Seasonal Affective Disorder: Symptoms And Treatment

Seasonal Affective Disorder, or S.A.D. has its origin in the seasonal fluctuations of daylight time. As the daylight reduces, depression sets in, which can become severe enough to cause disturbance and affect health. Its treatment consists of light and supportive treatment, but only after the advice of medical expert. Awareness, holds the key for its management.
Seasonal Affective Disorder: Symptoms and Treatment
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If you are unable to make out why someone close to you becomes so unbearable and sad with the advent of winter every year, you may be a witness to Seasonal Affective Disorder, and the poor victim of this medical syndrome may be in need of expert medical advice. For people living in colder climates, it is important to be aware of this condition, its signs and symptoms, remedies and prevention....


SEASONAL AFFECTIVE DISORDER or S.A.D. usually refers to depression that is associated with winter, hence also known as WINTER DEPRESSION or SEASONAL AFFECTIVE DEPRESSION DISORDER.

S.A.D., Sunshine & Winter

Mostly observed

in climates with very little sunshine in winter, like Nordic countries, Northern United States and Ireland, this condition consists of depressive tendencies, excessive sleepiness associated with early awakening, lack of energy and initiative, loss of interest in life and surroundings and sometimes a craving for sweet and starchy foods. The condition probably results from absence of sufficient exposure to light during winter.

Light induces stimulation of nerves, particularly retina, while darkness leads to production of 'melatonin' by the pineal gland. Lack of sufficient exposure to light leads to excess Melatonin and lesser conversion of 'serotonin' to one of its active forms called 'N-Acetyl Serotonin'. These changes may induce depression.

Identifying Seasonal Affective Disorder

The primary characteristic of S.A.D. is its recurrent and repetitive association with winter. American Psychiatric Association prescribes four criteria that must be satisfied for a condition to be identified as S.A.D. The depressive episodes must occur at a particular time in the year i.e.. winter; they must remit at a particular time, usually end of winter; they should have happened for at least two years and these episodes must outnumber any other depressive episodes during a person's lifetime. If all the criteria are met, we are looking at a case of Seasonal Affective Disorder.

However, there are a larger number of persons that show milder depressive symptoms, usually lack of energy and fall in moods not sufficient to be labeled depression, even though they meet all the other criteria of S.A.D. including characteristic association with winter. Such cases are now labeled SUBSYNDROMAL SEASONAL AFFECTIVE DISORDER or S.S.A.D., considered a milder variant of S.A.D.

Treatment of Seasonal Affective Disorder

Three modalities of treatment are available for this


condition, light therapy, mediation with anti-depressants and ionized air reception, apart from supportive psychotherapy, to combat depression.

1. LIGHT THERAPY - It consists of exposing the affected person to bright light for upto an hour, through specially designed lamps with 2500 to 10000 lux intensity but minimal Ultra violet radiation to avoid injuries to eyes and skin. For maximum efficacy it is scheduled at dawn. It can be as effective as anti-depressants but many persons find it inconvenient.

2. MEDICATION WITH ANTI DEPRESSNATS - The best results are shown by treatment with 'selective serotonin reuptake inhibitors' or SSRI group of anti depressants like FLUOXETINE and SERTRALINE, which bring about significant improvements in about two third of patients.

3. NEGATIVE AIR IONIZATION THERAPY - This consists of release of charged air particles during the sleep environment. It is somewhat less effective than the other modes of treatment but may serve to enhance their efficacy if combined with them.

Outlook and Prevention of Seasonal Affective Disorder

S.A.D. is a product of seasonal variation, though genetic predisposition may have a role, as evidenced in Iceland where people show much lesser vulnerability to S.A.D. A patient afflicted with this condition, if shifted to a sunny climate, is likely to experience an improvement.

There are certain possible measures which can lessen the severity of episodes. Walking out in the open during daytime, even if it is an overcast chilling day, is likely to help. Houses and workplaces with windows that allow light to come unhindered may also help. Modern architecture that maximizes inflow and Sunlight and adequately supplements it in winter may be the final answer to this disorder.
 



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