Seasonal Depression

Virtual Psychiatrist
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- Dr. Gundu Reddy
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    Seasonal Affective Disorder (SAD) or seasonal depression is a form of depression that typically occurs during the fall and winter months when there is less natural sunlight.

    It can significantly impact a person’s mood, energy levels, and daily functioning. Seasonal affective disorder (SAD) is characterized by annual major depressive episodes.

    Studies show that it generally occurs in young women during autumn and winter with full remission the following spring.

    What is Seasonal Depression?

    Seasonal depression, also known as SAD, was first reported and named in the early 1980s, by Norman E. Rosenthal, M.D., and his associates at the National Institute of Mental Health (NIMH).

    SAD is a type of depression that occurs at a specific time of year, usually in the winter when daylight hours are shorter. It can significantly impact the mood, energy levels, and daily functioning of an affected person.

    The symptoms of seasonal depression that occur during the fall or winter, often resolve during the spring and summer months.

    Some people, however, may get a rare form of SAD called ‘summer depression’. It starts in the late spring or early summer and ends in the fall. However, it is less common than the seasonal affective disorder that tends to come during winter.

    Causes of Seasonal Depression

    SAD has many causes, but the root cause is not yet solidified.

    Reduced Sunlight Exposure

    It has been found that people who have less exposure to sunlight are more prone to develop depression than those who have more exposure.

    During the fall and winter months, the amount of sunlight can be meager, which results in less exposure which leads to seasonal depression.

    The reduced exposure results in an imbalance in the body clock of the affected person. That is, the sleep cycle, eating time, etc. gets disrupted.

    Biological Clock

    As discussed earlier, the biological clock or body clock, scientifically known as the Circadian Rhythm gets disrupted due to lower levels of sunlight. This leads to unnatural habits in a person which further causes tiredness, bad health, etc.

    Geographical Location

    Certain locations that are situated further away from the Equator have lower exposure to the Sun as compared to others, especially in winter, such as – northern regions of North America, Europe, etc.

    People residing in these locations are more prone to develop seasonal depression.

    Vitamin D Deficiency

    Sunlight exposure helps produce vitamin D, which is important for serotonin production. Reduced sunlight in the winter can lead to vitamin D deficiency, potentially contributing to SAD.

    Psychological Factors

    A person prone to experiencing negative thoughts, or suffering from MDD (Major Depressive Disorder) can be easily affected by SAD during the winter or fall.

    Genetic Factors

    A family history of depression or SAD can be a risk factor. People belonging to such families are likely to develop depression due to the sharing of genes.

    Existing Mental Disorders

    Having a history of other mental disorders such as – major depression or bipolar disorder, can increase the risk of developing SAD.

    When does Seasonal Depression occur?

    Fall and Winter SAD

    The most prevalent form of Seasonal Affective Disorder occurs in the months of fall and winter. The symptoms typically begin showing during the late fall, around October or November, and persist through the winter months, peaking in January and February.

    The disorder usually starts to improve as the days get longer in spring, with most individuals feeling noticeable relief by April or May.

    Spring and Summer SAD

    Some individuals experience SAD during the spring and summer months. This form of SAD typically begins in late spring or early summer and subsides in the fall. It is usually an uncommon occurrence.

    Seasonal allergies that peak in the spring and summer are believed to cause summer depression.

    Symptoms of Seasonal Depression

    • Bad mood: Individuals with SAD often experience persistent feelings of sadness, hopelessness, and worthlessness. These feelings can be intense and may last for several weeks or months.
    • Fatigue: Overwhelming fatigue and a general lack of energy is a major symptom of Seasonal Affective Disorder. An affected individual will feel tired constantly and find it difficult to carry out daily tasks.
    • Sleep problem: Individuals suffering from seasonal depression can experience changes in sleep patterns, such as oversleeping (hypersomnia) or difficulty waking up in the morning. Some patients may, on the other hand, experience insomnia (sleeplessness) which further deteriorates their overall health.
    • Appetite change:
      People with SAD often experience an increase in appetite, particularly craving carbohydrates and sugary foods. This can lead to weight gain during the winter months. Conversely, some individuals may lose their appetite and lose weight.
    • Loss of interest: Also known as anhedonia, loss of interest in doing activities that earlier used to provide joy to a person, is a common symptom of SAD. This can include hobbies, social interactions, and even relationships.
    • Anxiety: Small frustrations can seem overwhelming, and stress levels can be higher during the winter months. People suffering from SAD tend to be more irritable and anxious than others. This often leads to social withdrawal.
    • Low concentration: Seasonal depression often leads to the impairment of cognitive abilities, making it hard to concentrate, make decisions, or complete tasks. This can affect work performance and overall productivity.
    • Suicidal thoughts: In severe cases, an individual’s mental health can be degraded to such a point that they might start thinking about self-harm or suicide.

