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Shining a light on Seasonal Affective Disorder

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Enjoying the sunlightAs days grow shorter and hours of sunlight diminish, many people in the Northern Hemisphere are experiencing a return of seasonal affective disorder (SAD). This is a depression condition that is triggered by a chemical change in the brain, brought on by less time spent outdoors and shorter days.

Seasonal affective disorder is also referred to as seasonal depression or simply the “winter blues.” It can have a significant impact on both the mental and physical well-being of individuals. It is essential for educators, corporate managers, parents, and anyone else who plays a pivotal role in the lives of others to recognize the subtle effects of SAD, along with its causes, symptoms, and potential remedies, so that they can offer effective support to those affected.

Understanding Seasonal Affective Disorder

SAD is not just the blues in the depths of winter. It is a type of depression that follows a seasonal pattern, typically worsening in the fall and winter months when sunlight is scarce. It typically recedes in the spring. The exact causes of SAD remain unclear, but it is believed to be linked to low levels of sunlight, which can disrupt the body’s internal clock (circadian rhythm,) leading to feelings of depression.

Additionally, reduced sunlight can trigger a drop in serotonin, a neurotransmitter that affects mood, and an increase in melatonin, which regulates sleep and can cause lethargy.

What symptoms to look out for in case you suspect a case of SAD?

Symptoms of seasonal affective disorder can vary from mild to severe and often include:

  • Feelings of depression, sadness, hopelessness, and despair.
  • Development of noticeable disinterest in activities that were once enjoyed.
  • Cravings for carbohydrates and resultant weight gain are common.
  • Insomnia and oversleeping; missing deadlines and skipping routine scheduled tasks.
  • A distinct drop in energy and increased fatigue.
  • Difficulty concentrating, focusing, or making decisions.
  • Restlessness or irritability.
  • Feelings of worthlessness or guilt.
  • Complaints of headaches, stomach problems, and joint or muscle pain.

What can place a person at risk of developing Seasonal Affective Disorder?

There are some possible influences:

  • Gender: Seasonal affective disorder is diagnosed more frequently in women than in men.
  • Age: SAD is more prevalent in younger adults than in older people.
  • Genetics: There is some evidence that SAD may be more prevalent in blood relatives of people who suffer from SAD or other forms of depression.
  • Comorbidity: People who suffer from bipolar disorder or clinical depression may also be subject to SAD.
  • Biological: Serotonin production strongly depends on the body’s vitamin D levels, which are produced in the skin when exposed to sunlight. A person not getting alternate supplies of vitamin D from foods or supplements may need help to maintain sufficient vitamin D levels in the body.
  • Geographic: The differences in hours of sunlight are greatest for people living further North or South of the equator, and this produces the steepest changes in natural influences.

What are the consequences of untreated SAD?

Seasonal affective disorder, if not taken seriously, can worsen and lead to other problems if it’s not treated. These include:

  • Suicidal thoughts
  • Substance abuse
  • Withdrawal from social interaction
  • Problems at school or work
  • Development of other disorders (anxiety, eating disorders)

Can Seasonal Affective Disorder be prevented?

Seasonal affective disorder cannot necessarily be prevented unless the sole trigger has been vitamin D deficiency, which can be handled with dietary supplements. The most effective way around the disorder is to manage the symptoms and, in so doing, to prevent the development of serious deterioration of mood, appetite, and energy levels. By being aware of the cyclic pattern that follows the onset of the winter months, which is the time of the year in which these symptoms may start, it is possible at least to prevent the more serious outcomes and complications by treating them before symptoms get too bad.

What are the leading causes of SAD?

The circadian rhythm has a strong influence on mood. It is the body’s internal clock and is pivotal in regulating numerous physiological processes, including sleep-wake cycles, hormone release, and body temperature. It is closely linked to the 24-hour day-night cycle and is primarily influenced by light exposure.

The circadian rhythm helps regulate sleep patterns. As the levels of light increase in the morning, it wakes people up by producing serotonin and keeps them alert during the day. In turn, darkness signals the body to produce melatonin, preparing a person for sleep.

