Birds migrate, bears hibernate, but in the winter, we stick it out. Yet not surprisingly, the cold, the snow and the short days and long nights do take their toll. Call it the winter blues – certainly after all the snow and sleet we’ve had, it’s understandable.
But for some people, the winter blues are a serious, life-altering problem. Dr. Linda Carpenter, chief of Butler Hospital’s Mood Disorders Program and an associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University, answered questions about seasonal affective disorder (SAD).
PBN: What is seasonal affective disorder, and how prevalent is it?
CARPENTER: It is a type of major depression that comes on with a seasonal pattern, typically with symptoms starting in fall or winter. It affects between 1 and 3 percent of all adults and is more common in women than men. Major depression is characterized by poor mood, low energy, difficulty concentrating, appetite and sleep disturbances, and negative thinking. Patients with SAD have symptoms of major depression, and they also tend to have a specific pattern characterized by increased sleepiness/napping, increased appetite and weight gain with carbohydrate craving.
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PBN: What kind of impact does SAD have on people’s ability to function?
CARPENTER: Because symptoms of SAD include impairments in mood, energy and thinking, the disorder may cause a person to have trouble working, socializing or being physically active. Major depression in general leads to decreased enjoyment in life and decreased overall functioning in all spheres. When depression is very severe, poor self-esteem, guilty feelings and hopelessness can lead to thoughts of death or suicide.
PBN: What causes SAD?
CARPENTER: While the exact cause is not known, there appears to be some genetic vulnerability – one is more vulnerable to develop SAD if one has biological family members who have suffered with it. There is some evidence that disregulation of neurotransmitter chemicals in the brain, such as serotonin and melatonin, are involved in the disorder. Studies of the functioning of retina (in the eyes) of patients with SAD suggest they may have a diminished sensitivity to light.
PBN: A lot of people feel a bit down when winter hits. How do you differentiate between that and SAD?
CARPENTER: Many individuals will experience mild forms of seasonal change in mood and energy. Winter blues are common. When the symptoms become significant enough to cause impairment in functioning, to impact one’s daily life in a meaningful way, it is possible that a diagnosis of SAD is appropriate. Also, there are specific symptoms that need to be present consistently for at least two weeks to meet diagnostic criteria for a major depressive episode.
PBN: How do you treat SAD?
CARPENTER: Phototherapy – treatment each morning with bright light that simulates sunlight – has been shown to be a beneficial treatment for more than half of patients. A number of antidepressant treatments have demonstrated themselves to be safe and useful as well. … Butler Hospital offers treatment for all forms of major depression, and patient evaluation by a Butler clinician can help those with SAD or other mental health symptoms determine which services or treatments will best serve them.