    It is advisable to get in touch with a psychiatrist if one is experiencing such symptoms. SAD, if left untreated, can keep deteriorating and may become severe.

    Treatment for Seasonal Depression

    There are a few methods for treating and managing the symptoms of SAD. Individuals suffering from seasonal depression can opt for one or more methods to get relief from the disorder.

    Light therapy for Seasonal Depression

    Light therapy, also known as Phototherapy, is one of the most common treatment methods for seasonal depression or Seasonal Affective Disorder.

    This method involves the use of a machine called the ‘Lightbox’ which mimics natural sunlight. Since less exposure to sunlight is one of the major causes of SAD, patients are prescribed to use the lightbox to get more exposure to sunlight, albeit non-naturally.

    The lightbox emits bright light, typically at a level of 10,000 lux, which is much more colorful and brighter than ordinary indoor lighting. However, it is a safe option.

    One should start light therapy after being prescribed by a psychiatrist and not on their own, as there might be complications that a psychiatrist evaluates, before prescribing the treatment.

    Once light therapy starts, the individual must maintain consistency in the timings of using the lightbox – that is – stick to the same time every day, preferably in the morning. This ensures the correct working of the biological clock.

    Daily use is crucial for effectiveness, especially during the darker months, which are the high time for SAD to strike.

    Light therapy helps to reduce the symptoms of SAD by triggering chemical changes in the brain that lift mood and alleviate other symptoms of depression.

    Psychotherapy for Seasonal Depression

    CBT or Cognitive Behavioral Therapy is a quite effective treatment method for managing seasonal depression symptoms.

    CBT focuses on identifying and changing negative thought patterns and behaviors that contribute to depression.

    The process involves recognizing and challenging pessimistic thoughts related to winter and shorter days and encouraging activities that bring enjoyment and structure to the day, even when it’s cold and dark outside.

    A skilled psychiatrist will help develop strategies to cope with specific issues related to SAD, such as social withdrawal and reduced motivation.

    Medication for Seasonal Depression

    In severe cases of SAD, a psychiatrist might prescribe antidepressants to help with the symptoms. It’s important to consult with a healthcare provider to determine if medication is appropriate and to discuss potential side effects.

    The most commonly used antidepressants include – Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs).

    SSRIs increase serotonin levels by preventing its reabsorption into neurons. This can improve mood and reduce depression symptoms. Some examples are – Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Citalopram (Celexa), and Escitalopram (Lexapro).

    SNRIs, such as Venlafaxine (Effexor) and Duloxetine (Cymbalta), increase levels of both serotonin and norepinephrine, which helps with energy and alertness. They can be effective for patients who do not respond to SSRIs.

    However, there can be mild side effects such as – nausea, dry mouth, and sexual dysfunction – in some patients.

    Lifestyle Changes for Seasonal Depression

    Changing certain lifestyle habits can help in alleviating the symptoms of seasonal depression. Some examples are:

    • Regular Exercise: Ensuring a daily dose of physical activity can boost mood and energy levels. Individuals suffering from SAD are advised to aim for at least 30 minutes of moderate exercise most days of the week.
    • Healthy Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health and well-being.
    • Sleep Hygiene: Maintaining a regular sleep schedule by going to bed and waking up at the same time each day helps keep the biological clock in check. Caffeine and electronics before bedtime should be avoided.
    • Outdoor Time: People suffering from SAD are advised to spend time outdoors during daylight hours, even on cloudy days. Natural light exposure can help regulate the mood.

    Supplements for Seasonal Depression

    The following supplements, often used alongside other treatments like light therapy and medication, can offer additional support for individuals experiencing SAD.

    Vitamin D:

    Since one of the major risk factors of SAD is the deficiency of vitamin D, due to less sunlight exposure, individuals suffering from SAD are usually asked to consume vitamin D supplements to alleviate the symptoms.

    It’s important to consult a healthcare provider to determine the appropriate dosage, as too much Vitamin D can be harmful.

    Vitamin B:

    B6 (pyridoxine) and B12 (cobalamin), play a crucial role in brain health and energy production.

