Winter in Vermont.
For many it conjures up pleasant thoughts of a winter wonderland with opportunities for winter sports, cozy fires and holiday celebrations. But for many who live here, winter is another story. Seasonal Affective Disorder (SAD) is a form of major depression that usually develops in the fall and winter months for up to 9–10 percent of the population.
You might think it’s normal to feel reduced vigor in winter. Many of us who live in cold climates are familiar with some degree of reduced energy in this season. But SAD is not just a case of the winter doldrums. It’s an actual mental health diagnosis. One of the reasons we may minimize the significance of this disorder identified in 1984 by the National Institute of Mental Health, is that an estimated 24.9 percent of the population experience subclinical levels of these symptoms, making some of the features of the illness fairly common.
To be diagnosed with SAD one must experience five or more of the following symptoms for at least a two week period:
- Depressed and/or irritable mood
- Diminished interest in activities
- Weight loss or weight gain
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue/decreased energy
- Feeling worthless or guilty
- Indecisiveness, trouble thinking/concentrating
- Recurrent thoughts of death or suicide
So how is a Seasonal Affective Disorder different from a more common Major Depressive Disorder? These depressive symptoms must appear at least two years in a row at the same seasonal time to signal a Seasonal Affective Disorder in someone — and the symptoms don’t come at other times of year. SAD typically occurs in fall or winter but some people can experience it in the spring or summer months.
People who are depressed can experience difficulty sleeping and a loss of appetite; with SAD people tend to eat and sleep too much. People often have trouble waking up in the morning and crave carbohydrates. In addition, people with SAD experience feelings of pessimism or hopelessness, a lack of energy, trouble completing tasks, and social withdrawal.
So who is at risk for SAD? Factors that put people most at risk for SAD are being female, living far from the equator (rates of SAD in Florida are around 1.4% versus 9.7% in New Hampshire) and having a family history of depression or SAD.
Anyone who thinks they may be experiencing a depression should get a diagnosis by a qualified health professional, a psychologist, social worker, licensed clinical mental health counselor, psychiatrist or primary care physician.
So what can be done to treat SAD? A variety of effective treatment options include:
- Psychotherapy to help people learn to manage stressors and to cope with symptoms of depression
- Medication to address the changes in neurochemistry that occur in depression
- Full spectrum light therapy. Caution: Light boxes should always be used under the direction of a health care professional since the use of a light box could trigger a manic reaction in those with a bi-polar disorder. Light boxes should be 10,000 Lux of light. Lux is a unit used to measure light intensity.
People can also help manage their symptoms of SAD without clinical intervention by increasing exposure to natural light: opening blinds and curtains, sitting by the window, trimming tree branches near windows; and by getting outside when possible, keeping up a regular exercise routine and getting together with friends.
People with Seasonal Affective Disorder do not have to simply wait out the season. With proper diagnosis and treatment they too can learn to enjoy the pleasures a Vermont winter can offer.
More information about SAD can be found at the Mayo Clinic Website.