What is seasonal affective disorder (SAD), what causes it and how can it be treated?

Seasonal affective disorder (SAD) is a type of depression that has a seasonal pattern. It typically affects people during winter, hence why it is also sometimes known as “winter” depression, and improves during spring.

What causes seasonal affective disorder?

SAD’s causes aren’t fully understood, but it is generally linked to reduced exposure to sunlight during the autumn and winter months. The leading idea behind SAD is that a lack of sunlight disrupts activity in a part of the brain called the hypothalamus.

This can have three main effects: decreased production of the mood-boosting hormone serotonin, increased production of the sleep-inducing hormone melatonin and disruption of circadian rhythms, the body’s internal clocks.

SAD may also have a genetic element, as it seems to sometimes run in families.

What are the symptoms?

SAD’s symptoms can vary in severity from person to person. For some, they are severe and can significantly affect their daily activities.

Like other forms of depression, SAD can cause a persistent low mood and a lack of pleasure or interest in normal, everyday activities. Some people also feel irritable, anxious, stressed, despairing, guilty or worthless.

A lack of energy and feeling fatigued during the day are also common symptoms, which may result in people sleeping for longer than they ordinarily do or finding it difficult to get up in the morning.

Some people with SAD have an increased appetite and particularly crave carbohydrates, which may cause them to gain weight. They may also have difficulty concentrating and experience a reduced sex drive.

How is it treated?

A range of treatments are available for SAD. Due to its link with a lack of sunlight, one of the most common treatments is light therapy. This can take the form of regularly using a light box that produces bright, blue-enriched light. However, England’s National Institute for Health and Care Excellence – which provides recommendations for healthcare – says there isn’t clear evidence that light therapy is effective for SAD.

Lifestyle measures may also help, such as trying to get as much sunlight as possible, making living and work spaces light and airy, and sitting near windows when indoors. Exercising regularly, particularly outdoors during daylight, and trying to manage stress could also be effective.

Talking therapies, such as cognitive behavioural therapy, and antidepressants can be effective for depression, and may therefore also help with SAD.

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