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Archive for February 16th, 2010

A 30 kHz bright light therapy lamp (Innosol Ro...
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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapists, Certified Wellness Coach, ACSM Personal Trainer

Lately everyone I talk to is feeling the effects of winter. In Chicago we’ve had little to no sunshine, lots of cold weather and snow, snow, snow. Crankiness, irritability, more frequent colds and flues result.  But for some people, the winter blues may be more serious, they may have Seasonal Affective Disorder (also called SAD).

According to the MayoClinic, SAD is a an actual medical disorder: Seasonal affective disorder  is a type of depression that occurs at the same time every year. If you’re like most people with seasonal affective disorder, your symptoms start in the fall and may continue into the winter months, sapping your energy and making you feel moody.

What Are the Symptoms of SAD?

Seasonal affective disorder is a cyclic, seasonal condition. This means that signs and symptoms come back and go away at the same time every year. Usually, seasonal affective disorder symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer. Some people have the opposite pattern and become depressed with the onset of spring or summer. In either case, problems may start out mild and become more severe as the season progresses.

Fall and winter seasonal affective disorder (winter depression)
Winter-onset seasonal affective disorder symptoms include:

  • Depression
  • Hopelessness
  • Anxiety
  • Loss of energy
  • Social withdrawal
  • Oversleeping
  • Loss of interest in activities you once enjoyed
  • Appetite changes, especially a craving for foods high in carbohydrates
  • Weight gain
  • Difficulty concentrating and processing information

What Causes SAD?

The specific cause of seasonal affective disorder remains unknown. It’s likely, as with many mental health conditions, that genetics, age and, perhaps most importantly, your body’s natural chemical makeup all play a role in developing the condition. A few specific factors that may come into play include:

  • Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may disrupt your body’s internal clock, which lets you know when you should sleep or be awake. This disruption of your circadian rhythm may lead to feelings of depression.
  • Melatonin levels. The change in season can disrupt the balance of the natural hormone melatonin, which plays a role in sleep patterns and mood. Talk to your doctor to see whether taking melatonin supplements is a good option.
  • Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in seasonal affective disorder. Reduced sunlight can cause a drop in serotonin, perhaps leading to depression.

How Do I Know if I Have SAD or Just Hate Winter?

To help diagnose seasonal affective disorder, your doctor or mental health provider will do a thorough evaluation, which generally includes:

  • Detailed questions. Your doctor or mental health provider may ask about your mood, seasonal changes in your thoughts and behavior, your lifestyle and social situation, and sleeping and eating patterns, for example. You may also fill out psychological questionnaires.
  • Physical exam. Your doctor or mental health provider may do a physical examination to check for any underlying physical issues that could be linked to your depression.
  • Medical tests. There’s no medical test for seasonal affective disorder, but if your doctor suspects a physical condition may be causing or worsening your depression, you may need blood tests or other tests to rule out an underlying problem.

Seasonal affective disorder is considered a subtype of depression or bipolar disorder. Even with a thorough evaluation, it can sometimes be difficult for your doctor or mental health provider to diagnose seasonal affective disorder because other types of depression or mental health conditions may mimic seasonal affective disorder.

How Can I Treat My SAD?

Treatment for seasonal affective disorder may include light therapy, medications and psychotherapy.

Light therapy
In light therapy, also called phototherapy, you sit a few feet from a specialized light therapy box so that you’re exposed to bright light. Light therapy mimics outdoor light and appears to cause a change in brain chemicals linked to mood. This treatment is easy to use and seems to have few side effects.

Although light therapy is widely used and appears to be helpful, it isn’t clear how light therapy works and how effective it is in treating seasonal affective disorder. Before you purchase a light therapy box or consider light therapy, talk to your doctor or mental health provider to make sure it’s a good idea and to make sure you’re getting a high-quality light therapy box.

Medications
Some people with seasonal affective disorder benefit from treatment with antidepressants, especially if symptoms are severe. Medications commonly used to treat seasonal affective disorder include:
• Bupropion. An extended-release version of the antidepressant bupropion (Wellbutrin XL) may help prevent depressive episodes in people with a history of seasonal affective disorder.
• Other antidepressants. Antidepressants commonly used to treat seasonal affective disorder include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor)

Psychotherapy
Psychotherapy is another option to treat seasonal affective disorder. Although seasonal affective disorder is thought to be related to biochemical processes, your mood and behavior also can add to symptoms. Psychotherapy can help you identify and change negative thoughts and behaviors that may be making you feel worse. You can also learn healthy ways to cope with seasonal affective disorder and manage stress.

Do It Yourself Treatments for SAD

  • Make your environment sunnier and brighter. Open blinds, add skylights and trim tree branches that block sunlight. Sit closer to bright windows while at home or in the office.
  • Get outside. Take a long walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun. Even on cold or cloudy days, outdoor light can help — especially if you spend some time outside within two hours of getting up in the morning.
  • Exercise regularly. Physical exercise helps relieve stress and anxiety, both of which can increase seasonal affective disorder symptoms. Being more fit can make you feel better about yourself, too, which can lift your mood.

Mind-body therapies that may help relieve depression symptoms include:

  • Acupuncture
  • Yoga
  • Meditation
  • Guided imagery
  • Massage therapy

Read the entire article at MayoClinics’ website here.

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