Seasonal Depression: Signs, Treatment, and Prevention

 

Do you become tired, sad, depressed, or fed-up with life during a certain season? Does the beginning of fall or winter initiate a new chapter in your life full of depression?

Feeling less than enthused about the colder nights is common, but feeling overly bleak during Winter might be something more.

During the winter many people suffer more from depression and such period of season-specific depression is termed as Seasonal Depression or Seasonal Affective Depression (SAD).  In the Diagnostic Manual of Mental Disorders (DSM-5), this disorder is identified as a type of depression – Major Depressive Disorder with Seasonal Pattern.

Seasonal affective disorder (SAD) is a mood disorder found in which people who have normal mental health throughout most of the year but exhibit depressive symptoms at the same time each year, most commonly at the beginning of fall or winter. But some individuals can also show such symptoms in spring or summer too.

SAD is sometimes known as "winter depression" because the symptoms are usually more apparent and more severe during the winter. Sometimes people mix SAD with “winter blues” but they are not the same. Severe SAD can even lead to suicide or attempt to suicide.

People with SAD experience mood changes and symptoms similar to depression. The symptoms usually occur during the fall and winter months when there is less sunlight and usually improve with the arrival of spring. 

Almost half a million people in the USA suffer from SAD, while 10 to 20% may suffer from a milder form of winter blues. And the majority of the sufferers are women, and the symptoms usually start in early adulthood but also can occur in children and adolescents. Though research suggests that older people are less likely to experience SAD.

Cause of Seasonal Affective Depression –

 

The real mechanism behind Seasonal Depression is still not known. But scientists managed to comb some links to it. It is primarily thought that the period of depression is associated with the availability of light. It is believed that light helps our brain maintain our Biological Clock (Circadian Rhythm).

Our biological clock maintains are sleeping pattern, mood, hormones secretion. Lack of light disrupts this rhythm which in turn leads to mental imbalance and depressive symptoms exhibit.

Along with the biological clock (Circadian Rhythm), another two hormones are thought to play a role in this disorder. They are namely –

·         Serotonin –

With the lack of sunlight, our body reduces the secretion of Serotonin which is a major hormone that influences our mood. And lack of it leads to depression.

·         Melatonin –

Melatonin is produced by our body when exposure to light is reduced. It affects our sleep pattern and thought make one feel sluggish and sleepy. Reduced light exposure during winter increases melatonin production. And for that, we feel declined to do anything and which further exaggerates the effect of depression.

Symptoms of Seasonal Affective Depression –

 

Symptoms found in SDA are a mixture of normal depression and winter blues. But a few specific ones are seen depending on the season it is occurring on. The symptoms are –

·         Feeling Sad or depressed most of the day or all day long.

·         Heightened Anxiety.

·         Sleeping Problems.

·         Short Temper or Irritability.

·         Loss of interest to do anything even if it is something you enjoyed doing.

·         Social Withdrawal.

·         Lack of concentration.

·         Extreme Tiredness / Sluggishness. Feeling sleepy all day.

·         Feeling weak and body feels like it lacks energy

·         Change in Appetite.

·         Change in Weight.

·         Extreme symptoms lead to feeling worthless, a burden to others.

·         And finally, thoughts of death or attempting suicide.

Fall and Winter Specific SAD Symptoms –

Such symptoms are predominately seen in Winter or fall season –

·         Oversleeping

·         Appetite changes, especially a craving for foods high in carbohydrates

·         Weight gain

·         Tiredness or low energy

Spring and Summer Specific SAD Symptoms –

Such symptoms are predominately seen in the Spring or Summer season –

·         Trouble sleeping (insomnia)

·         Poor appetite

·         Weight loss

·         Agitation or anxiety

 

Risk and Complications –

 

You should keep an eye for some factors as they are found to have a connection with the development of SAD. This Risk factors are –

·         Family history - People with SAD maybe more likely to have blood relatives with SAD or another form of depression.

·         Having major depression or bipolar disorder - Symptoms of depression may worsen seasonally if you have one of these conditions.

·         Living far from the equator - SAD appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter and longer days during the summer months.

SAD if left untreated can cause some major issues. And these can include –

·         Diminished social standing due to avoiding social gathering and family activity.

·         Avoiding going to school or work.

·         Inclining towards drug and alcohol to fight off the depression.

·         Prolonged SDA can create permanent mental health disorder like anxiety, general depression, or an eating disorder.

·         Risky or Suicidal thoughts and behavior.

 

Diagnosis –

 

There are some steps available to diagnose SDA but often it can be difficult to identify. As the symptoms are Seasonal Depression overlaps with the symptoms of many other depressions and mental disorders. But still there are Four things that can be used to diagnose it. These are –

·         Physical Examination – This is mainly a question and answer session. Done to identify any changes in behavior, regular activity, and diet.

·         Lab Tests – Blood test may be recommended along with a thyroid test to detect hormone concentration and such.

·         Psychological Evaluation – This is also a question and answer session but this time it deals with more mental changes to identify any depression in general.

·         DSM-5 – Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is a list of criteria for Seasonal Depression. Your physician can use them to evaluate your condition.

 

Treatment –

 

For treatment three processes are used individually or in combination with others. They are light therapy, medication, and psychotherapy. It is very important to let your doctor know if you have any other depression or disorder as treatment may vary according to them. Such as people with bipolar disorder can develop manic attacks due to light therapy and anti-depressant medication.

·         Light Therapy – It is nothing much but the patient is exposed to an artificial light for a certain amount of time each day. This helps with maintaining the Biological Clock of the body. This can also be done at home by using a special type of lightbox.

·         Medication – Medication is similar to normal depression as some people are found to be benefitted from them.

·         Psychotherapy – Also known as Talk Therapy or Cognitive Behavioral Therapy. In this regard research is extremely limited so is success.

 

Prevention –

 

According to the current understanding of Seasonal Depression. It is seen that light plays an important factor. So, for preventing it from occurring steps needs to taken centering around it. So, steps that can be taken to prevent Seasonal Depression –

·         Make sure your home and surrounding is bright and shiny but within a comfortable range. Avoid staying in dark and gloomy places. Utilize bright LED lights to always keep your room lighted.

·         Do regular Exercise. Exercise makes our body active and stimulates the heart, hormones, and many other things. It is not only effective for SDA but also for any normal depression.

·         Stay Active. Go out for a walk or go meet friends and family instead of staying all day in the house. This will keep your mind active and fresh and also prevent depressive thoughts from emerging.

·         Practice Mind-Body Techniques. Yoga, meditation, or art and music therapy is said to help cope with Seasonal Depression. But lacks any solid evidence.

 

“It is always best to stay cautious of one’s mental health. And anything out of normal should be noted and kept under check. If these symptoms stay for a prolonged period or start to hamper normal regular lifestyle than it is best to consult a doctor as soon as possible.”

 

Reference –

·         https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/diagnosis-treatment/drc-20364722

·         https://en.wikipedia.org/wiki/Seasonal_affective_disorder

·         https://my.clevelandclinic.org/health/diseases/9293-seasonal-depression

·         https://www.webmd.com/depression/guide/seasonal-affective-disorder#2

·         https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder

·         https://www.nhs.uk/conditions/seasonal-affective-disorder-sad/

·         https://www.mhanational.org/conditions/seasonal-affective-disorder-sad

·         https://www.beyondblue.org.au/personal-best/pillar/in-focus/feeling-sad-seasonal-affective-disorder