Seasonal Affective Disorder (SAD)
The symptoms of depression are very common. Some people experience these only at times of stress, while others may experience them regularly at certain times of the year. Seasonal affective disorder (SAD) is characterized by recurrent episodes of depression, usually in winters, alternating with periods of normal or high mood the rest of the year.
It has been suggested that women are more likely to have this illness than men and that SAD is less likely in older individuals. SAD can also occur in children and adolescents, in which case the syndrome is usually first suspected by parents and teachers rather than the individual themselves.
For all depressive episodes, it is important to understand what stresses or triggers contribute to the depressive symptoms. In SAD, the seasonal variation in mood states is the key dimension to understand. Through recognition of the pattern of symptoms over time, developing a more targeted treatment plan is possible. Symptoms of SAD usually begin in early winters and subside around onset of summers. Depressions are usually mild to moderate, but they can be severe. Treatment planning needs to match the severity of the condition for the individual. Safety is the first consideration in all assessment of depression, as suicide can be a risk for more severe depressive symptoms.
Although some individuals do not necessarily show these symptoms, the characteristics of winter depression include oversleeping, daytime fatigue, carbohydrate craving and weight gain. Additionally, many people may experience other features of depression including decreased sexual interest, lethargy, hopelessness, suicidal thoughts, lack of interest in normal activities and decreased socialization.
A person with any of these symptoms should feel comfortable asking their doctors about SAD. A full medical evaluation of a person who is experiencing these symptoms for the first time should include a thorough physical examination.
Antidepressant medications have been found to be useful in treating people with SAD. Some people may require treatment of their symptoms only for the period of the year in which they experience symptoms. Other people may elect for year-round treatment. Psychotherapy—specifically types of psychotherapy with documented clinical efficacy in the treatment of depression including cognitive behavioral therapy (CBT)—is likely a useful additional option for some people with SAD.