Seasonal Affective Disorder
Seasonal Affective Disorder (SAD), is characterized by recurrent major depression episodes during the fall-winter months, with remissions during the spring-summer months.
A milder form, called Subsyndromal-SAD (S-SAD), also known as the “Winter Blues,” is a sub-clinical level of SAD that produces similar, but less acute, symptoms.
Onset for SAD typically occurs in your late teens or twenties, and younger adults and women are at higher risk for developing symptoms. Among college students in the northeast, seasonal patterns of depression are especially common: SAD affects about 5-13% of the population while the prevalence rate for S-SAD is approximately 16-20%. Studies at Bates and at other New England institutions confirm that women are more likely than men to suffer from both forms of SAD, as are students who have moved from more southern latitudes.
How Does SAD Develop?
SAD has been linked to a biochemical imbalance in the brain resulting from shorter daylight hours and an overall lack of sunlight. Darkness triggers the production of melatonin, a sleep hormone that is linked to depression. As sunlight decreases during the winter, increased levels of melatonin may cause the changes in mood, energy level, and concentration, observed in SAD. Serotonin, a neurotransmitter responsible for mood, hunger, and sleep, is also implicated in SAD, although experts are unclear as to what role it plays.
What Are the Symptoms of SAD?
Symptoms appear during the fall and winter months when there is less exposure to sunlight. Depression symptoms may be moderate but they can also become severe. In fact, in the college environment, researchers found that SAD is more prevalent and more clinically severe than non-seasonal major depressive episodes.
In young adults, symptoms can include, but are not limited to:
Get Out and About
Aerobic exercise is proven to help alleviate SAD symptoms because it raises serotonin levels and reduces stress. Exercising outside can yield even greater benefits due to the natural light exposure. A study found that one hour of outdoor aerobic activity (even with a cloudy skies overhead) had the same benefits as 2.5 hours of light treatment indoors. Incorporating more outdoor exercise, or even taking a longer route on your walk to class can make a positive difference in your mood.
Skip Seconds at the Sundae Bar
Many people who suffer from the winter blues crave high-sugar foods and soda because carbohydrates increase serotonin levels, which can boost your mood and make you feel better in the short term. Instead, try eating larger portions of complex carbohydrates, like pasta and rice, and healthy simple carbohydrates like fruits and fruit juices. These foods will provide more sustaining energy than the quick, momentary fix of sugary options.
Rise and Shine
Because exposure to light helps lessen SAD symptoms, it is important for students to take advantage of winter’s short daylight hours. This often means modifying the classic college sleep schedule (keeping late nights and sleeping through the mornings) by making an effort to get up with the sun. Try to limit sleep to 8-hour periods on a regular schedule and avoid napping during the day. Oversleeping and inconsistent wake-up times causes increases in levels of melatonin during sleep, which can contribute to feelings of depression.
How is SAD Treated?
If depressive symptoms are significantly affecting your daily life, there are a number of treatment solutions available through the Health Center. Light therapy has been proven to be a helpful treatment option. This form of therapy involves exposure to very bright light for 20-30 minutes a day during the winter months. Vitamin D supplements have also been shown to have a positive effect. Additional treatment includes psychotherapy sessions with a Health Center counselor. Anti-depressants can be prescribed for SAD, although it is important to note that there is a 2-3 week delay in response and also certain side effects. Those interested in anti-depressants should first speak with a counselor. Students who suffer from more severe cases can pursue anti-depressant options in conjunction with other forms of therapy. Finally, a proactive approach is always best- if you are aware of seasonal patterns in your mood, you can start certain treatments in the fall.
Substantial evidence suggests that bright light can alleviate SAD symptoms. Light boxes emit high intensities of light similar in effect to natural sunlight, which improves mood by limiting the secretion of melatonin in the brain. Studies indicate that 4 out of 5 people with seasonal difficulties can expect to feel better with light therapy, and it has also been shown to reduce depressive symptoms within a week of starting treatment. To benefit from light therapy, health professionals recommend daily morning exposure for at least 20 minutes. Treatment requires students to sit within 18 inches of the light box. Students should not stare directly into the light but should be facing towards the light (while reading, for instance), and it is also important that students remain awake. Light therapy has a low side effect profile; headaches, jitteriness, and difficulty falling asleep are the most commonly reported complaints. You can purchase light on-line: “The Sunbox Company” http://www.sunbox.com/
November through March, students can also utilize a light at the Health Center on a first come first serve basis for 30 minutes daily, from 7 am to 5 pm, Monday, Tuesday and Thursday.
For more information:
National Institute of Mental Health http://www.nimh.nih.gov/index.shtmlAmerican Psychiatric Association http://ww.healthyminds.orgSociety for Light Treatment Biological Rhythm http://www.websciences.org/sltbrCenter for environmental therapeutics http://www.cet.org/eng/Tools_ENG.html#Winter Blues: Seasonal Affective Disorder, What it is and how to cure it. (1993). Norman Rosenthal. New York: Guilford Press.
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