Seasonal Affective Disorder: Signs and Treatment Options
Seasonal Affective Disorder, or SAD, is a subtype of clinical depression. Depression is a common mental health condition, and one of the leading causes of disability worldwide. There are numerous different subtypes of depression, and each one will manifest different symptoms, and various stresses and circumstances can trigger them. In patients with SAD, changes in weather and sunlight trigger depressive symptoms. As many as 6 percent of all people in the U.S. have what’s called winter depression, or SAD, and most people develop the disorder after age twenty. The disease is rarely seen in children and teens. Up to 20% of people are estimated to exhibit mild symptoms of SAD, and the disorder is more common in women than men.
Why do people get SAD?
Seasonal affective disorder is not considered a separate disorder from major clinical depression. However, what differentiates SAD is that symptoms are cyclical and predictable. The majority of SAD patients display signs in the late fall or early winter. A minority of patients will experience symptoms in spring and summer, but it is rare. For doctors to diagnose a patient with SAD, the patient must meet the criteria for major clinical depression, and symptoms must happen in either the winter or summer months for a period of at least two years. If a person ever experiences a non-seasonal depressive episode, they can still be diagnosed with SAD if the majority of their incidents occur in either winter or summer months.
What are the symptoms of SAD?
For a diagnosis of SAD, patients must manifest the symptoms of clinical depression in predominantly winter or summer months:
- Relentless feelings of guilt, hopelessness, or sadness
- Increased irritability
- Sleep disturbances
- Fatigue
- Unexplained aches and pains
- Trouble eating or eating too much
- Changes in weight
- Trouble concentrating
- Lack of enjoyment
- Thoughts of death or suicide
The symptoms of SAD for the winter months are:
- Extremely low energy
- Sleeping for more than normal
- Wanting to “hibernate” and withdrawal from society
- Increased appetite and cravings for carbs
- Weight gain
Symptoms of SAD in the summertime:
- Poor appetite and weight loss
- Insomnia
- Irritability
- Restlessness and anxiety
- Violent behavior
What causes SAD?
There is no known cause of depression, including SAD. But research suggests that disruptions to the body’s natural circadian rhythms in the summer and the winter can contribute to the onset of SAD. It is believed that natural light from the sun can influence brain chemistry and the levels of neurotransmitters like serotonin in the body. Cloudy weather, changes in temperature, and high levels of melatonin are thought to affect the manifestation of SAD symptoms.
SAD is more common in certain places of the world, especially in areas where the seasons significantly change throughout the year. For people who live near the equator, they can increase their chances of developing SAD symptoms if they move to a place that experiences markedly different and shifting seasonal patterns.
At night when it is dark, the brain produces the hormone melatonin. Melatonin helps trigger the feeling of sleepiness and prepares the body for sleep. People with SAD seem to produce higher levels of melatonin during the winter months. What research has found is that a person with high levels of melatonin can decrease their levels if they are exposed to bright light. However, the bright light does not affect the symptoms of depression.
What are the risk factors of SAD?
- Being a woman
- Living far north or far south of the equator
- Having a close family member with any type of depression
- Already having a diagnosis of depression or bipolar can increase the chances of SAD
- Being a young adult
Researchers have also found that people with SAD have problems maintaining and regulating essential neurotransmitters in the brain. For example, people with SAD have higher levels of serotonin transporter protein in the brain during the winter months than people without SAD. Having high levels of serotonin transporter protein means there is less serotonin left within the brain’s synapses, which can manifest as depressive symptoms.
People with SAD also overproduce the hormone melatonin. The lack of light during the winter months naturally increases melatonin production, but this is increased in people with SAD, leaving them with feelings of increased fatigue and a desire to withdraw. Patients with SAD are also found deficient in vitamin D than the general population. Research has found that vitamin D plays a crucial role in preventing depression symptoms from manifesting.
How is SAD treated?
SAD patients can find relief with medication, talk therapy, light therapy, and vitamin D supplementation. However, it’s crucial to understand that SAD is a type of clinical depression, and as such, it is a chronic illness. Chronic mental health conditions like SAD require patients to participate in ongoing maintenance treatment to prevent a recurrence of symptoms, Talk therapy is usually the most beneficial aspect of continuing treatment, in that patients can learn their triggers and develop skills and tools to prevent a recurrence of symptoms, or learn how to adequately cope with symptoms should they recur. Transcranial magnetic stimulation techniques are also highly useful in preventing recurrence.
In studies on TMS patients and depression, TMS patients were able to experience fast relief from acute depression symptoms. Patients were also able to use intermittent TMS treatment to prevent the recurrence of symptoms. TMS is non-invasive and is showing great promise in the science of depression treatment and maintenance of other mental health disorders. For patients with SAD and other forms of clinical depression, it is critical that they find an ongoing treatment regimen that works for them.
Are you or a loved one suffering from SAD? There is help available. The experienced mental health professionals at Pulse TMS have helped hundreds of patients find relief from SAD and clinical depression symptoms with TMS. Technicians are standing by to answer any questions you may have about this non-invasive and highly effective treatment for depression. Please contact Pulse TMS today to learn more about TMS treatment for SAD.