Seasonal Affective Disorder
Published: 08 July 2018
Published: 08 July 2018
If you think of Winter, you may at first associate it with the flu, colds, or respiratory complications such as pneumonia. However, in the cooler months, seasonal affective disorder (SAD) may be often overlooked as a simple case of the ‘winter blues’ (Healthdirect 2016).
SAD is a mood disorder that takes trend in the form of a seasonal depression, each year (Healthdirect 2016), with the condition generally concluding in Spring or Summer (the warmer seasons) (Healthdirect 2016). However, some people can even suffer SAD through Spring and Summer too (MayoClinic 2017).
Some of the SAD signs to watch for in Autumn and Winter can include:
(Healthdirect 2016; MayoClinic 2017)
Some of the SAD signs to watch for in Spring and Summer:
Nussbaumer et al. (2015) state that many people living in northern latitudes commonly experience a ‘Winter blues’. However, for some people, these ‘Winter blues’ eventuate into clinical depression.
Strikingly, up to 75% of people with seasonal affective disorder are female (Kaminski-Hartenthaler et al. 2015).
For most (up to 2 in 3) people with Winter-SAD, they can expect to suffer it every year (Fornasier et al. 2015; Nussbaumer et al. 2015). Forneris et al. (2015) acknowledge that one benefit of this is that its predictability could help to implement prevention or intervention strategies.
According to research by Forneris et al. (2015) ‘the prevalence of SAD ranges from 1.5% to 9%’, with the variance due to a difference in geographical latitude.
Living further away from the equator appears to increase the risk of SAD. This is quite possibly due to the limited sunlight in Winter months and longer Summer days (MayoClinic 2017).
Unfortunately, there is currently insufficient evidence to conclude whether psychological therapy is effective in preventing SAD (Forneris et al. 2015).
Similarly, there is not enough high-quality research (e.g. RCTs) to compare the effectiveness of psychological interventions (e.g. CBT, behaviour therapy) to other treatments such as light therapy, melatonin treatment, agomelatine, lifestyle modifications, placebos and second-generation antidepressants (SGAs) (Fornasier et al. 2015).
Light therapy is the act of exposing a person to light to simulate different times of day in the hope to manipulate the body clock and, in turn other body functions (Cunnington 2015).
Examples of light therapy can include bright white light and dawn simulation (Terman, 2005 cited in Nussbaumer et al. 2015).
As there is evidence to suggest disruptions to sleep and circadian rhythms can contribute to mood disorders (Srinivasan et al. 2015), the idea behind using light therapy to treat seasonal affective disorder is that it might manipulate brain chemicals to improve mood (MayoClinic 2016).
According to a systematic review by Nussbaumer et al. (2015), only limited evidence was found in support of light therapy as an effective tool in preventing SAD.
According to Srinivasan et al. (2012), disruptions to sleep and circadian rhythms, such as ‘Malfunctioning of the SCN–pineal–melatonin link’, can contribute to mood disorders (e.g. SAD).
‘Melatonin is essential for the control of mood and behaviour’, and it is involved in rhythm-regulation and sleep regulation (Srinivasan et al. 2012).
Agomelatine is a ‘melatonergic antidepressant’ that Srinivasan et al. state is also effective for treating mood disorders (e.g. SAD).
However, Kaminski-Hartenthaler et al. (2015) found in their systematic review that there is not enough evidence to determine whether or not melatonin or agomelatine are able to prevent SAD or improve outcomes for clients. Thereby, more high quality RCTs are necessary to investigate their effects, particularly in comparison to other SAD therapies (e.g. light therapy, psychological therapy) (Kaminski-Hartenthaler et al. 2015).
It is proposed that other second-generation antidepressants can be used in the treatment of Autumn/Winter SAD and may help to prevent depression (Gartlehner et al. 2015). However, research by Gartlehner et al. (2015) and Morgan et al. (2015) state that to confidently conclude SGAs should be used in preventing SAD, more high-quality research on this topic would be needed.
Better Health Channel (n.d.) reinforces that seasonal affective disorder is uncommon in Australia, and mostly suffered in colder-climate-areas of the Northern Hemisphere who experience shorter days with longer durations of darkness, however, if you are experiencing any extended feelings of sadness, Better Health Channel recommends the following resources to reach out to:
Madeline Gilkes, CNS, RN, is a <a href="https://www.lifestylemedicine.org.au/fellows" target="_blank">Fellow of the Australasian Society of Lifestyle Medicine</a>. She focussed her master of healthcare leadership research project on health coaching for long-term weight loss in obese adults. In recent years, Madeline has found a passion for preventative nursing, transitioning from leadership roles (CNS Gerontology & Education, Clinical Facilitator) in hospital settings to primary healthcare nursing. Madeline’s vision is to implement lifestyle medicine to prevent and treat chronic conditions. Her brief research proposal for her PhD application involves Lifestyle Medicine for Type 2 Diabetes Mellitus. Madeline is working towards Credentialled Diabetes Educator (CDE) status and primarily works in the role of Head of Nursing. Madeline’s philosophy focuses on using humanistic management, adult learning theories/evidence and self-efficacy theories and interventions to promote positive learning environments. In addition to her Master of Healthcare Leadership, Madeline has a Graduate Certificate in Diabetes Education & Management, Graduate Certificate in Adult & Vocational Education, Graduate Certificate of Aged Care Nursing, and a Bachelor of Nursing. See Educator Profile