Seasonal Affective Disorder, or SAD, is a psychological disorder that tends to occur at certain times of the year. The main complaint is depression that manifests in the winter months. The predominant symptoms of SAD include sadness, decreased activity, anxiety, irritability, and daytime tiredness. Individuals with SAD also present with increased sleep, increased appetite, and decreased sexual interest. The symptoms can mirror a major depressive disorder, but the distinguishing feature of SAD is that this disorder regularly appears in early autumn and winter with improved mood in the spring and summer followed by depression returning in the winter months.
The symptoms of SAD include:
SAD was first introduced into the psychiatric community in 1984 by Norman Rosenthal, MD. Depression related to changes in the seasons, however, has been observed for centuries. Hippocrates, circa 400 BC discussed individuals with a melancholy that seemed to arise in the winter months, while Esquirol in 1845 described changes in mood due to changes in the seasons.
The prevalence rates for SAD are estimated to be about 5% of the population. Studies have consistently shown that SAD occurs more frequently among women and tends to occur more often in younger people. SAD has also been found to have higher rates in northern regions and lower rates in southern areas.
Several causes have been put forth to explain SAD, including decreased exposure to sunlight, disruption to serotonin, and changes in circadian rhythms. The treatments for SAD have included light therapy, anti-depressant medication, and the use of melatonin.
Treatments for SAD include:
The presence of a seasonal depressive disorder can be debilitating for individuals. Practitioners need to ask the right questions to determine if individuals presenting with depression are suffering from a seasonal affective disorder which can only be done by a thorough assessment of the temporal relationship between an individual’s depressive symptoms, time of year, and history.
Marc J. Romano, Psy.D., APRN, BC, CAP, is a consultant with Delphi Behavioral Health Group.