Disruptions in the circadian rhythm can have an impact on mental health. When a person’s internal clock is misaligned with the external environment, as often happens during the shorter days of winter, it can lead to symptoms of depression and mood disorders like SAD. This misalignment can affect the regulation of neurotransmitters and hormones that influence mood.

What are the roles of serotonin and melatonin in mood control?

Serotonin and melatonin are neurotransmitters – chemical messengers that significantly regulate mood and behavior deep inside the brain. Their balance is essential for maintaining mental health.

Serotonin is sometimes called the ‘feel-good’ neurotransmitter. It impacts every part of the body, from emotions to motor skills. It is a crucial molecule that stabilizes mood, feelings of well-being, and happiness. Serotonin also helps with sleeping, eating, and digestion. 

How does serotonin relate to Seasonal Affective Disorder?

Sunlight helps regulate serotonin levels. Adequate serotonin levels are crucial for brain function and mood regulation. Low levels have been linked to depression, anxiety, and sleep disorders, but reduced sunlight levels in winter lead to lower serotonin levels, contributing to depressive symptoms seen in SAD.

How does melatonin relate to SAD?

Melatonin is produced in response to lower levels of ambient light, helps with the timing of circadian rhythms, and so affects the onset of sleep. Being exposed to brighter light at night can block melatonin production.

In the longer winter nights, extended melatonin production can start earlier and last longer. This can cause symptoms like lethargy and a desire to sleep more – both common symptoms in SAD.

The relationship of the two neurotransmitters can have more complicated effects. Although melatonin is the primary regulator of the sleep cycle, an imbalance can disrupt the sleep-wake cycle, leading to poor sleep quality, which can exacerbate mood disorders.

The bottom line is that the interaction between the circadian rhythm, serotonin, and melatonin is complex and strongly influences a person’s overall mental health. 

What are the potential approaches to treat SAD?

  • Light therapy is the primary treatment for SAD since lower levels of ambient natural light are the primary triggers of the disorder. Properly designed light therapy boxes can mimic outdoor light and stimulate the production of serotonin (and block melatonin production) if the body is systematically exposed to the light at appropriate times.
  • Low levels of Vitamin D resulting from decreased exposure to sunlight may play a role in SAD. Dietary supplements with Vitamin D can sometimes help stave off the development of SAD’s symptoms. Several vitamin D supplements are available over-the counter, such as Vitamin D Drops,  and Active Guard.
  • If the symptoms of depression and anxiety are severe, doctors can prescribe appropriate antidepressant medications that might be especially effective in controlling the symptoms that come from serotonin/melatonin imbalance. In the main, these are:
    • SSRIs (selective serotonin reuptake inhibitors) increase serotonin levels in the brain by blocking its reabsorption. They are effective for both depression and anxiety disorders. The most frequently prescribed medications in these categories are Elavil (amitriptyline), Prozac (fluoxetine), Celexa (citalopram), Paxil (paroxetine), and Zoloft (sertraline). They are considered safe and have fewer side effects than older antidepressants.
    • SNRIs (serotonin-norepinephrine reuptake inhibitors) can increase the levels of both serotonin and norepinephrine in the brain by blocking their reuptake. The most frequently prescribed medications in these categories are Cymbalta (duloxetine) and Effexor (venlafaxine). They are effective for major depression and certain types of anxiety disorders.
    • Melatonin, such as Circadin, is a sustained-release supplement. 
  • Cognitive-behavioral therapy (CBT) can be effective by helping individuals manage their negative thoughts and behaviors.
  • Lifestyle modifications involve regular exercise, proper sleeping patterns, a healthy diet, and exposure to more natural light or light therapy.

What can parents, teachers, and managers do to help people avoid SAD?

Anyone who is in a position to observe the first signs of seasonal affective disorder and give guidance and advice should take some of these steps:

  • Watch out for the typical signs, such as changes in behavior, mood, or academic performance that might signal a problem.
  • Create a supportive environment where people know that talking about their feelings is OK.
  • Promote activities that can help stave off the onset of SAD, such as exercise and time outdoors during daylight hours.
  • Where possible, create an optimal environment where people spend daytime hours when it’s dark outside. Maximize natural light and install light bulbs that mimic natural light.
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