What is SAD? It is Seasonal Affective Disorder, a type of depression that occurs this time of year. Like many people, you may develop cabin fever during the winter months. Or you may find yourself eating more or sleeping more when the temperature drops and darkness comes earlier. While those are common and normal reactions to the changing seasons, people with SAD experience a much more serious reaction when summer shifts to fall and then to winter.

With SAD, fall’s short days and long nights may trigger feelings of depression, lethargy, fatigue and other problems. Don’t brush this off as simply a case of the “winter blues” that you have to suffer though on your own.

SAD is a type of depression, and it can severely impair your daily life. With an appropriate diagnosis and treatment, you don’t have to dread the dawning of each fall or winter.

SAD is a cyclic, seasonal condition. This means that signs and symptoms usually come back and go at the same time every year. Usually, SAD symptoms appear during late fall or early winter and go away during the warmer, sunnier days of spring and summer. The symptoms of winter-onset seasonal affective disorder include:

• depression

• hopelessness

• anxiety

• joss of energy

• social withdrawal

• oversleeping

• joss of interest in activities you once enjoyed

• appetite changes, especially a craving for foods high in carbohydrates

• weight gain

• difficulty concentrating and processing information  

The specific cause of SAD remains unknown. It is likely, as with many mental health conditions, that genetics, age and perhaps most importantly, the body’s natural chemical makeup, all play a role in developing SAD.

Specifically, the culprits may include:

• Circadian rhythm. Some researchers suspect that the reduced level of sunlight in fall and winter may disrupt the circadian rhythm in certain people. The circadian rhythm is a physiological process that helps regulate the body’s internal clock — letting you know when to sleep or wake. Disruption of this natural body clock may cause depression.

• Melatonin. Some researchers think SAD may be tied to melatonin, a sleep-related hormone that, in turn, has been linked to depression. The body’s production of melatonin usually increases during the long nights of winter.

• Serotonin. Other research suggests that a lack of serotonin, a natural brain chemical (neurotransmitter) that affects mood, may play a role. Reduced sunlight can cause a drop in serotonin, perhaps leading to depression.  

Most people experience some days when they feel down. But if you feel down for days at a time and you can’t seem to get motivated to do activities you normally enjoy, see your doctor. This is particularly important if you notice that your sleep patterns and appetite have changed — and certainly if you feel hopeless, think about suicide, or find yourself turning to alcohol for comfort or relaxation.

Take seasonal affective disorder seriously. Like its cousin depression, SAD can have serious complications if left untreated, including suicidal thoughts or behavior, social withdrawal, school or work problems, or substance abuse.

Like depression, it is often possible to successfully manage SAD. In milder cases, you may be able to take measures on your own, such as spending more time outdoors or sitting closer to bright windows while at home or in the office.

Other treatments for seasonal affective disorder include:

• Light therapy. Because increased sunlight improves symptoms, light therapy is often a main treatment for many people with seasonal affective disorder. Light therapy mimics outdoor light and causes a biochemical change in your brain that lifts your mood, relieving symptoms of seasonal affective disorder.

• Medications. Some people with seasonal affective disorder benefit from treatment with antidepressants or other psychiatric medications, especially if symptoms are severe.

• Psychotherapy. Although SAD is thought to be related to biochemical processes, your mood and behavior also can contribute to symptoms. Psychotherapy can help you identify and change negative thoughts and behaviors that may be making you feel worse.

There’s no known way to prevent the development of SAD. However, if you take steps early on to manage symptoms, you may be able to prevent them from getting worse over time.

Here are tips to help you manage the condition, in conjunction with your doctor or mental health provider:

• Stick to your treatment plan. Take medications as directed and attend therapy appointments as scheduled.

• Let there be light. Make your home sunnier and brighter. Open blinds, add skylights and trim tree branches that block sunlight.

• Get out. Get outdoors on sunny days, even during winter.

• Exercise regularly. Physical exercise helps relieve stress and anxiety, both of which can increase SAD symptoms.

• Take care of yourself. Get enough rest, eat a balanced diet and take time to relax. Don’t turn to alcohol or unprescribed drugs for relief.

• Practice stress management. Learn how to better manage stress. Unmanaged stress can lead to depression, overeating, or other unhealthy thoughts and behaviors.

• Socialize. Stay connected with people you enjoy being around. They can offer support, a shoulder to cry on or a joke to give you a little boost.

• Take a trip. If possible, take winter vacations in sunny, warm locations.

You don’t have to be SAD, just because the seasons change.

Sherry Mullenix (J.D., R.N.) co-owns The Pharmacy in Mount Olive with her husband, Steve Mullenix (R.Ph). They can be reached at 631-1201.