HEALTHPLAN MAGAZINE

According to the NHS, estimates suggest that over 2 million people in the UK suffer with SAD, with that figure rising to an astonishing 12 million for Northern Europe. SAD, or Seasonal Affective Disorder, is a form of depression that occurs when access to natural sunlight is limited, generally occurring between Autumn and early Spring. This depression in its mild form is also known as 'winter depression' or the 'winter blues' and it varies in severity from mild to severely debilitating. SAD attacks all age groups including children, but is most frequently associated with 18-30 year olds.

Symptoms of SAD

The symptoms for SAD are very similar to those you would expect for other types of common depression. Sufferers 'feel gloomy' or have a low mood and may be more tearful than normal. However, symptoms vary in intensity, and some sufferers will find themselves with increasing levels of agitation or irritability, which manifests itself in anxiety and stress. Other symptoms include not taking an interest in anything, becoming indecisive and not being able to concentrate. There may be feelings of despair, guilt or worthlessness coupled with low self-esteem. Common side effects of SAD include that people eat more or less, feel tired or lethargic and have less interest in sex.

Causes of SAD

No-one is absolutely certain about the causes of Seasonal Affective Disorder, although common thinking links SAD to a lack of sunlight. When the sun shines people tend to feel more energetic, happy and healthy than they do when there is a lack of light. Shorter days and cloudy skies – a common feature of the winter season in the UK and Northern Europe generally – seem to affect the chemistry in the brain.

What is known for certain is that light stimulates a part of the brain known as the hypothalamus. The hypothalamus is important for regulating our sleep, appetite and mood. When the hypothalamus is starved of light, this affects a number of important functions. Firstly we create more melatonin. Melatonin is a hormone that is produced when it gets dark. When our brain is flooded with melatonin we like to go to sleep. Secondly, we produce less serotonin. Serotonin is our happy hormone and this is produced in the light. It keeps us awake and cheerful.

When does Seasonal Affective Disorder Occur?

A lack of sunlight affects our circadian rhythms. These are an essential part of human beings that have evolved within us since the dawn of mankind. Traditionally mankind has risen at dawn to attend to hunting, gathering, cooking, eating and digesting - and general survival - and then gone to sleep at dusk. With the advent of electric light during the late nineteenth and early twentieth centuries we have completely confused these rhythms. In this sense SAD is the archetypal modern illness. We no longer use light sources to timetable our days. We can stay up until the early hours or go out on the town – exposing ourselves to more light and excitement – which messes with our body clock and may explain why 18-30 years olds are the age group most affected.

According to Mind UK, our manipulation of light and dark, using electric light and our hours of socialisation, disrupt our body clocks and cause particular problems among night shift workers and those who travel a great deal.

Besides access to natural light, other triggers for SAD include anything that causes hormonal changes within the body, including childbirth and hysterectomy for example. SAD is also known to be more common among those who have a family history of depression, those who have had adverse childhood experiences and people who are naturally anxious, isolated or prefer their own company.

Treatments for SAD

There are a number of possible treatments for SAD. The most well-known of these is probably light therapy. The sufferer sits in front of or below a light box or lamp, which contains a very bright light. This light encourages the brain to produce less melatonin and more serotonin. Research studies have concluded that everyday use does improve symptoms. The few side effects include headaches, mild anxiety and irritability.

Antidepressants are also an option for the SAD sufferer with more severe symptoms. Selective Serotonin Reuptake Inhibitors (SSRI's) are used to increase serotonin levels. The tablets do take between 4 and 6 weeks to work and there can be some side effects including an upset stomach.

Another option worth considering is 'talking therapies' or Cognitive Behavioural Therapy (CBT). CBT works by asking you to consider how and why you react to situations. You then change your behaviour so that the things you do and come into contact with don't make you unhappy.

Self Help for Seasonal Affective Disorder

For milder symptoms of SAD there is a range of ways to help yourself. Get out and about in the sunlight as much as possible and keep your home environment light and airy. Sit near a window if you can. Try to manage your stress, eat a healthy diet and take regular exercise. As a final option, if you can afford it, take a winter sun holiday and escape from the blues altogether, although if you are living here in Spain, this will most likely not be necessary.

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