Seasonal affective disorders (SAD)

We all know what it is like to experience the winter blues – it’s dark when you get up in the morning; it’s dark when you go to bed; the temperature is plummeting, you can’t face going outside and you long for a flicker of daylight...

But when do these normal feelings become a health problem such as Seasonal Affective Disorder?

Seasonal Affective Disorder (or SAD) is a type of depression which has a distinct pattern as symptoms strike at specific times of the year. Typically, most sufferers of SAD experience the condition during the winter months although for others, the summer months can be the most challenging.

You can only be affected by SAD during particular seasons. If you are noticing symptoms outwith these seasons, then you may be suffering from some other type of depression.

SAD is often thought to be a relic of hibernation. This ‘condition’ is necessary for some species as winter presents limited food supplies and difficult living conditions. However, humans are well adapted to surviving a winter without having to hibernate, although at times simply curling up in bed seems an easier option!

Our body has very distinct responses to light and although not yet fully understood, it is this which results in the symptoms of SAD. Natural sunlight influences the production of chemicals and hormones in the brain. These are most notably, melatonin and serotonin, and affect the body’s circadian rhythms (your body clock).

Melatonin helps to regulate your body clock. In darkness, the level of melatonin produced increases so that you fall asleep. When we are experiencing long dark winter days, our bodies produce more melatonin, making us feel lethargic and sleepy. This in turn affects and disrupts our sleeping pattern.

Lower amounts of sunlight may also trigger a drop in the hormone serotonin, a chemical which makes us feel happy. So with lowered levels of serotonin, raised levels of melatonin and a disrupted sleeping pattern, we may experience the first symptoms of SAD.

In addition to all this, factors such as your personality and genetics play a role in determining whether you become a sufferer of SAD or not.

Symptoms of SAD only appear at certain times of the year. The condition varies from feeling low in mood to feelings of clinical depression.

Although varying from person to person, symptoms will start off fairly mild at the start of the winter season, with a gradual worsening, before easing again when spring appears.

The main symptoms of SAD include:

• Feeling fed-up or low in mood
• Lethargy
• Irritability
• Low self-esteem or a feeling of worthlessness
• Upset in sleeping patterns
• Changes in appetite

Most people experience SAD during the winter months. However, the condition can appear during the summer with its warmer, longer days. This condition is sometimes referred to as reverse SAD.

Again the exact cause of the condition is unknown, especially as there is not a logical explanation relating to the production of chemicals in the brain when levels of natural daylight are higher. However, it is thought that warmer temperatures could affect a part of the brain called the hypothalamus which controls our hormones. It may be this that makes it more difficult for us to manage stress and control our mood.

However, other factors may also play a role. The start of the summer often entails the start of expensive holidays, children being at home all the time (instead of at school), and the loss of a routine. All these things may have more of an impact on you than you realise.

The symptoms of summer SAD are the same as SAD in the winter, only six months adrift.

There are a number of things you can do to help yourself:

• Plan ahead. The good thing about SAD (if there is one) is that you know when the symptoms are likely to come. Armed with this knowledge, you can plan the troublesome season accordingly. Make plans to eliminate stress – for example, if you have a couple of weeks holiday from work a year, use these weeks wisely. If being at work is only going to add extra stress, take the time off then and use the freedom to relax. If you suffer from reverse SAD, try to coordinate your child’s holiday camp with your worst symptoms. In this way, you can be guaranteed some peace and quiet
• Stick with a routine. It is often said that a good routine is one of the best ways of counteracting any kind of low mood or depression. This includes eating three adequate meals at the same time each day and adhering to a regular sleeping routine. It is also of benefit to exercise regularly. However, too much exercise can actually have a negative effect, as can setting yourself goals which are too high. Nevertheless, a daily walk will, at the very least, increase the levels of happy serotonin released into your bloodstream
• Manage your exposure to daylight. If you suffer from winter SAD, it is important to get out yourself out of your front door each day. Even if it is a cloudy day, you will be exposed to some natural daylight. However, if you suffer from summer SAD, limiting your time in the sun is more likely to help. Wearing sunglasses outside or even in the house is found to be effective
• Control your temperature. Being too warm, or too cold, can cause you to plunge you deeper into a mood. Those who suffer from summer SAD will do well by trying to keep as cool as possible. On the other hand, those suffering from winter SAD often find that keeping warm and cosy eases their symptoms.

As ever, diet is one of the first aspects to consider. The obvious things to avoid are:

• Stimulants such as tea, coffee and caffeinated drinks as these can put your adrenal glands under stress. (Your adrenal glands are your friends! They help you cope with stress so if they are under stress themselves they won’t be able to help you! Try not to abuse them!)
• Sugary foods and drinks and refined foods are of limited benefit as they contain very little nutritional value.

Foods to add to your diet are:

• Fish (rich in omega 3 essential fatty acids) or, for the vegetarians and vegans amongst you, linseeds.
• Avocados, beans, bananas, wheat germ, porridge oats, brown rice and wholemeal pasta are foods that help to increase serotonin, the brain chemical that makes you feel happy.
• Water and non-caffeinated drinks such as herb teas can help to keep you hydrated. (Just as important in the winter as in the summer!)
• Vitamin D is an important nutrient to take as levels can drop during the winter months. Most of our vitamin D is produced in the body by the action of sunlight on the skin.

As mad as it may sound, going for a bracing walk in wild winter weather can literally ‘blow the cobwebs away’! If the wind is whipping up a storm it will certainly oxygenate you! And exercise produces endorphins – those wonderful chemicals that make you feel good.

Like with many types of low mood or depression, there is a range of effective treatments, although finding the most effective for you may take a little time.

• Bright light therapy. This is one of the most common types of treatment for winter SAD. It involves being exposed to light of a specific frequency for a certain length of time each day. This treatment is designed to rebalance the production of melatonin and serotonin in your brain, which will help to ease your symptoms
• Conventional medicines. These are usually a last resort because the side effects of the usual types of treatment such as anti-depressants can outweigh the benefits. However, if you are already on medication for depression, you may find that increasing your dosage during the winter or summer months will be of benefit
• Herbal remedies. These may be effective as the main type of treatment used, but can also be taken alongside other types of self-help measures or bright light therapy. You will need to consult your doctor if you are already taking conventional medicines for depression or other conditions. The most common types of herbal remedies for SAD are Valerian and hops in the form of Deep Sleep to help you to sleep at night.

Seeking medical advice is always advisory if your symptoms are worrying you, or are beginning to interfere with your daily life. This is also the case if you have not found self-help techniques or herbal remedies  to be effective.

In addition, if you have experienced any thoughts of suicide, then immediate medical attention is necessary.