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Page 1 of 3 Throughout the centuries, poets have described a sense of sadness, loss and lethargy which can accompany the shortening days of fall and winter. Many cultures and religions have winter festivals associated with candles or fire. Many of us notice tiredness, a bit of weight gain, difficulty getting out of bed and bouts of "the blues" as fall turns to winter.
However some people experience an exaggerated form of these symptoms. Their depression and lack of energy become debilitating. Work and relationships suffer. This condition, known as Seasonal Affective Disorder (SAD) may affect over 10 million Americans while the milder, "Winter Blues" may affect a larger number of individuals.
Symptoms of Seasonal Affective Disorder
The typical symptoms of SAD include depression, lack of energy, increased need for sleep, a craving for sweets and weight gain. Symptoms begin in the fall, peak in the winter and usually resolve in the spring. Some individuals experience great bursts of energy and creativity in the spring or early summer. Susceptible individuals who work in buildings without windows may experience SAD-type symptoms at any time of year. Some people with SAD have mild or occasionally severe periods of mania during the spring or summer. If the symptoms are mild, no treatment may be necessary. If they are problematic, then a mood stabilizer such as Lithium might be considered. There is a smaller group of individuals who suffer from summer depression.
SAD is recognized in the DSM-IV (The American Psychiatric Association's diagnostic manual) as a subtype of major depressive episode. The classic major depression involves decreased appetite, decreased sleep, and often, poor appetite and weight loss. It has long been recognized that some depressed individuals had a "atypical depression" with increased sleep and appetite along with decreased energy. Some, but not all of these atypical individuals also had a seasonal pattern. Some people with winter depression also have mild or occasionally severe manic mood swings in the spring and summer. If these episodes are severe, the individual might be diagnosed with Bipolar Disorder. (formerly called manic depressive illness).
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What Seasonal Affective Disorder Is Like
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Angela, mother-of-two spent years down in the dumps until her depressive winter illness was diagnosed as Seasonal Affective Disorder (SAD). Backed by the experts, she bought a high powered light producing device and its twice-daily use helped her beat the blues. The 51 year old office worker, who has a young granddaughter, said "The box is my ray of sunshine". I could not live without it. I would probably be suicidal by now".
Angela, who first became ill in 1989 explained "I was so down. I could not understand what was happening to my body and my mind. The tiredness was unexplainable". "I was admitted to the City Hospital in Birmingham, treated for clinical depression and put on anti-depressants. In 1994, my community psychiatric nurse realized I had a pattern of feeling better in the summer and ill in the winter. I went to a psychiatrist who diagnosed SAD".
Angela, who today uses a box which emits a light intensity of 10,000 lux, said "It was the best investment I have ever made. From October to April, I sit in front of it for half an hour every morning and again in the afternoon and take a portable box with me if I am ever away from home. I am a SAD case, but thanks to light therapy and a positive attitude I hold down a job, look after the family and live an active and enjoyable life."
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Women Comprise Majority of SAD Sufferers
About 70-80% of those with SAD are women. The most common age of onset is in one's thirties, but cases of childhood SAD have been reported and successfully treated. For every individual with full blown SAD, there are many more with milder "Winter Blues." The incidence of SAD increases with increasing latitude up to a point, but does not continue increasing all the way to the poles. There seems to be interplay between an individual's innate vulnerability and her degree of light exposure. For instance, one person might feel fine all year in Texas but develop SAD when she moves to Toronto. Another individual may be symptomatic in New York City, but have few symptoms in Miami. Some individuals who work long hours inside office buildings with few windows may experience symptoms all year round. Some very sensitive individuals may note changes in mood during long stretches of cloudy weather.
continue: Using A Light Box for Treatment of Seasonal Affective Disorder
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