Are you feeling SAD?

Published: Saturday 8th November 2014 by The News Editor

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Now that the days are shorter and darker, many people understandably feel a little miserable. But an estimated half a million of them aren’t just a little low – they have seasonal affective disorder.

And that means their malaise could last from around now until April, when spring is in the air again.

For up to 2% of the UK population, seasonal affective disorder (SAD) is a seriously disabling psychiatric disorder that prevents them from functioning normally without medical treatment. Symptoms can include depression, extreme lethargy, sleep problems, overeating, anxiety, social problems, mood changes and loss of libido.

For a further 20%, it’s a more mild, but still somewhat debilitating, called subsyndromal SAD or, more commonly, “winter blues”. With this milder form of the condition, while there may be symptoms such as low mood, and sleep and eating problems, full-blown depression and anxiety tend to be absent or mild.

A seasonal trend

Symptoms usually recur regularly each winter, starting between September and November and continuing until March or April. Prolonged periods of low light at other times of the year may also trigger symptoms.

A diagnosis can be made after three or more consecutive winters of symptoms, which disappear in spring, either suddenly with a few weeks of hyperactivity, or gradually, depending on the intensity of sunlight in the spring and early summer.

While the exact cause of SAD is still unknown, it’s thought to be linked to t he hypothalamus, which controls mood, sleep and appetite. In people with SAD, lack of sunlight may prevent the hypothalamus from working properly, increasing the production of the hormone melatonin, which helps you sleep, and reducing the production of the hormone serotonin, a neurotransmitter thought to contribute to feelings of wellbeing and happiness.

Seeing the light

Consultant psychiatrist Dr Aarohee Desai-Gupta says SAD patients tend to be extremely sleepy and lethargic with an excessive appetite, compared to people with typical depression, who lack an appetite and often can’t sleep.

While antidepressants and cognitive behavioural therapy (CBT) can help, she says bright light also works well. Light therapy, involving daily exposure to very bright light, at least 10 times the intensity of normal domestic lighting, has been shown to help in up to 85% of diagnosed SAD cases.

“One of the theories about the cause of SAD is a change in circadian rhythms,” explains Dr Desai-Gupta. “The body’s internal clock fails to adjust to the change in the length of the day and reduced light, and as a result, the serotonin and melatonin levels in the brain change.

“So exposure to bright light in the dark hours may help the body clock get back to normal, and thus reduce some of the SAD symptoms.”

Hope on the horizon

Jenny Scott-Thompson, spokesperson for the Seasonal Affective Disorder Association (SADA), says her condition has improved enormously since she started having light therapy.

“The light box has made a really big difference. It took a few days to feel the effect, but suddenly I had energy again.”

Light boxes cost around £100, and the affected person sits in front of them and can work or read as normal. The length of time a light box is used varies from person to person, but can be as little as half an hour once or twice a day.

Scott-Thompson advises anyone who thinks they may suffer from SAD to talk to their GP, particularly if they’re depressed as well, and suggests: “Most reputable light box companies offer a free trial, so you can borrow one for a few weeks and see if you notice a difference.”

Copyright Press Association 2014

Published: Saturday 8th November 2014 by The News Editor

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