Welcoming Winter 101: Causes and Treatment of Seasonal Affective Disorder
Winter depression is also known by the names of seasonal affective disorder, winter blues, summer depression, summer blues and seasonal depression. It is a recurrent depression disorder in which a person feels low or depressive at some specific time of the year. It may occur in summer also but noticed more in winter season. I myself have experienced episodes of winter depression and that is why, I thought to write about it.
CAUSES OF SEASONAL AFFECTIVE DISORDER
The exact cause of seasonal affective disorder is still not known. However, less availability of sunlight is thought to play an important role in it. Following are the factors that may play a role:
1- Melatonin Levels:
Om Wehr, a researcher at the National Institute of Mental Health, proposed the role of melatonin in the seasonal affective disorder. Melatonin is released by the pineal gland. It is responsible for regulating the Circadian cycle or sleep-wake cycle in humans. Its like our biological clock. Melatonin secretion is stimulated by darkness and inhibited by light. Its high levels are responsible for causing drowsiness and sleep. He said that it’s high levels are responsible for causing depression during winter .
2- Serotonin Levels:
Serotonin is a neurotransmitter that is released by the brain. It is responsible for the mood elevation. Less sunlight reduces the level of serotonin and plays an important role in causing depression.
RISK FACTORS FOR DEVELOPING SEASONAL AFFECTIVE DISORDER
If you have one of the following risk factors, you are at greater risk of developing seasonal affective disorder:
1- Women > Men:
Women are at higher risk of developing the seasonal affective disorder than male. But as for depression also, the symptoms of seasonal affective disorders are more severe in women than wmen.
2- Countries With Cold Climate:
Seasonal affective disorder is more common in the countries where the climate is mostly cold .e.g. Canada, Russia, USA, Greenland, due to the reduced sunlight.
3- Bipolar Disorders:
Patients with bipolar disorders can also develop seasonal affective disorder. It is important to discriminate between the seasonal affective disorder and bipolar disorder. The people with bipolar disorder will have a history of depression that becomes worse during winters whereas people with seasonal depressive disorder will experience depression only during winter and will have a depression-free interval otherwise.
4- Family History:
A person, with positive family history of the seasonal depressive disorder, is more likely to develop this disorder.
CLINICAL FEATURES OF SEASONAL AFFECTIVE DISORDER
The clinical features are different with summer and winter depression. A person with winter depression is more likely to present with the following clinical features:
– Low mood
– Lack of concentration
– Increased appetite
– Weight gain
– Withdrawal from society
– Loss of libido
The clinical features of summer depression are almost opposite to the clinical features of winter depression. They include:
– Increased libido
– Loss of appetite
– Weight loss
You must visit your doctor if you experience some or all of the clinical features that are mentioned above.
DIAGNOSIS OF SEASONAL AFECTIVE DISORDER
Diagnosis of seasonal affective disorder is mostly based on history of the patient. It is based on a questionnaire known as the Seasonal Pattern Assessment Questionnaire (SPAQ). This questionnaire asks about the bio data of the patient, degree of seasonal changes, month or months in which these changes are experienced, weight fluctuation, sleep pattern and change in food preference. The purpose of the Seasonal Pattern Assessment Questionnaire (SPAQ) is to determine how the mood and behavior of a person changes with season.
The other criteria for the diagnosis of seasonal affective disorder is established by the American Psychiatric Association’s and it is known as the Diagnostic and Statistical Manual of Mental Disorders (DSM). According to this, a person must be diagnosed with seasonal affective disorder if he or she shows:
– Clinical features of depression during the same season every year, for two consecutive years.
– These symptoms are followed by a depression free interval through out the year.
– There is no other reason for depression.
Other than this, a physical and medical test should be performed by the doctor to rule out other medical condition that may cause these clinical features.
TREATMENT OF SEASONAL AFFECTIVE DISORDER:
The treatment of seasonal affective disorder can be divided under four headings:
1- Light therapy
2- Medical therapy
4- Lifestyle changes
1- Light Therapy:
Light therapy is also known as phototherapy. It is considered as the first line treatment for seasonal affective disorder. In this therapy, a special light therapy lamp is placed in front of the patient, at a distance of 30-60 cms, for 30 minutes daily. Light therapy is highly effective and starts to work in 2-4 days.
2- Medical Therapy:
In some patients, light therapy is not effective and doctor may start anti-depressant agents. The most commonly prescribed anti-depressant agents for the treatment of seasonal affective disorder are paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor).
Psychotherapy is another option for treating the seasonal affective disorder. It does not exactly treat the disorder but enables the patient to deal with the symptoms. It helps in avoiding the complications of seasonal affective disorders (suicidal thoughts, substance abuse). It enables the patient to live a healthy social and mental life .
4- Lifestyle Changes:
Lifestyle changes play an important role in dealing with seasonal affective disorder. Following are the changes that may help:
– Make your surrounding brighter
– Do regular aerobic exercise
– Eat healthy food
– Offer prayers regularly
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