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In most cases, seasonal affective disorder symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer.

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Throughout the centuries, poets have described a sense of sadness, loss and lethargy that can accompany the shortening days of autumn and winter. Many cultures and religions have winter festivals associated with candles or fire.

Many of us notice tiredness, a bit of weight gain, difficulty getting out of bed and bouts of “the blues” as winter arrives.

Weather often affects people’s moods. Sunlight breaking through clouds can lift our spirits, while a dull; rainy day may make us feel a little gloomy. Like many people, you may experience cabin fever during the winter months. Or, you may tend to eat more or sleep more when the temperature drops. While noticeable, these shifts in mood generally do not affect our ability to cope with daily life.

Some people, however, are vulnerable to a type of depression that follows a seasonal pattern. For them, the shortening days of late autumn are the beginning of a type of clinical depression that can last until spring. This condition is called “seasonal affective disorder,” or SAD. Seasonal affective disorder is much more than the winter blahs.

While awareness of this mental condition has existed for more than 150 years, it was only recognised as a disorder in the early 1980s. Many people with SAD may not be aware that it exists or that help is available.

If you have seasonal affective disorder, winter’s short days and long nights may induce feelings of depression, lethargy, fatigue, cravings for sweets and starches, headaches, sleep problems and irritability. Seasonal affective disorder commonly begins in young adulthood and is more common in women. Symptoms are present only during a particular season and then go away. Most of the time, the signs and symptoms of SAD appear during winter and recede during spring and summer. Research suggests that between 2% and 3% of the general population may have SAD. Another 15% have a less severe experience described as the “winter blues.”

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The amount of sunlight you receive may be one cause of SAD. In some people, however, recurring episodes of depression may occur in the summer, rather than in the winter. Although there’s no cure for seasonal affective disorder, treatments can help you successfully manage the condition so that you can go through every season of the year in relative comfort.

SAD can be difficult to diagnose, since many of the symptoms are similar to those of other types of depression or bipolar disorder. Even physical conditions, such as thyroid problems, can look like depression. Generally, symptoms that recur for at least 2 consecutive winters, without any other explanation for the changes in mood and behaviour, can indicate the presence of SAD.

Symptoms may include change in appetite, in particular a craving for sweet or starchy foods; weight gain; decreased energy and fatigue; tendency to oversleep; difficulty concentrating; irritability; avoidance of social situations; and feelings of anxiety and despair. The symptoms of SAD generally disappear when spring arrives. For some people, this happens suddenly with a short time of heightened activity. For others, the effects of SAD gradually dissipate.

SAD can be a debilitating condition, preventing sufferers from functioning normally. It may affect their personal and professional lives, and seriously limit their potential. It is important to learn about the symptoms, and to know that there is treatment to help people with SAD live a productive life year-round.

There is effective treatment for SAD. Even people with severe symptoms can get rapid relief once they begin treatment.

People with mild symptoms can benefit from spending more time outdoors during the day and by arranging their environments so that they receive maximum sunlight. Trim tree branches that block light, for example, and keep curtains open during the day. Move furniture so that you sit near a window. Installing skylights and adding lamps can also help.

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Exercise relieves stress, builds energy and increases your mental and physical well-being. Build physical activity into your lifestyle before SAD symptoms take hold. If you exercise indoors, position yourself near a window. Make a habit of taking a daily noon-hour walk. The activity and increased exposure to natural light can raise your spirits.

Many people with SAD respond well to exposure to bright, artificial light. “Light therapy,” involves sitting beside a special fluorescent light box for several minutes day. A health care professional should be consulted before beginning light therapy. Bright white fluorescent light has been shown to reverse the winter depressive symptoms of SAD. Studies show between 50% and 80% of users showing essentially complete remission of symptoms, although the treatment needs to continue throughout the difficult season in order to maintain this benefit.

For people who are more severely affected by SAD, antidepressant medications are safe and effective in relieving symptoms. Counselling and therapy, especially short-term treatments such as cognitive-behavioural therapy, may also be helpful for winter depression.

The following suggestions may help you manage SAD:

  • Increase the amount of light in your home. Open blinds, add skylights and trim tree branches that block sunlight.
  • Get outside. Walk outdoors on sunny days, even during winter.
  • Exercise regularly. Physical exercise helps relieve stress and anxiety, which can accentuate SAD. Being more fit can make you feel better about yourself.
  • Find ways to relax. Learn how to better manage stress.
  • Create a sun-room. If possible, create a warm room with lots of light and green plants that you can sit and relax in.

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Signs and symptoms of SAD:

  • Depression
  • Anxiety
  • Loss of energy
  • Social withdrawal
  • Increased sleep and sleepiness
  • Loss of interest in activities you once enjoyed, including sex
  • Overeating, especially foods high in carbohydrates
  • Weight gain
  • Difficulty concentrating and processing information

Increasing your exposure to light, monitoring your diet, sleep patterns and exercise levels are important first steps. For those who are severely affected, devising a treatment plan with a health care professional consisting of light therapy, medication and cognitive-behavioural therapy may also be needed.

Author: By Janine Shamos as published in the African Journal of Psychiatry – http://ajop.co.za/Journals/August2007/August_9.pdf

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