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Seasonal Affective Disorder: Real Thing?

Greetings from the surface of Hoth....I mean Chicago.  We've been busy here this winter breaking records for most days at or below zero degrees (26) and accumulating over 70 inches of snow.  After the 2 previous years being incredibly mild with low snowfalls, this winter was enough to drive the heartiest Chicagoan into a state of partial hibernation.  

How I've been commuting to work.
Seasonal Affective Disorder (SAD) came into the fray in 1984 as a marked change in mood related to seasonal changes, usually associated with winter but not always.  In the most recent iteration of the psychiatric diagnostic manual, DSM-5, SAD is no longer its own diagnosis but has become a qualifier for another mood disorder.  So now anxiety or depression can have a "with seasonal pattern" description.  

Some skepticism exists around the idea of seasonal changes in mood being classified as a disorder, and there are concerns that people will seek unnecessary treatments.  However, SAD can be severe, even leading to suicidal feelings and hospitalizations.  Symptoms include low mood, lack of energy, sleeping too much, social withdrawal, nausea, and overeating in the winter to increased anxiety and irritability, even manic symptoms, in the summer. Symptoms are caused by disruptions to circadian rhythm and/or changes to certain chemicals in the brain like serotonin and melatonin.  So what are the stats?
  • Rates of SAD vary depending on geography, with up to 10% of people in Alaska or New Hampshire but only 1.5% of people in Florida reporting symptoms.
  • Up to 14% of the US population experiences "subsyndromal" SAD, where the symptoms aren't severe enough to significantly affect the person's ability to function.
  • Women are four times more likely to be affected than men.
  • The average age for SAD to start is 23 years old.
  • SAD symptoms usually start around September and continue through March.
  • SAD tends to run in families.
So how is it treated?  The good news is bright light treatment is very effective.  The bad news is up to 69% of people report it to be inconvenient and struggle with doing it consistently.  The ideal light box contains white or green light and the person should sit a few feet in front of it (but not stare at it) for 30-60 minutes a day.  Other non-drug treatments that help are dawn simulators, which light up a person's bedroom gradually over an hour or so, and changing the ionization of the person's bedroom air.  A simple treatment is to simply spend more time outside on sunny days, fully recognizing that mother nature may not cooperate with this one.  These treatments should be given sufficient time to work before giving up on them - around 3 to 4 weeks.

How has your winter been in your neck of the woods?  Has it affected your mood?  Remember, only 3 months until summer!

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