Treatments differ like the seasons

The changing of the seasons is an exciting time for many. Late fall and winter are typically an occasion for holiday celebrations and gathering time for families worldwide. However, the progression toward shorter days, longer nights and colder weather can be problematic for some. Seasonal Affective Disorder (SAD) is a condition that affects individuals in certain climates during seasonal changes. Although most cases are “winter-pattern SAD,” a smaller number of individuals may experience “summerpattern SAD,” which presents itself in the late spring and summer months.

Seasonal Affective Disorder is a type of depression with a seasonal pattern. As such, this condition may be characterized by subjective feelings of depression, sleep changes, low interest, guilty feelings, low energy, trouble concentrating, changes in appetite or weight, restlessness, a slowing down of mental or physical activity and thoughts of hopelessness, death or suicide. All of these symptoms don’t need to be present, but affected individuals often exhibit more than one. It may be difficult for a person to recognize a seasonal pattern to their symptoms, but a thorough history with a mental health professional should help to reveal the nature of the issue.

There are differences in how the variants of Seasonal Affective Disorder present themselves. Winter-pattern SAD is more likely to involve increased sleeping, tiredness, low energy, weight gain and appetite changes, which may result in craving high-carbohydrate foods. Alternatively, summer-pattern SAD is likely to present with trouble sleeping, anxiety, irritability, low appetite and weight loss. This highlights the nuance involved when diagnosing and treating this condition and why a mental health professional should be contacted if you experience these symptoms.

According to the American Psychiatric Association, about 5% of the U.S. population (or 16.6 million people) suffer from Seasonal Affective Disorder. Affected individuals have symptoms for about 40% of the year, and women are generally more likely to develop SAD than men. SAD typically develops between the ages of 18 and 30 but can develop at any age.

The treatment of Seasonal Affective Disorder may involve different methods which can be used separately or together. Clinicians may use medications, counseling or light therapy to treat the symptoms of this condition. Treatment is often initiated by a mental health professional, such as a psychiatrist, psychologist or another type of therapist, or even through a primary care provider. Additionally, a clinician may consider checking an individual’s vitamin D level, which, if low in the context of limited sunlight exposure, may contribute to the symptoms of SAD.

Light therapy is a treatment unique to Seasonal Affective Disorder. Because winter-pattern SAD is thought to result (at least in part) from reduced exposure to light during winter months, increasing light exposure may be an effective tool to combat the disorder. Lightboxes are readily available from retailers. These are generally 10,000 lux and usually don’t expose the user to UV radiation. A health-care professional should be consulted before utilizing this as a treatment option.

If you believe you are experiencing symptoms of Seasonal Affective Disorder, reach out to a mental health professional or your primary care provider to make an appointment. Treatment is available, so don’t wait.

Shawn E. McNeil, MD, FAPA, is a clinical assistant professor of psychiatry and behavioral medicine, LSU Health Shreveport.