Seasonal Affective Disorder (SAD): From our Health Pack number 26

We featured this article below in our Health Pack Number 26.  For other articles on health, as well as mind-set, nutrition and exercise, please check all our health packs out. They can be found on our website:

www.hmhb2016.org.uk

I thought it would be a good subject to look at now that summer has finished, autumn is with us, and winter approaches. I know a couple of people who have self-diagnosed with this, and they are probably right. I don’t think I have it, but I am definitely a warm weather person, already missing the sunshine.

Seasonal affective disorder (SAD) is a mood disorder subset in which people who have normal mental health throughout most of the year exhibit depressive symptoms at the same time each year, most commonly in winter, but it is also found in people in the summer.

It is no longer classified as a unique mood disorder but is now a specifier, called "with seasonal pattern", for recurrent major depressive disorder that occurs at a specific time of the year. Although experts were initially sceptical, this condition is now recognized as a common disorder.

Research on SAD began in the United States in 1979 when Herb Kern, a research engineer, had noticed that he felt depressed during the winter months. Kern suspected that scarcer light in winter was the cause and discussed the idea with scientists at the NIMH (National Institute of Mental Health) who were working on bodily rhythms. They were intrigued, and responded by devising a lightbox to treat Kern’s depression. Kern felt much better within a few days of treatments, as did other patients treated in the same way.

Sufferers may exhibit any of the associated symptoms, such as feelings of hopelessness and worthlessness, thoughts of suicide, loss of interest in activities, withdrawal from social interaction, sleep and appetite problems, difficulty with concentrating and making decisions, decreased libido, a lack of energy, or agitation. Maybe I do have it!!!

Symptoms of winter SAD often include oversleeping or difficulty waking up in the morning, nausea, and a tendency to overeat, often with a craving for carbohydrates, which leads to weight gain. Yep, that’s me.

SAD is typically associated with winter depression, but springtime lethargy or other seasonal mood patterns are not uncommon.  Although each individual case is different, in contrast to winter SAD, people who experience spring and summer depression may be more likely to show symptoms such as insomnia, decreased appetite and weight loss, and agitation or anxiety.

You should consider seeing your GP if you think you might have SAD and you're struggling to cope.  Your GP can carry out an assessment to check your mental health. They may ask you about your mood, lifestyle, eating habits and sleeping patterns, plus any seasonal changes in your thoughts and behaviour.

The exact cause of Seasonal Affective Disorder isn't fully understood, but it's often linked to reduced exposure to sunlight during the shorter autumn and winter days.

The main theory is that a lack of sunlight might stop a part of the brain called the hypothalamus working properly, which may affect the:

production of melatonin – melatonin is a hormone that makes you feel sleepy; in people with SAD, the body may produce it in higher than normal levels

production of serotonin – serotonin is a hormone that affects your mood, appetite and sleep; a lack of sunlight may lead to lower serotonin levels, which is linked to feelings of depression

body's internal clock (circadian rhythm) – your body uses sunlight to time various important functions, such as when you wake up, so lower light levels during the winter may disrupt your body clock and lead to symptoms of SAD.

It's also possible that some people are more vulnerable to SAD as a result of their genes, as some cases appear to run in families.

A range of treatments are available for SAD. Your GP will recommend the most suitable treatment programme for you.

The main treatments are:

Lifestyle measures:  including getting as much natural sunlight as possible, exercising regularly and managing your stress level

Light therapy:  where a special lamp called a light box is used to simulate exposure to sunlight

Talking therapies:  such as Cognitive Behavioural Therapy or counselling

Antidepressant medication:  such as selective serotonin reuptake inhibitors (SSRIs).

A study of people from Iceland, and Canadians of wholly Icelandic descent, showed low levels of SAD.  It has more recently been suggested that this may be attributed to the large amount of fish traditionally eaten by Icelandic people, in 2007 about 90 kilograms per person per year as opposed to about 24 kg in the US and Canada, rather than to genetic predisposition. A similar anomaly is noted in Japan, where annual fish consumption in recent years averages about 60 kg per capita.  Fish are high in Vitamin D. Fish also contain docosahexaenoic acid (DHA), which helps with a variety of neurological dysfunctions.

Recent research has shown that one in three people in the UK suffers from Seasonal Affective Disorder.  According to the findings, women are 40 per cent more likely than men to experience symptoms of the condition sometimes referred to as “winter depression”.  The research, commissioned by The Weather Channel and YouGov, shows that 29 per cent of adults experience symptoms of SAD at this time of year, ranging from low energy levels, to low self-esteem and anxiety. For eight per cent of people the symptoms are acute, while the remaining 21 per cent suffer a milder form of subsyndromal SAD.  Over half (57 per cent) of adults say their overall mood is worse in the winter season compared to the summer season. highlighting the strong links between the weather and wellbeing. Meanwhile, 40 per cent of people suffer from fatigue during the winter months.