Have The Winter Blues Got You Down?
Jan 20, 2014 - 2:53:37 PM
Dr. Samton explains that, "In most cases, seasonal affective disorder symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer. However, some people with the opposite pattern have symptoms that begin in spring or summer. In either case, symptoms may start out mild and become more severe as the season progresses."
The following are symptoms to look for to see if you are suffering from SAD
- Loss of energy
- Heavy, "leaden" feeling in the arms or legs
- Social withdrawal
- Loss of interest in activities you once enjoyed
- Appetite changes, especially a craving for foods high in carbohydrates
- Weight gain
- Difficulty concentrating
How is SAD treated?
Many people with SAD will find that their symptoms respond to a very specific treatment called bright light therapy. For people who are not severely depressed and are unable-or unwilling-to use antidepressant medications, light therapy may be the best initial treatment option says Dr. Samton.
Light therapy consists of regular, daily exposure to a "light box," which artificially simulates high-intensity sunlight. Practically, this means that a person will spend approximately 30 minutes sitting in front of this device shortly after they awaken in the morning. If patients do not improve, a second exposure of 20-30 minutes may be added in the early afternoon. Treatment usually continues from the time of year that a person's symptoms begin, such as in fall, on a daily basis throughout the winter months. Because light boxes are created to provide a specific type of light, they are expensive and may not be covered by insurance. Unfortunately, having lots of lamps in one's house and spending extra time outside is not as effective as this more expensive treatment.
Dr. Samton states that, "Side effects of light therapy are uncommon and usually reversible when the intensity of light therapy is decreased. The most commonly experienced side effects include irritability, eyestrain, headaches, nausea and fatigue."
Scientific studies have shown light therapy to be very effective when compared to placebo and as effective as antidepressants in many cases of non-severe SAD. Light therapy may also work faster than antidepressants for some people with notable effects beginning with in a few days of starting treatment. Other people may find that it takes a few weeks for light therapy to work, which can also be the case for most people who take antidepressant medications. Although not explicitly recommended, some people may elect for treatment with both light therapy and antidepressant medications. The combination of these treatments may be synergistic and a more robust way to address the symptoms of SAD.
In her practice Dr. Samton has found that antidepressant medications have been useful in treating people with SAD. Of the antidepressants, fluoxetine (Prozac) and bupropion (Wellbutrin) have been studied in the treatment of SAD and shown to be effective. The U.S. Food and Drug Administration (FDA) has approved these medications for treatment of major depressive disorder. Dr. Samton cautions that, "Any person considering treatment with an antidepressant medication should discuss the benefits and risks of treatment with their doctors."
Individuals with a predisposition to bipolar disorder should be more cautious in approaching treatment for SAD and depression in general. Light therapy, like antidepressant therapy has been associated with increased risk of experiencing a manic episode. The specifics of this are beyond the scope of this review and again, should be discussed with one's doctors.
Finally, a healthy lifestyle, including regular exercise, a good diet and a strong social network, is also likely to help you cope with SAD.
About Dr. Julia Samton
Dr. Julia Samton is Board Certified in Psychiatry and Neurology. Her unique training gives her the expertise to treat a diverse range of mood disorders. Her specialties include attention deficit disorder (ADHD), depression, anxiety, and other conditions related to psychological stress. Through an individualized combination of psychopharmacology, psychotherapy, and behavioral counseling, Dr. Samton is dedicated to helping her patients lead more satisfying lives. At Manhattan Neuropsychiatric, Dr. Samton also provides neuropsychological testing to diagnose and treat ADHD, guide career selection, and help optimize professional and academic achievement.
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