Seasonal affective disorder (SAD) treatment

Light therapy

This is an effective treatment method for SAD, that has been found to result in positive outcomes for around eight in ten SAD patients. Light therapy consists of you being exposed on a daily basis to a very bright light, emitted from a specially designed light box.

The light that is used in light therapy is around ten times brighter than the lights that you may be exposed to at home or in work such as standard light bulbs or lamps, and is designed to mimic natural daylight. However, the light will not harm your eyes in the same way that ultraviolet (UV) light from the sun does.

Many people with SAD notice a significant improvement in their symptoms less than one week after starting light therapy, and this form of therapy should be continued on a daily basis until natural daylight hours become longer, with the onset of spring.

Antidepressant medication

Selective serotonin reuptake inhibitors (SSRIs), a widely used form of non-sedative antidepressant medication, have been found to be effective in treating SAD.

Example SSRIs that can be used to treat SAD include sertraline (Lustral), paroxetine (Seroxat), fluoxetine (Prozac) and citalopram (Celexa). Antidepressants can help with the depressive symptoms of SAD and work well alongside light therapy.

If antidepressants are prescribed to help to alleviate your symptoms of SAD, you should only need to take them during the autumn and winter seasons.

Psychotherapy

Psychotherapy, counselling and the widely used psychotherapeutic method, cognitive behavioural therapy (CBT), have been found to be highly beneficial treatment methods for those suffering with SAD.

CBT works according to the principle that mental health conditions, including SAD, may be triggered and intensified by a series of unhealthy thought patterns.

For example, when something unfortunate happens, those suffering from SAD and depression tend to blame themselves, but when a positive experience happens, they may tell themselves that it is just a coincidence, or that they’ve just been lucky.

CBT will help you to think in a more balanced way and challenges the negative assumptions and beliefs that you hold about your life.

By tackling these negative thought patterns, CBT will help you to identify and change any aspects of your behaviour that may be causing or exacerbating your symptoms of SAD.

SAD is a specific form of depression, and a formally recognised mental health condition. The symptoms of SAD, including persistent low moods, a lack of energy, and poor concentration, are typically experienced during the winter months when people are exposed to less natural daylight.  

It is estimated that SAD affects around half a million people in the UK, where there are more weather changes and varying amounts of daylight hours throughout the year, than in many other countries.

Notably, the majority of people with SAD are found throughout the northern and southern hemispheres (places that experience longer hours of darkness during winter), and SAD is extremely rare in those living near the equator, where daylight hours are reliably long and bright.

Although it can happen at any stage in life, SAD has been found to occur more frequently in people aged between 18 and 30, and is more common amongst women. In addition, if you already suffer from depression, SAD can increase the existing depression symptoms that you experience throughout the rest of the year, thus making it imperative that you seek help as early as possible.

The signs and symptoms of SAD can vary between people, and are similar to the symptoms that are associated with other types of depression. You may receive a diagnosis of SAD if your symptoms have been present for three or more consecutive years during autumn and winter. The most common symptoms of SAD include:

• Experiencing persistent low moods and feelings of sadness, most of the time
• Irritability
• Finding that you need to sleep more than usual
• Loss of interest in everyday activities and hobbies that you once enjoyed
• Lethargy
• Craving of carbohydrates resulting in weight gain
• Anxiety
• Mood swings
• Weakened immune system during winter and autumn

The symptoms of SAD tend to disappear with the onset of spring, and may even be accompanied by a short period of hypomania - a mild form of mania that is characterised by elation and hyperactivity. The symptoms of SAD may disappear suddenly, or this could be a more gradual process, depending on the levels of sunlight that you are exposed to during early spring.

Some research suggests that melatonin, a hormone in your brain that is known to regulate sleep and wake patterns, as well as being linked to levels of daylight, is responsible for causing the symptoms of SAD. However, it has also been found that medicines that are aimed at slowing the release of melatonin do not prevent the symptoms of SAD. As such, this suggests that melatonin is not the only factor contributing to the condition.

Research indicates that SAD is caused by a chemical imbalance in the areas of the brain that are involved in controlling mood, appetite and sleep. This imbalance is ultimately the result of the lack of natural light that you are exposed to during the shortened daylight hours of autumn and winter.

Your body’s reaction to this lack of natural light involves a reduction in the levels of serotonin in your brain, a chemical that is widely known as being one of the brain’s ‘happy chemicals’ and which helps to create positive sensations. Serotonin is replaced instead with increased amounts of melatonin, which slows down your body clock and negatively affects your sleeping patterns and mood.

The causes of SAD include:

Poor sleep patterns

Your body’s internal clock uses sunlight as a guide to when you should wake up or go to sleep, with the lower levels of sunlight during winter confusing your usual cycle and leading to symptoms of SAD.

Low serotonin levels

Serotonin levels help your mood, appetite and sleep to remain stable; a lack of sunlight may reduce the amounts of serotonin in the brain and is therefore linked to low mood, appetite changes, sleep disturbances and SAD.

High melatonin levels

Melatonin is produced at night to make you feel sleepy, and may be produced in higher than normal levels if you have SAD.

If you think that you may be suffering with SAD, and the thought of the clocks going back at the end of October fills you with dread, there are several simple steps that you can take to help to reduce the symptoms of this condition.

Finding natural light at home and in work

Ensuring that your work and living environment benefit from as much natural light as possible can help to lift your mood during the day. If you are at work, you may be able to request a seat close to a window for maximum light exposure, and take breaks outside if possible to avoid spending all day under the glow of manufactured lighting.    

Exercising and eating well

If you tend to exercise in the gym, try and shift your cardio workout to the outdoors if it’s light during your workout. In addition, when you combine endorphin-releasing outdoor exercise with fruit and vegetables containing a variety of vitamins, symptoms of depression can be reduced and your mood can be improved.

Avoid sleeping too much

While it can be tempting to sleep in at weekends after a week at work, and the cold, dark nights mean that going to bed early is an appealing option, this can leave you with limited light exposure. It’s important to remember that if you have SAD, your brain may produce more melatonin which makes you want to sleep more, so make sure your eyes are exposed to as much daylight as possible.

Make time for hobbies and socialising

Maintaining hobbies and seeing friends and family can be more difficult during winter when staying indoors seems more appealing, but socialising and planning regular activities can help to provide daily structure and lift your mood.