Ask Dr Michelle: what is seasonal affective disorder and what can be done about it?
Seasonal affective disorder, or as you might have heard it called, ‘winter depression’, is something that 2 to 3 % of people living in the northern hemisphere suffer with. It is a type of depression where a person develops symptoms specifically during the winter months of the year. Here in Switzerland, this could be any time between October and April.
The exact reason why some people develop seasonal affective disorder is not certain. The main theory is that with the reduced amount of sunlight during the winter months, less light passes through a person’s eyes to stimulate the parts of their brain responsible for the production of some chemicals and hormones that impact mood, particularly serotonin and melatonin. There do also seem to be genetic factors involved.
Towards the end of September and during October, people with seasonal affective disorder usually start to have difficulty waking up in the mornings. They have less energy and may also find their appetite increases and they start to crave starchy foods.
As winter ‘proper’ starts, they will usually be sleeping more, find that their concentration is affected, that their libido is reduced and they may start to withdraw from family and friends.
Symptoms of depression and anxiety tend to be more prominent during the months of January and February, including persistently low mood or sadness with loss of interest in things that the person usually enjoys. As spring arrives, all of these symptoms start to lift and the person’s mood improves. It is this that distinguishes seasonal affective disorder from the more common form of depression.
If you think that you may have seasonal affective disorder, keeping a symptom diary and completing a “Seasonal Pattern Assessment Questionnaire” may be useful for you and your doctor and may help you to reach a diagnosis.
Treatment Options
There are treatment options out there. Firstly, talking about your symptoms and getting support from family and friends is essential. Self-help includes getting as much natural sunlight as possible. Living in the Lake Geneva region like I do, we often get prolonged periods of low cloud blocking sunlight on the plain during the winter months. If you get up above the cloud into the mountains and into the sunshine, then this can be really beneficial. Winter sun holidays may also be an option.
Getting regular exercise outside can also be an important part of treatment. This not only exposes you to sunlight but the physical activity itself can be mood boosting, as well as having the added benefits for your cardiovascular and bone health.
Most doctors will agree that light therapy can help to improve symptoms for people with seasonal affective disorder. Ordinary light bulbs are not strong enough so special light boxes specifically for treating seasonal affective disorder have been manufactured. However, treatment needs to be started in the autumn and the light box needs to be used every day.
Antidepressants and therapies such as cognitive behavioural therapy are other treatment options. There is a theory that starting these before winter arrives may be preventive.
So if you think you could have seasonal affective disorder, don’t suffer in silence: go and talk to your doctor. Get a diagnosis and start a treatment plan.
About the Author
Dr Michelle Wright is a British-trained General Practitioner and Executive Director of HealthFirst, providing dynamic First Aid Training and Health Education in English throughout Switzerland (www.healthfirst.ch). She also has a regular radio show about health on World Radio Switzerland (www.worldradio.ch/healthmatters).
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