Seasonal Affective Disorder
Seasonal Affective Disorder
Light Therapy for the Winter Blues
A blue mood on a gray November day is normal. Four months of the winter doldrums, however, sounds suspiciously like an outright form of depression called seasonal affective disorder (SAD).
The depression associated with SAD can be oppressive--typically, all you want to do is eat, sleep and laze around. The problem does, in fact, arrive in winter, when daylight tapers off by late afternoon. It disappears in spring, when the light lingers longer. SAD is more common in northern, sun-spare places like Massachusetts than in sun-soaked southern locales like Florida. And it's considerably more common among women than men--three to four times as common.
Sleepiness and carbohydrate cravings are two additional markers of SAD. Symptoms of SAD (and their severity and duration) vary from person to person, says psychiatrist Ruth Ragucci, M.D., assistant clinical professor of psychiatry at Case Western Reserve University in Cleveland.
Summer Sadness: It Happens If you feel fine in winter but, come summer, lack energy and generally get irritable, you may have the summertime version of Seasonal Affective Disorder (SAD). Or you may switch from winter SAD-ness to the summer version with the change of seasons.
Scientists don't know what causes summer SAD, but they suspect that heat may play a role, says Ellen Leibenluft, M.D., a researcher in the clinical psychobiology branch of the National Institutes of Mental Health. In that case, low humidity, coolness and dark--say, staying indoors in an air-conditioned environment--may help.
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When To See A Doctor If you think you have Seasonal Affective Disorder (SAD), it's important to see your doctor to rule out other health problems--thyroid disorders, low blood sugar or viruses--that can mimic SAD's symptoms, says Ellen Leibenluft, M.D., a researcher in the clinical psychobiology branch of the National Institutes of Mental Health. Doctors advise seeing a doctor if: * You can't function at normal capacity--can't concentrate, finish things as quickly as usual or get to work on time. * You feel severely depressed. * You need several extra hours of sleep every night. * You have a hard time waking up in the morning. * You can't control your eating. * You have suicidal thoughts or thoughts of death.
If your doctor diagnoses SAD, she's likely to prescribe some kind of light therapy, says Dr. Leibenluft.
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While some people with SAD are affected in late October and drag themselves through May, others succumb only when the days are at their shortest, in December and January. Both the light-sensitive hormone melatonin, which regulates our sleep pattern, as well as the hormone seratonin, which affects our mood pattern, may play a role, says Dr. Ragucci.
"We really don't know exactly what causes SAD," says Ellen Leibenluft, M.D., a researcher in the clinical psychobiology branch of the National Institutes of Mental Health. Hormones and other biochemical factors seem to play a part, because they vary between men and women or from individual to individual.
SOLAR THERAPY
The good news is that SAD is successfully and simply treated--with light. If you feel less enthusiastic or less productive during winter months, you can help yourself with these strategies.
Go for a walk at lunch. The sun's rays are strongest at noon, which may make it the best time to soak up some therapeutic daylight. Walking while you soak doubles the benefit, since the exercise will help stave off weight gain and possibly depression.
Research suggests that light need only enter your eyes (not soak through your skin) to have a beneficial effect, so you can still wear sunscreen.
Light up your home and office. "Most people feel better in a well-lit environment," says Dr. Ragucci. For some people, increasing regular household or office lighting will do.
Spend your winter vacation down south. "This has only a temporary effect, but most of the people who try it say they feel fine during those weeks," says Dr. Ragucci.
Graduate to light-box therapy. If increased exposure to more light--outdoor or indoor--doesn't help and SAD is casting a shadow over your winters, ask your doctor about a light box, says Dr. Leibenluft. She may recommend a bright light burning at 10,000 lux for 30 minutes to two hours a day. Dr. Ragucci estimates that three out of four people she treats respond to light-box therapy.
Plug in a dawn simulator. Even more convenient than a light box, this device is like having the sun at your bedside: Every morning around 4:00 a.m., rain or shine, it clicks on and, over the next two hours, emits light that gradually grows brighter, simulating sunrise. Doctors say that early trials with dawn simulators have been encouraging. Light boxes and dawn simulators are available from SunBox Company, 19217 Orbit Drive, Gaithersburg, MD 20879.