When most people gear up for apple picking, fall foliage outings, and possibly a Pumpkin Spice Latte, others are entering a season of depression. SAD is described as a situational depression which typically occurs during the fall and winter months resolving during spring and summer in a repetitive pattern each year.
SAD effects, on average, about five percent of the population, 80 percent of which are typically women. Average onset for SAD is between 20 and 30 years of age; however, it has been observed in the late teens as well. Causes for SAD include an increased production of melatonin in the body during the darker months, which has been linked to depression. Northern regions tend to have a higher instance of SAD than southern regions, this is due to the discrepancy in the number of hours the sun is exposed in each region. Melatonin is produced and secreted through the pineal gland (found in the brain) during the dark hours of the day. This creates an overproduction during fall and winter months, resulting in feelings of depression, anxiety, sleep issues, mood changes, anhedonia, overeating, decrease in libido, and withdrawal from social interaction.
Diagnostic criteria for SAD include onset of the symptoms during a specific time of year (fall or winter, in a repetitive pattern that cannot be explained in another way). A complete reversal of the symptoms which also repeat during a specific time of year (spring or summer). The pattern of the cycle has occurred for at least two years with no symptoms in between the cycles as well as the individual experiencing more cycles including the SAD symptoms than without. Symptoms may vary between mild, moderate, and severe depending on the individual seeking treatment.
There is hope for individuals suffering the effects of SAD. Treatment recommendation include the use of phototherapy, antidepressants, professional therapy, exercise (preventatively as well), increased light in the home, stress management techniques such as meditation and animal therapy, and spending more time in sunny areas – Rio de Janeiro is always nice during the winter!
Laurie Spataro, MA, MCAP, ICADC, SAP, is a Registered Mental Health Clinical Intern, Program Director at The Palm Beach Institute, a Delphi Behavioral Health Group facility.
References:
4. Mc Mahon, B et al.”Seasonal difference in brain serotonin transporter binding predicts symptom severity in patients with seasonal affective disorder.” Brain. 2016 May;139(Pt 5):1605-14. doi: 10.1093/brain/aww043. Epub 2016 Mar 19.
5. Specifiers for depressive disorders: With seasonal pattern. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org.
