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Seasonal Affective Disorder

Seasonal affective disorder (also referred to as SAD) is a condition which effects over half a million people in UK alone. This condition impacts the mental well being of people during the winter months when the days begin to shorten. In England, SAD may manifest from September until April. The winter months, however, contain the majority of cases.

What is SAD?

SAD is a condition that primarily affects mood. In the northern latitudes, during the winter, the days become shorter, and we have less daylight hours.

This lack of daylight seems to have an effect on the hypothalamus. The hypothalamus plays a key role in many complex functions ranging from hormone cycles to sleep and wake cycle control. It also plays a role in our emotional state. It is thought that changes in levels of certain chemicals with in the hypothalamus bring about the various symptoms of SAD.

What are the symptoms?

SAD tends to affect people between the ages of 18 and 30. People can present with a variety of symptoms, which tend to be those that are commonly found in depression:

Low mood
Lack of concentration
Disturbed sleep
Self neglect
Pessimistic thoughts
Poor motivation and a lack of activity
Despair

SAD can also present with features of anxiety:

Nervousness
Difficulty coping with everyday situations

The symptoms may completely disrupt an individual's life during the winter months, causing them become withdrawn and even avoid contact with others. As spring approaches, some sufferers with SAD can experience a sudden reversal of mood and even an elevated mood, with periods of over activity. While with others, symptoms improve in a more gradual manner.

A milder form of SAD, known sometimes as the “winter blues” can also occur. This is where similar symptoms may manifest themselves, but with far less severity. With these “winter blues”, day-to-day life is not impaired.

How is SAD diagnosed?

SAD is usually diagnosed by a doctor, in many cases a psychiatrist. It normally requires that the individual show improvement of symptoms as spring commences, and there must also be a history of at least three or more consecutive winters where the above symptoms have occurred.

Can SAD be treated?

The condition is treated using one or a combination of the following treatment strategies:

Light therapy
Anti-depressants
Counselling and psychotherapy

Based on the theory that SAD is caused by the reduced availability of sunlight during shorter days in the winter months, artificial light therapy has been found to significantly relieve sufferer's symptoms. It normally involves sitting in front of specifically designed lamps that emit a very large amounts of light. While the normal intensity of room lighting it usually around 300 lux, these special lamps aim to provide up to 10,000 lux. Patients often report feeling better within several days of treatment.

The newer non-sedating antidepressants belonging to the group called the selective serotonin reuptake inhibitors (aka SSRI) have been found to help in some cases, such as Prozac®. Older antidepressants, which tended to causes increasing sedation, have been found to provide little benefit. In fact, in some cases making the symptoms even worse.

Counselling and psychotherapy can help patients come to terms with their diagnosis and provide coping strategies to deal with their negative thoughts. Therapy may include relaxation techniques and also helping patients to gain greater insight in to their mental health.

SAD further information

For further information please talk to your GP, or you can talk to our doctors online. An information pack on SAD can be obtained from The Seasonal Affective Disorder Association.

Dr Shazan Chughtai MB BS

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