Might be SAD
By Henry Gerson, MD
As residents of America’s
north, we can expect to experience some “winter blues.” Each year, an estimated
25 percent of the population living in the higher latitudes of the United
States will suffer some form of seasonal depression. These individuals
generally cope with it well and recuperate completely in spring. But some
suffer with worse symptoms in a pattern that we have come to know as seasonal
affective disorder (SAD).
What is seasonal affective
SAD is a form of
depression that arises when the hours of daylight fall. It manifests in fall
and winter, with peak incidence in January and February; and it dissipates with
spring and its longer days.
What are the symptoms of
Sadness, low energy, loss
of interest in activities you typically enjoy, social isolation, cravings for
food that is high in carbohydrates, and weight gain. Symptoms generally rate
as bothersome but in some cases they can become severe and can interfere with
What causes SAD?
The theoretic cause of SAD
is reduced exposure to sunlight. Lower light exposure affects the neurological
processes linked to our circadian rhythm, which regulates the body’s internal
clock. This affects the body’s production of melatonin, the sleep hormone,
which increases during dark periods. People working in offices without windows
are at somewhat greater risk and Ithaca’s cloudy weather may certainly be a
contributing factor here.
What if I have the “winter
If you are mildly blue
this time of year but are basically functioning okay, you may have a mild
(sub-clinical) form of SAD. There are steps you can take that may help you feel
better. If feasible, spend increased time outside in the sun and use your home
or office space in such way to maximize your direct exposure to the sun though
windows. Moderate aerobic exercise and complex movement activities, such as
yoga, dance, or tai chi are general tonics for mood maintenance.
What if I feel
If you are bothered by
symptoms of SAD, you merit evaluation by your doctor or a mental health
professional. A good evaluation is important because similar symptoms could be
caused by other medical problems that include (among other less common causes)
hypothyroidism, hypoglycemia, infections, bipolar disorder or major depressive
disorder. A proper diagnosis is the first step to successful treatment and
One tragic consequence of
serious cases of seasonal affective disorder and other forms of depression can
be suicide. Any individual experiencing suicidal thoughts merits immediate
attention from a health care professional or evaluation in the nearest hospital
or clinic Emergency Room.
How is SAD treated?
A skilled clinician can
diagnose and effectively treat SAD. Light therapy with a specialized light box
for 30 to 90 minutes a day has been proven effective. Psychotherapy and
antidepressant medications can provide additional relief. With the proper help,
SAD can be manageable.
Dr. Gerson is a board
certified psychiatrist and member of the medical staff at Cayuga Medical Center
at Ithaca. He also develops community and corporate stress management and
mental wellness programming through the Cayuga Center for Healthy Living (CCHL),
located at the Island Health Center. To find out more about programs at CCHL