    St. John’s Wort:

    This herbal supplement has been used for centuries to treat mild to moderate depression. It has been found to also help with SAD. However, St. John’s Wort can interact with many medications, hence, one should check with a psychiatrist first.

    Magnesium:

    This mineral is important for many bodily functions. Low magnesium levels are associated with an increased risk of depression. It can help improve mood and reduce symptoms of anxiety and depression.

    Melatonin:

    It regulates the sleep-wake cycle and can be helpful for individuals with SAD who experience disrupted sleep patterns. Taking melatonin supplements in the evening can help improve sleep quality and adjust the body’s internal clock.

    Alternative Treatment for Seasonal Depression

    While conventional treatments like light therapy and medication, as discussed above, are commonly used, several alternative treatments can also help manage SAD symptoms effectively.

    Mindfulness:

    Mindfulness practices such as mindfulness meditation can help individuals manage depression and maintain a positive outlook. These techniques encourage present-moment awareness and reduce the impact of negative thoughts.

    Aromatherapy:

    This alternative method involves using essential oils to promote mental and physical well-being. Certain scents, such as lavender, bergamot, and citrus, have been found to have mood-lifting properties.

    These essential oils can be diffused in the air, added to bath water, or used in massage oils. Aromatherapy can create a calming and uplifting environment, which can be particularly helpful for people suffering from SAD.

    Acupuncture:

    It is a traditional medical method that originated in Ancient China. It involves inserting thin needles into specific points on the body. Advocates claim it helps to balance the body’s energy flow and improve overall health.

    One should make sure to visit a licensed acupuncturist for treatment, as they will consider all the factors before starting the session, which is extremely important to avoid complications.

    Yoga:

    Yoga combines physical postures, breathing exercises, and meditation to promote physical and mental well-being. Practicing yoga regularly can help reduce stress, improve mood, and enhance overall mental health.

    It is advisable to practice yoga under the supervision of an instructor, to ensure an effective session.

    Tips to prevent Seasonal Depression

    Prioritize Exposure to Natural Light

    Sunlight exposure plays a crucial role in regulating mood and sleep patterns. Try to spend time outdoors during daylight hours, even during the winter. Avoid dark settings and make sure to allow ample sunlight to enter the rooms.

    Maintain a Healthy Sleep Routine

    Consistent sleep patterns are essential for mental health. Aim for 7-9 hours of quality sleep each night. Limit screen time before sleep to ensure peaceful and uninterrupted sleep. Avoid sleeping at late hours.

    Stay Active

    Regular exercise has proven benefits for mental health by reducing stress, anxiety, and depression. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. Outdoor activities like walking, jogging, or hiking can provide additional exposure to natural light.

    Eat a Balanced Diet

    Nutrition plays a role in mental well-being. Maintain a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Omega-3 fatty acids, found in fish like salmon and flaxseeds, may help support mood regulation.

    Practice Stress Management Techniques

    Chronic stress can exacerbate symptoms of SAD. Practice relaxation techniques such as deep breathing, meditation, yoga, or tai chi. Engage in hobbies and activities that promote relaxation and enjoyment.

    Stay Connected

    Social support is vital for mental health. Maintain relationships with friends and family members. Join clubs, groups, or classes that align with your interests to foster new connections and combat feelings of isolation.

    Seek Professional Support

    If you experience symptoms of depression or SAD that persist beyond seasonal changes, seek help from a mental health professional. Therapy, such as cognitive-behavioral therapy (CBT), can provide tools to manage symptoms effectively.

    Monitor and Manage Stress

    Identify sources of stress in your life and develop strategies to manage them effectively. Delegate tasks, set realistic goals, and prioritize self-care. Learning to say no and setting boundaries can also help reduce stress levels.

    Practice Mindfulness and Relaxation

    Mindfulness practices, such as mindfulness meditation or progressive muscle relaxation, can help increase self-awareness and reduce stress. Incorporate these practices into your daily routine to promote emotional well-being.

    Plan Ahead for Seasonal Changes

    If you have a history of SAD, plan ahead for seasonal transitions. Begin light therapy or other preventive measures before symptoms typically begin. Adjust your schedule or activities to maximize exposure to natural light during darker months.

    To learn more about our services and seek help for depression, visit www.gabapsychiatrist.com.

    References

    Virtual Psychiatrist
    Fact Checked by
    - Dr. Gundu Reddy

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