SEasonal AFFECTIVE DISORDER

Well, its that time of year again. If you're feeing a little blue about winter approaching, read on.

1. What is seasonal affective disorder (SAD) and how is it different from winter blues or other types of depression?

• Seasonal affective disorder, also known as winter depression, is a lowering of mood that occurs in the winter months. As the nights draw in through autumn sufferers notice a lack of energy, low mood, and the desire to spend more time in bed – but the sleep is not refreshing. Carbohydrate cravings can become strong which, combined with tiredness, lead to reducing exercise and a spiral of low self-esteem and withdrawal.
• Seasonal affective disorder looks very similar to depression so some doctors do not consider it a separate diagnosis. It is more common in women and affects approximately 3% of the population. Winter blues is a milder form of the same condition.

2. Top tips for avoiding SAD?

• If you had SAD last winter or you might be prone to it, watch out for the signs as the days get shorter. If you are not sure, plot your daily mood on a chart.
• Try to keep exercising, just a little every day. Be careful not to push yourself too hard. Walk whenever you can during daylight hours as this gives both exercise and exposure to natural light. Even when it feels difficult, remind yourself that you are doing something positive for your body.
• Be mindful of carbohydrate cravings. Brown rice and sweet potato make good alternatives. Even if you succumb to cakes and chocolate, all is not lost. Keep up regular meals to maintain your nutritional intake and add a multi-vitamin. Try to limit the amount of alcohol and stay well hydrated with warm drinks like herbal teas.
• Keep your usual routine and social engagements as this helps maintain your sense of wellbeing. You may need to bring some wisdom to your social calendar to ensure you get good rests and don’t spread yourself too thinly.

3. What are the types of treatments available for this condition, and at what point would you advise people to seek treatment?

• Think holistically – tell your loved ones what to expect and how best to help you.
• Light boxes and dawn simulating alarm clocks that mimic natural light can also help.
• Some people find antidepressants beneficial, especially if they have depression at other times. For best results seek advice from your doctor sooner rather than later. Psychological therapy such as CBT (cognitive behavioural therapy) offers mood management strategies.

4. Is there a cure for this condition?

• Like depression, there is no cure, so the key is to get to know your individual pattern of symptoms and take control of how you manage them.
• Explore what works best for you and get the support you need from professionals, family and friends. Most importantly, remember to be kind to yourself – this condition is not your fault and you are doing your best. Remember that things will get better in the spring.

For more information see: Light therapy and the management of winter depression. John M. Eagles: Advances in Psychiatric Treatment May 2004, 10 (3) 233-240; DOI: 10.1192/apt.10.3.233