Biology 103
2000 Third Web Report
On Serendip

Seasonal Affective Disorder or (SAD) refers to mood changes that include the symptoms: depression, hypersomnia, hyperphagia (increase of food consumption and/or appetite), and weight gain. (1). These symptoms are atypical symptoms of clinical depression in which there is a loss of sleep and appetite in some cases.

One should note already that the symptoms of SAD are not typical for depression but include others as well. Hence the condition is not called Seasonal Depression Disorder, but Seasonal Affective Disorder because it can encompass a vast range of symptoms, only some of which can also be depression symptoms. Another interesting fact is that this disorder can and does appear in the summer months and is not confined to wintertime. Depending of the time of year the symptoms can vary and as is always the case, the symptoms depend on the individual and his/her family history. For a long time, people thought that SAD occurred only in the winter months, resulting from a lack of sunlight, and was treatable with special lights. After beginning research into the field and examining different geographic populations, SAD appears to be more complicated than was originally thought.

Some of the first people to pioneer the research into SAD were a group of psychiatrists who published an article in 1984 titled, "Seasonal Affective Disorder: A description of the Syndrome and Preliminary Findings with Light Therapy" (1).. This article helped to define SAD and since that time there has been continuing research on this disorder. As mention earlier, the symptoms of SAD have been recognized as including not only depression, but weight gain, hyperinsomnia, and hyperphagia as well. Doctors are looking increasingly into patters in people with SAD and other forms of depression. One factor they are hoping to further explore and learn from are possible depressions that may fall in family histories. One discovery that has been made thus far is that there appears to be a relationship between patients with SAD and a history of alcoholism in their families. (1).

The geographic research into SAD has included a series of case studies in different parts of the world such as Alaska, Switzerland, Italy, and Canada. The results of these studies included the statistics that in Canada, 20% of people diagnosed with clinical depression also displayed symptoms of SAD showing that there might be a correlation between SAD and other forms of depression. In Italy, 9.7% of patients with mood disorders occurred in a seasonal pattern. (1).. The American Academy of Family Physicians has specific guidelines and diagnostic criteria to test whether or not you might have SAD. To see the specifics, you should visit their web site (2)..

Some useful facts about SAD that might seem surprising are that 4-6% of the population with SAD experience winter depression symptoms, and women with SAD outnumber men with SAD 4 to1 (2). The average age when the symptoms reach a peak is 23, but children can have SAD and supposedly, the symptoms decrease with age as well.

Although SAD has become recognized as a serious form of depression in itself, many doctors see the distinction between SAD, severe forms of SAD, and other serious forms of depression to be crucial in the health and diagnosis of the patient. In other words, if someone is depressed during the wintertime, it does not mean that they definitely have SAD and other forms of depression should be considered before treatment. Although there is some overlap between symptoms of SAD and other mood disorders, one must be careful when making a diagnosis and seeking treatment.

Perhaps one of the reasons why doctors are cautious in these respects is because the treatments for some types of SAD are quite unique to this mood disorder. For example, the typical treatment for people with winter SAD is a form of Phototherapy in which a 10,000-lux light box is directed toward the patients eyes. People usually start with 10-15 minute sessions at first and then increase the times(2) . The positive effects of phototherapy should show within the first few days to several weeks. The most common treatment for Summer SAD consist of anti-depressants depending on the symptoms and the severity of the disorder. (2)

Phototherapy has received negative press because of the possible side effects that one might experience. These include, photophobia, headaches, fatigue, irritability, hypomania, insomnia, and the possibility of retinal damage (*note that there is little evidence to support this last side effect) (2) . It is important to realize that not all cases of the so called "winter-time blues" are the only definition of seasonal affective disorder. As mentioned repeatedly by the sources I located at on the web, the normal symptoms of winter time such as increased sleepiness, mild weight gain etc are affect people with SAD to the extent these symptoms can interfere greatly with the person's daily life. I have even found a few sources that describe the occasional use of Lithium to treat someone with a sever case of SAD (3). This alone should show how serious this illness can be at its worst.

Some other important facts regarding SAD that one should be aware are that people who spend a lot of time in an office with poor lighting might suffer from similar symptoms as someone with SAD. The lack of sunlight and/or exposure to poor lighting might cause someone to have some of the similar symptoms as a person with SAD. As far as non phototherapy treatment for SAD is concerned doctors recommend that people could take walks outside for at least an hour everyday, exercise, and eat a balanced diet (3). There also seems to be an emphasis on the results people have found using anti-depressants to treat SAD. But, just in case one decides to buy the lights used for treatment, they cost between $250 and $500 and they are usually not covered by insurance. (3) The point of this paper is that although everyone feels a little down in the wintertime when it is always dark outside, there can be symptoms that interfere with your life greatly. You should not have to wait for the sun to come out again. Life is too short. On the other hand, one should not have to spend 500+ dollars on lights. It sounds that the start of treatment for any kind of depression should include living a safe and healthy lifestyle.

WWW Sources

2) American Family Physicians page ,

3) The Northern County Psychiatric Associates ,

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