Is it the Blues or Are You Really SAD?Nov 18, 2013
The holidays can be stressful and bring down anyone’s mood temporarily. But how do you know when you’ve got Seasonal Affective Disorder (SAD) and not just the Winter Blues? If your interest level drops, you prefer to be alone and you often pretend to be happy when you’re not, it might be SAD. Dr. Jason Hunziker from the University of Utah describes the symptoms of SAD and explains why it happens. He also discusses risk factors and potential treatments for SAD.
Dr. Jason Hunziker: Seasonal Affective Disorder is not the same as winter blues. Ignoring your symptoms could make the holiday season less than jolly.
I'm Jason Hunziker, Psychiatrist at the University of Utah. And that's what coming up on The Scope.
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Dr. Jason Hunziker: Often with the winter blues even though you're feeling down and sad, your emotions can change based on the environment that you are in. If you're watching a show that's funny or happy you can laugh, or if somebody tells you a joke you can get happy or it's fun to out with your friends and it's still fun to go skiing, but other times you're feeling down and stressed.
With seasonal affective disorder your mood doesn't generally change. Things don't make you happy anymore and you don't find pleasure in those things that you used to find pleasure in. You're interest level drops and you prefer to stay by yourself rather than be around other people. Often you feel you are pretending to be happy just so that others around you won't know how sad you really are. The difference is the symptoms last longer, they are more severe, and they impact all aspects of your life.
Sometimes the patients are able to go through the whole winter without any treatment and it doesn't cause much disruption. However because this is a sub-type of depression, it can lead to more significant symptoms and problems.
This is different than just feeling the so called winter blues or seasonal funk as some people will say, because it actually impairs your life and the life of those around you when you have this type of depression.
The way that this can affect others in your life is that many of these symptoms of depression include isolation, avoidance, irritability, poor sleep, overeating, weight gain, sadness, crying episodes, all of those things which can impact your family and friends and coworkers.
The cause of season affective disorder is still not clear; however there are a few theories on how this illness comes about. One of those theories is the biological clock or circadian rhythm suggesting that because of less sunlight in the fall and winter you are more likely to have moments of depression and sadness.
Another theory is that melatonin levels also change when seasons change and then based on your melatonin production or melatonin levels you will also experience changes in your mood pattern.
And lastly serotonin levels are always looked at when we're talking about depression and changes in the serotonin particularly around stressful times such as the holidays can increase people's sadness and difficulty in coping with stress.
The literature would suggest that women are at a much higher risk of this illness than men; however when men do get seasonal affective disorder their symptoms are much more severe and place them at higher risk of self harm and suicide.
Those of us who live further from the equator are also more at risk, mainly because the changes in the dark and light patterns in our seasons make us more at risk. If you have a family history of someone with depression or anxiety or substance use disorder, you are also more at risk of this sub-type of depression.
The most common age that we start to see seasonal affective disorder is sometime around 20 years old. The age range generally is between 20 and 40; however depression can come at any time during your life. And if you do notice the symptoms of seasonal affective disorder what are you going to do about that? I think the important thing is to go in and talk to your primary care doctor, your family practice doctor, your nurse practitioner or whoever your healthcare provider is so that you can get the appropriate care and treatment for this syndrome.
The important things that you should talk to your doctor about when you recognize that these symptoms may be more than just the winter blues include when these symptoms start every year. If you notice that every year in September you start to have trouble sleeping, eat more, have trouble moving around, that's important for your doctor to know.
Looking at your history and telling your doctor how long these symptoms have been present, if it lasts from September to December, or if you've ever been suicidal, or if you notice you're drinking more alcohol during that time, it's very important for your doctor to know. If you have family history about depression, bipolar disorder, other mental illness your doctor should also know that as well.
And then after this appointment your doctor may suggest to you several different types of treatment. One of the most commonly recommended treatments for seasonal affective disorder is light therapy. Even though this treatment is not FDA approved, there is a lot of anecdotal evidence that the light therapy will work for this illness. Light therapy is composed of a box that sits on your desk or that you can carry with you that essentially is bright light that shines into your eyes for anywhere from 15 minutes to 2 hours a day to help you with your mood symptoms; based on the theory that the change in the amount of light that we get every day this treatment will help improve your mood symptoms.
Additional therapy could be medication use including SSRI medications like Prozac or Paxil or Zoloft or other medications like Wellbutrin that can be taken during this period of time that you have your symptoms and then with the help of your doctor you could come off of those medicines for the remainder of the year.
The holiday can be very stressful, family parties, family get togethers, seeing people that you really don't want to be around can be stressful at this time and having someone you can go to and talk to about these symptoms is very beneficial for most patients.
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