Seasonal Affective Disorder? A white Christmas might help, says Priory expert
- Some adults have recurrent major depressive episodes linked to the seasons
- About 20% of people in the UK experience mildly debilitating symptoms of SAD or “winter blues”
- SAD itself is a complex depressive illness most likely triggered by lack of sunlight in winter, which affects levels of melatonin and serotonin in the brain controlling mood, sleep and appetite – our circadian rhythms
- A white Christmas could help some sufferers because snow reflects light
With British Summer Time at an end (on Sunday 27 October), a Priory expert offers her insight into - and advice for those affected by - Seasonal Affective Disorder, or so-called SAD syndrome.
Leading consultant psychiatrist Dr Natasha Bijlani, of Priory’s Roehampton Hospital in south-west London, says: “It is well recognised that SAD may be related to changes in the amount of daylight during the autumn and winter months, which can affect the levels of serotonin and melatonin in the brain that influence mood.”
Serotonin is a neurotransmitter, responsible for sending messages between nerve cells and producing responses. Melatonin is a neurotransmitter-like substance.
“During the night, the brain produces melatonin which contributes to making us feel drowsy and induces sleep. At daybreak, the effect of bright light, coupled with the natural rhythm of the brain, suppresses melatonin. In those susceptible to SAD, not enough light, on dull winter days, may lead to the development of symptoms of SAD,” says Dr Bijlani.
The symptoms can recur each winter and continue until spring. It’s not unusual for older people to notice symptoms for the first time if they start to spend more time indoors due to health or mobility problems.
Interestingly, a white Christmas could help sufferers. Dr Bijlani suggests that having snow on the ground may help those affected because “snow reflects what light there is and makes the darkness more bearable".
SAD is not thought to occur in countries around the equator. It is a problem in parts of the world where the body's natural daily rhythm is disturbed by dawn and dusk coming closer together in winter. Light therapy has been shown to be effective in up to 85% of SAD cases, says Dr Bijlani.
"People with SAD sometimes need four hours a day of special bright light at 10 times the intensity of ordinary lighting.
"It's a very simple treatment, but when used regularly throughout the winter months can take away the worst of the feelings."
She says those with SAD might experience low mood for most of the day; lethargy; a greater desire to sleep; tension and inability to tolerate stress; decreased interest in sex and physical contact; cravings for sugary food and those that are high in carbohydrates.
Those affected might feel a loss of self-esteem, with feelings of hopelessness or despair.
“SAD syndrome is different from other forms of depression in three main ways; you can usually predict its onset according to the seasons, patients report sensitivity to environmental light, and they respond favourably to bright light therapy,” says Dr Bijlani.
For some with mild symptoms, it can be alleviated by working in more brightly-lit areas and keeping blinds wide open during the day. Making time for exercise outdoors such as cycling to work or regular walks can be beneficial.
Dr Bijlani also recommends using a ‘lightbox’, starting in early autumn when the first symptoms appear, and doctors may prescribe selective serotonin reuptake inhibitors (SSRIs). These work by increasing the levels of serotonin.
Psychological treatment focusing around cognitive behaviour therapy – a talking therapy -can also be helpful.
About Priory Group
The Priory Group is the leading provider of behavioural care in the UK, caring for around 30,000 people a year for conditions including depression, anxiety, drug and alcohol addiction, eating disorders and self-harming. The Group is organised into four divisions – healthcare, education and children’s services, adult care and Middle East. The Priory Group is owned by NASDAQ-listed Acadia Healthcare, which is recognised as a global leader in behavioural health.