Autumn Is Coming: Seasonal Affective Disorder
Although September this year has provided a record-breaking heat wave, for some, autumn to winter depression is only around the corner. For most of us, it’s a negligible transition: an extra hour in bed, then lowering skies, a winter hiatus before the year starts again.
But for a small minority, winter starts a heavy toll of depression. In the UK, about 3% of the population are estimated to suffer from a seasonal affective disorder, a debilitating illness which prevents those affected from functioning normally without appropriate treatment. About 20% of people in the UK experience mildly debilitating symptoms of depression, called “subsyndromal SAD” or “winter blues”.
What is SAD?
SAD is a complex depressive illness. It is most likely triggered by the lack of sunlight in winter, which affects levels of hormones (melatonin and serotonin) in the part of the brain controlling mood, sleep and appetite – our circadian rhythms.
Symptoms of SAD are wide-ranging and can include depression, lack of energy, concentration problems, anxiety, overeating, loss of libido, social and relationship problems and sudden mood changes or periods of hypomania (over-activity) in spring.
As such, it is best to think of SAD as a spectrum. On one end of the scale, some people are not at all affected by seasonal changes. Further along, those experiencing “winter blues” might find themselves feeling tired, grumpy and a bit down. At the other end of the depression spectrum, though, some people may have to take time off work and drastically limit their daily routines.
How do I know it’s the change in seasons causing me to feel this way?
While “traditional” depression usually comes with sleeping problems and reduced appetite, SAD is associated with a yearning to “hibernate”. People affected have a strongly increased desire to sleep and eat, with a craving for carbohydrates, comfort food and sweet treats very common for SAD sufferers.
The other main indicator that SAD is at work is the timing of these feelings: When does the depression set in and fade away? Most commonly, SAD is a winter-related malady that recurs each year. In the northern hemisphere, it usually starts between September and November and lasts until March or April. Diagnosis for SAD can usually be made after two to three consecutive winters with the symptoms.
Medication and Cognitive Behavioural Therapy (CBT)
Antidepressants may be helpful in SAD. Since medication that causes drowsiness is often impractical, doctors usually prescribe selective serotonin reuptake inhibitors (SSRIs). These work by increasing the levels of serotonin, a neurotransmitter thought to have a positive influence on mood, sleep and eating.
Alternatively, evidence that Cognitive Behavioural Therapy, a treatment for anxiety and depression in general, can help seasonal depression and may prevent it recurring in future years.
Of course, the first step is to recognise you are affected. The combination of treatments and preventive measures best for tackling your symptoms will be highly individual and should be discussed with your doctor.
Whether you’re struck down by “seasonal blues” or SAD depression, the most important thing to remember is this: you don’t have to wait for winter to pass to start feeling better.