Seasonal Affective Disorder or SAD is a form of depression which develops in the autumn and improves in the spring. It is thought to be caused by lack of light in winter.

Many people, whether or not they have SAD, find they dislike the dark mornings and early evenings of autumn and winter, preferring the longer outside light of the other seasons. However, seven per cent of people in Scotland will develop full blown SAD and a further 15 per cent of us will have the winter blues – a milder version. People affected by SAD may experience the following: – Feeling low, depressed, feelings of despair, misery, guilt and anxiety. – Sleep problems – oversleeping but not waking up feeling refreshed, not being able to get out of bed, needing a nap in the afternoon, always feeling tired. – Overeating and food cravings – while it is common for people with other types of depression to not want to eat, people with SAD often crave sweet and starchy foods and may gain weight over the winter months. – Social problems – avoiding company, feeling irritable, a loss of libido. – Lethargy – feeling too tired to cope, every-thing seeming a huge effort, can’t be bothered to do anything.
Physical Symptoms include joint pain or stomach problems, or a lowered resistance to infection.

TREATING SAD

Light therapy
As SAD is caused by lack of light, recent research indicates that concentrating on increasing light exposure by artificial means is able to reduce the effects of SAD. This involves exposure to very bright light which must be at least 2500 lux. Lights used in offices and the home are around 200–500 lux so a special light box is needed. For many people sitting in front of a light box, allowing the light to reach the eyes, will alleviate most symptoms. When using a light box you do not have to stare at the light, but get on with normal tasks like watching TV, reading, knitting, sewing, using the computer. The length of time you will need to sit in front of the light box depends on the brightness of the light you obtain. Treatment time usually varies from between 20 minutes and around one or two hours but manufacturers will normally advise you as to the optimal use of the equipment. If you are really busy and don’t have time to sit in front of a box, some companies sell light visors which can be worn on the head while you do other things. It is normally recommended that you start light treatment in early autumn, September or October and continue it until the days become lighter in March or April. There are no absolute contra-indications for using a light box. This means that there are no medical conditions or treatments that mean you absolutely shouldn’t use a light box. However, because light boxes are very bright there are some risk factors. These include: eye disease; diabetes – which can cause problems in the eyes; certain medication can make you more photo-sensitive. Check with your doctor before starting light therapy to make sure that you are not at risk.

Getting out in the sun
Increasing exposure to sunlight is one way you can help to reduce symptoms. If you can afford a winter holiday in the sun, where you will obtain good sunlight but not excessive heat, this can be really helpful. Going skiing or to a snowy area can also help. If you can’t afford to go abroad, it may help to get outside as often as possible, particularly at noon, which is the brightest part of the day.

Exercise
If you are also able to take part in regular physical exercise, such as swimming or walking, you may also find your symptoms of SAD getting better.

Antidepressants
Because SAD is thought to be caused by disturbances in the brain chemical serotonin, newer antidepressants such as Prozac and Lustral, which act on serotonin, may help those affected by SAD. These can be used with light therapy. Other treatment Other forms of treatment for depression like psycho-therapy, Cognitive Behaviour Therapy, nutrition and alternative reme-dies may be useful for people with SAD.

Summer depression
Some people find that they have summer depression or “Reverse Seasonal Affective Disorder”. They feel fine in the winter but experience symptoms in the summer. According to one article, the condition af-fects an estimated 600,000 people in the UK. Summer depression is more likely to occur in hotter areas so it may not affect many people in Scotland. Symptoms include insomnia, decreased appetite, weight loss, and agitation or anxiety. As in all depression, those affected by summer depression may feel miserable and low for no reason. There has been little research into summer depression and there is clearly a need for more investigation into this topic. Also, in particularly overcast Scottish summers where there is not much sun, those affected by winter SAD may experience symptoms. Using a light box in the summer may help.

Visit www.dascot.org for more information.