What is SAD?

Some people think SAD is a made up condition, an excuse for people not to behave normally and perform their daily duties.  I however, am undecided.  I do know that more of the patients I deal with appear depressed at this time of year than at any other time.  

For people who actually suffer from this, the period between September and March is a source of great depression and the inability to function at full capacity.

1. The most obvious one would be feelings of depression – Low mood, guilt, hopelessness, negative thoughts.  Some people will suffer from apathy and an inability to feel

2. The need to hibernate – You sleep more, and find it difficult to stay awake during the day.  Or on the side of the scale you may have disturbed sleep at night and wake early every morning.

3. Over eating – You might crave carbohydrates and sweet foods and guess where that might lead – Obesity! Another health issue to deal with. 

4. You might feel irritable with people all the time and you begin to prefer your own company.

5. Your concentration and memory might deteriorate.  You feel a bit slower in the intelligence department.      

6. You feel lethargic all the time.      

7. You might feel increasingly anxious.

8. Then you feel completely better in the Spring.

Now this list of symptoms could be used to describe quite a lot of people in the winter, apart from the people with a particularly sunny disposition.

So the main determining factor would be the timing of the symptoms and if they have occurred over three or more winters.

There are three main sources of treatment

Light Therapy - Now this is the big one.  Several pieces of research seem to point to the fact that this works in up to 85% of diagnosed cases. It has been used for over 20 years to treat various mental health conditions and it is mainstay treatment for sufferers from SAD.

The idea is to expose oneself to brighter than normal light. The brightness of a light is measured in Lux.  this measures  illuminance over a given area.  Normal light is in the region of 200 - 500 lux.  The light used in SAD is at a very bare minimum 2500lux.  Treatment times using this amount of lux however would be pretty long, so it is a bit impractical in today's world to sit around for about 4 hours.

Thankfully, there is a wide amount of choice at the moment.  Some lights go up to 10000lux which will then reduce treatment time to about 30 mins a day.  

There is also blue light therapy which seeks to imitate a blue cloudless sky.

Actual sunlight on a bright day  can measure up to 100000 lux so this cannot completely be replicated yet, as far as I am aware but these lights provide the next best thing.

Anti depressants - Some people do not feel better using just light and some others feel uncomfortable just sitting with bright light blaring towards them.  In these cases, anti-depressant medication is used as well or instead.

Selective Serotonin Reuptake Inhibitors such as fluoxetine and sertraline are used more usually.  Something to be aware of when using anti-depressants - They can initially make you feel worse before you get better.  It takes about 3 weeks to notice their effect.

Psychotherapy - this is the other way people use to combat the symptoms of SAD. This could include group session dealing with specific symptoms of SAD and their consequences, Cognitive behavioural therapy, problem-solving therapies and more.  This can help people deal with the specific behaviors and thoughts that may be enhancing the disorder.