Not Just Sad, but SAD

I think it is fair to say that the majority of us get a bit sad when the summer ends and the fall begins. Although it is a beautiful time of year, there is the realization that the beautiful colors of the flowers and trees will soon be gone, replaced by cold and sometimes gloomy days. The days also get shorter. There is often less physical and social activity as people tend to stay indoors. The natural sunlight diminishes rapidly, especially after daylight saving.

This change in season can actually trigger a depression in some people that is called Seasonal Affective Disorder or SAD. This is a well documented mental health problem and is presumptively caused by lack of daylight. Two theories on what cause SAD that go with this are that people with SAD have too much Melatonin and not enough Serotonin.

Serotonin is a neurotransmitter that is vital in balancing sleep, appetite and mood. Melatonin is a hormone that also can affect mood and sleep patterns. People at higher risk for SAD include females, people that live in areas further from the equator (therefore with more drastic change in sunlight with seasonal changes), and people with a family history of depression.

The common symptoms that occur with SAD include depression, hopelessness and loss of interest, lack of energy; sometimes to a point of the body feeling too heavy to move, social isolation, increased need for sleep (some call it hibernating), increased appetite; usually for foods high in carbohydrates, weight gain, and suicidal thoughts.

There is a less common form of SAD that can occur in the spring or early summer that is marked by insomnia, agitation, anxiety, weight loss and possible hypomania. That is not for the scope of this article.

How do you know if you suffer from SAD and not just “end of the summer blues”? I always tell people that the best way to determine that is to first look at their history and if they have noticed a significant mood change at the same time each year (end of summer, early fall) for at least two years, they likely have it, especially if the depression consistently clears as the seasons advance toward spring. The best way to follow the severity is to document moods and how your life is affected by feeling depressed, especially following sleep, appetite, weight, energy, work productivity, and social activity. Treatment should begin when it is clear that a person’s life is adversely affected in any way from the SAD symptoms.

The common treatments include light therapy and antidepressants (most people try Wellbutrin XL first). I will not go into the details of the options in this article, except to say that you should discuss these options at length with your provider including risks and side effects. You deserve and should expect thorough explanations and support and education on SAD and the way to treat it.

On top of medication and light therapy, things you can do that are safe and should help include regular exercise (as difficult as that is to do with SAD, it is so helpful). Additionally, getting outside and being exposed to sunlight as much as possible is always a benefit. With that, try to keep shades open in your house and at work. Try to be social. Make a point of being with friends and loved ones. In other words, try to do the opposite of what SAD causes you to do.

Some people also get benefits from therapy for support and coping skills, including stress management and relaxation techniques. There are some natural, over the counter supplements that may be tried, including SAMe and Melatonin, but I would recommend you discuss these with your health care provider before trying them.

SAD is a very real thing that can cause a person to feel very bad. If you are suspicious that you suffer from it, don’t just write your feelings off as “sad”, but consider SAD and remember that it is not a normal way to feel and you do not have to feel that way.