symptoms in conjunction with the increased anxiety and social changes due to the pandemic is a concern for experts in the field. Leela R. Magavi, M.D., a child and adolescent psychiatrist with Mindful Health, says with so much going on, many clinicians do not ask about SAD and individuals will minimize their symptoms as they may feel weak conveying that the weather affects their mood. “This year, individuals may experience SAD symptoms for the first time, or they may experience severe SAD symptoms,” says Dr. Magavi. Many of us are already experiencing depressive and anxiety symptoms due to limited social interaction, lack of routine, job loss, the political climate, and various other psychosocial stressors. Dr. Magavi says the seasonal changes can exacerbate symptoms of demotivation, apathy, fatigue and irritability. People of all ages can experience similar symptoms and be diagnosed with SAD; however, Dr. Magavi notes that in children and teens SAD may manifest as irritability and/or they may have low or limited responses to exciting news. Some kids will struggle with attention and retaining information, which can lead to them repeating themselves or asking the same question repeatedly. Children may also express disinterest in playing with their favorite toys or with their closest friends. For all ages, experts recommend preparing a treatment plan that includes a variety of approaches. It is important to plan activities that the individual found enjoyable before seasonal depressive symptoms started. Treatment should include a combination of: Exercise; Continuous contact by phone or video with friends and family; Maintaining a daily routine; Maximizing the amount of light in your home; Eating healthy foods; Social interaction; Therapy (in-person or via telehealth); Medication; and/or Lightbox therapy.

Because SAD is linked to winter’s shorter days and decreased sunlight, daily light therapy (phototherapy) can be used to help replace the lack of sunshine during these months. Diminished exposure to sunlight may disrupt melatonin and serotonin levels. Fluctuations in these levels can adversely affect your sleep, mood and overall functionality. “Phototherapy may normalize your circadian rhythms by stimulating retinal cells, which connect to the hypothalamus,” says Dr. Magavi. She recommends sitting by a light box for 30 minutes or as long as possible in the morning. Therapeutic light boxes usually provide 10,000 lux (lux is a light intensity measurement).

Source: https://www.yalemedicine.org/news/seasonal-affective-disorder-how-to-cope#page-container

https://www.verywellmind.com/what-is-seasonal-affective- disorder-1065408#sad-in-children

https://giving.massgeneral.org/stories/seasonal-affective- disorder/#content

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