Treating Seasonal Affective Disorder

During this time of the year, sometimes people do get the winter blues. It gets a little gray, a little cold, and we start to feel the blues a little bit, but sometimes it's more than that for people. It could be seasonal affective disorder, known as SAD. If you have significant changes in your mood and behavior when the seasons change, know that treatment options exist.

What Is Seasonal Affective Disorder (SAD)?

The important characteristic to keep in mind is that SAD is a type of depression that generally "comes and goes."

"The season typically starts in late fall and early winter. Then, we see it go away in the spring and summer. It actually can occur in the summertime and go away in winter. However, that's not nearly as typical, especially here in Indiana," states Ashley Turner, board-certified psychiatric mental health nurse practitioner with Franciscan Physician Network Outpatient Behavioral Health Center in Lafayette.

The so-called winter blues are often linked to something specific, such as stressful holidays or reminders of absent loved ones.

What Are Symptoms Of Seasonal Affective Disorder?

Symptoms of SAD mimic those of traditional depression. For example, feeling sad or "down," lacking energy, and feeling constantly fatigued. Additional symptoms include weight gain, increased appetite and excessive sleep.

"Sometimes, people find themselves withdrawing from social situations; isolating themselves," notes Turner.

Who's At Risk For Seasonal Affective Disorder?

Women are four times more likely than males to develop SAD. And, the farther away one lives from the equator, the more likely they are to develop the condition.

"The statistics show around one percent of individuals in Florida have seasonal affective disorder, and about nine percent in the New England and Alaska areas," explains Turner. "Of course, we live in the Midwest where it's not sunny very much in the winter, so we see it a lot here."

How Can I Ease The Effects Of Seasonal Affective Disorder?

Turner suggests trying non-medication treatments to improve our health first.

"Try doing the exercise, getting the vitamin D checked, utilizing the light therapy. As long as someone is not to the point where they're feeling suicidal or they're not taking care of themselves, I think doing those natural things first, is a great way to start improving their mental health before relying on medications."

Turner shares a number of ways SAD can be addressed:

• Get outside whenever possible, even if it's for a short amount of time - and even if it's cold (just bundle up) or overcast. "You're still getting light, and that's really important," Turner said.
• Keep tabs on your vitamin D levels to ensure you're not deficient.
• If you have previously struggled with seasonal affective disorder, or any other mental health issue, do what you can to "stay ahead of the game" by being aware of symptoms that may be creeping up.
• Exercise regularly, aiming for three to five times a week, 20 minutes a day. Physical activity boosts all the "good" chemicals in the human brain. It also produces brain derived neurotrophic factor, or BDNF. "BDNF is essentially like Miracle Grow for your brain. It spurs on neurogenesis, which helps the brain heal and make smoother connections so it's not as static. It helps release natural endogenous endorphins that help with pain control, mood, and sense of safety and security. It can mitigate the symptoms of SAD and other mental health issues people are facing," assures Turner.

How Does Light Therapy Help SAD Symptoms?

"l'm a fan of light therapy, and light therapy has been shown to be very effective for individuals suffering from seasonal affective disorder," Turner said. "I typically tell my patients to get a light and that it doesn't matter what brand of light you get. It just has to be 10,000 LUX. That's the power of the light and using it in the morning for about 20 to 30 minutes."

Sit with the light two feet away from your face because of the brightness.

"What that light does is it helps shut down natural melatonin production to restore that circadian rhythm," Turner explained. "And when the circadian rhythm is restored, that kind of helps with sleep, helps you feel more energetic during the day and helps with those symptoms of the seasonal affective disorder, because they think one of the theories is that because it gets dark early, is that it creates a disruption in our circadian rhythm that kind of leads to these depressive symptoms. And that's kind of the theory behind light therapy. I use it a lot for my patients and a lot of them have found it pretty helpful."

Are Medications Needed For Seasonal Affective Disorder?

If non-medication treatments aren't easing symptoms of SAD, there are prescription medications available. See your physician.

"When it comes to medications, medications such as SSRIs and Wellbutrin are good options for treating seasonal affective disorder," Turner said.

Experiencing Seasonal Affective Disorder? Don't Hesitate To Seek Help

One of the biggest challenges Turner and her colleagues encounter is the stigma surrounding mental health concerns. While greater awareness has lessened the stigma slightly, it still exists.

"A lot of people think that because they're experiencing mental health symptoms they're 'weak' or there's something wrong with them," she says. "But, it's really no different than if they had diabetes or some other physical ailment. It's important for people to know that if they are feeling bad, they should absolutely reach out to their primary care provider who can help with a referral. Or, reach out to a close friend." Many employers have established employee assistance programs, which are confidential.

"Don't be afraid to ask for help or even just to be assessed. You don't necessarily need medication. We can offer other suggestions. We have therapy in our office. Maybe it's just that you need to talk to somebody. Really, don't wait before it gets too out of control. If you're feeling bad, seek help," urges Turner.