Download SAD (Seasonal Affective Disorder) is a type of winter depression that

SAD (Seasonal Affective Disorder)
By Sylvia Whyte
Autumn can be a time of year when many individuals start to feel depressed with thought
of the cooler months to come as well as darker mornings and evenings. For some it can
be more serious than just feeling down and the disorder known as SAD has now been
recognized as a medical condition.
It is estimated to affect up to half a million people between the end of September and the
beginning of April, when the daylight hours become shorter and we are quite often
waking up in darkness and coming home late afternoon in darkness.
There are mixed views as to the exact cause but a likely theory is that it is linked to an
imbalance of melatonin and serotonin. At night time the pineal gland, which is found in
the brain, produces a substance called melatonin which makes us drowsy. The natural
daylight causes the gland to stop producing and allows us to wake up. However, during
the long dark winter months there is insufficient daylight to switch off the melatonin,
causing many of us to remain in a sluggish state where we just want to hibernate.
Further evidence exists which links the exposure of bright light to an increased
production of serotonin. Serotonin carries signals from the output of one nerve to the
next inside the brain. Lack of serotonin is linked to a cause of depression and is found in
drugs such as Prozac and SSRI.
For many individuals the effects are little more than feeling a bit low and perhaps lacking
a bit of motivation to start new things in the cold winter months. For others however,
SAD can be very disabling, preventing them from functioning normally without
intervention. Symptoms include:
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Sleep problems – a desire to oversleep, difficulty staying awake, disturbed sleep
and early morning awakening
Lethargy – a constant feeling of fatigue so much that it prevents the individual
from carrying out everyday tasks.
Overeating – a craving for carbohydrates and sweet foods – normally resulting in
weight gain.
Depression – feeling of misery, guilt and loss of self esteem, hopelessness,
despair, apathy, loss of feelings.
Social Problems – Irritability and desire to avoid social contact
Anxiety – Inability to cope with stress.
Loss of Libido – decreased interest in sex or physical contact
Mood changes – extremes of mood
Weakened immune system – vulnerable to infections and other illnesses.
For an individual suffering from SAD their symptoms will disappear in the Spring.
Sometimes this can be with a flurry of activity or a gradual return to the body’s normal
state. This is often dependent on the early or lateness of spring and whether it is
particularly sunny and bright or damp and dull.
The most natural treatment for SAD would be to spend the winter months in the southern
hemisphere but unfortunately this is not very practical for most individuals! The cheaper
alternative is to invest in a light box. A light box provides access to strong light to
replace natural sunlight which is absent in the winter months.
Ordinary artificial light bulbs emit an intensity of 200 – 500 lux (measure of brightness)
whereas the minimum recommended dose to treat SAD is 2500 lux. The intensity of a
bright summer’s day can be 100 000 lux. Light treatment should be used daily in winter,
for an average of 1 to 2 hours during which time you should sit 2 to 3 feet away allowing
the light to shine directly through the eyes. It is not necessary to be absolutely still but
any activities undertaken must be carried out in front of the box – such as reading,
working, eating, needlework etc.
A difference can be felt within 3 to 4 days for up to 85% of diagnosed cases and
continues throughout the winter, provided treatment is on a daily basis. Some light
boxes emit up to 10 000 lux which can reduce treatment to half an hour a day.
One of the symptoms related to SAD is a craving for carbohydrates during the winter
months. This could be a natural way of the body telling us to increase carbohydrate rich
meals as they can often increase serotonin levels. However, to manipulate the levels
through carbohydrates are difficult to manage as the effects vary in different people.
Some people may experience a temporary lift in their mood whilst others may become
relaxed and sleepy which is exactly the effect we do not want to promote. Some foods in
this category are not the most healthiest of choices either. Sweets and chocolates have
the greatest impact but the effect is only short-lived for 1 to 2 hours. (so not advisable)
Complex carbohydrates such as rice, potatoes and pasta are less effective because
although they may increase serotonin levels the protein content within these foods may
inhibit serotonin production. This is due to the digestive process for carbohydrates.
When a carbohydrate rich meal is consumed the hormone insulin is secreted which
causes a lowering of the blood levels of most amino acids, with the exception of
tryptophan. Tryptophan is a precursor to serotonin. When there are high levels of
tryptophan in relation to other amino acids it enters the brain at a higher rate,
synthesizing more serotonin. Tryptophan is evident in many protein rich foods which
have been found to prevent serotonin production.
Although the condition is now medically recognized a trip to a GP will probably still result
in a prescription for anti depressants to help get over the winter. This is probably due to
light boxes being unavailable on the NHS as well as some GP’s being in denial as to the
route cause. Some anti depressants, such as tricyclics, are not normally helpful as they
exacerbate the sleepiness and lethargy that are symptoms of the illness.