While everyone around you is humming Christmas songs, lighting their menorahs or making ski vacation plans , are you left feeling sad? Perhaps it's not the holiday blues, but SAD- Seasonal Affective Disorder. This depressive disorder was formally named only a few decades ago, in the 1980's. It affects over half a million people each winter, including some symptoms in up to a third of patients seeing their primary care physicians during this season.
Who gets seasonal affective disorder? It's most common in women (3:1 over males) and young adults 20-30 years old, but it is seen in across the board. January and February are the most common months that SAD is diagnosed.
What are the complaints? Often fatigue, weight gain and recurrent illness are the primary issues, rather than simply "sadness". The symptoms range from a mild case of "winter blues" to serious depression.
What is the cause? There are different theories, most of which are linked to hours of sunlight. There is disruption in our circadian rhythms as well as decreased seratonin secretion during winter months, and of course, less Sunshine vitamin (Vitamin D).
Prevention? Light therapy (using full spectrum light bulbs in your home and work) or consciously spending more time outside in the sunlight can help prevent S.A.D. Of course, moving to a more southern location can help, especially if you are far north, but that is not typically feasible for most people.
Treatment? Light therapy is the treatment of choice. Anti-depressant medications (Buproprion is the only one FDA indicated, but SSRI's such as prozac are also used), and Vitamin D replacement (if low) have also shown effectiveness in improving symptoms.
What is "light therapy"? Light therapy aims to artificially increase your exposure to light during the time of year when our natural daylight is limited. Typically light therapy is performed by sitting in front of a light therapy box, which simply gives off bright light that is similar to natural outdoor daylight (rather than standard light bulbs). During the session, the person may read, write or even eat- he or she does not need to focus on the light. Although most people with SAD will require the therapeutic intensity of a light therapy box, many people with mild symptoms will respond to simple full spectrum light bulbs replacing their normal light sources at home.
Does light therapy work for other depressive disorders? Maybe. More studies are needed as we try to find depression treatments that do not carry large side effect profiles, and light therapy is a perfect example. One such study (Controlled trial of safety and efficacy of bright light therapy vs. negative air ions in patients with bipolar depression) published this year started looking at the effects of light therapy in bipolar disorder, but this small study (44 patients) did not yield statistically significant differences. However, bright light therapy has been effectively used to improve symptoms in chronic depression, post-partum depression (baby blues), premenstrual depression (PMS) and in disorders in the sleep cycle.
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