As the warmth of the winter holidays fades, leaving a steady march of cold months and oftentimes dreary weather ahead, a common depressive disorder stands ready to rear its head: seasonal affective disorder, or SAD.
“Seasonal affective disorder is a particular form of depression characterized by onset during a particular season of the year,” said William Hale, a Lawrence Memorial Hospital psychiatrist from the Overland Park area. “For most people who have it, it’s sometime in the darker half of the year.”
According to American Family Physician (aafp.org), 4 to 6 percent of the population suffer from clinical SAD annually, with 10 to 20 percent experiencing mild SAD symptoms. Fortunately, according to Hale, the phenomenon is well-known and treatable.
NAMING THE ENEMY
No one group of people are more susceptible to SAD, Hale said.
“If there is, it would be people who have depression in general, but I don’t think there is a particular group that is more likely,” Hale said.
Though a body of research on the cause of SAD is just now accumulating in the 21st century, the suspected factors ring with common sense, Hale said.
“It’s been more or less clearly demonstrated that lack of light is the main cause of SAD,” Hale said. “Other factors are cold weather, being indoors more, and not being able to get as much exercise in the winter as in the summers — it makes common sense that these contribute to depression.”
The holiday season — both during and after — doesn’t help matters either, Hale noted.
“Certainly, the holidays are hard for a certain percentage of people, and there may be another subset of people for whom the end of the holidays bring some sadness,” he said.
According to Hale, symptoms of the disorder mirror those of depression generally, with a tendency toward lethargy.
“Particularly for seasonal affective disorder, the typical symptoms are sleeping excessively, appetite changes — in the direction of increased appetite and cravings for high carbohydrate foods — weight gain, impaired concentration and low energy or tiredness,” he said.
LIGHT THERAPY PART OF TREATMENT
The first step toward breaking free of SAD is seeking help, Hale said.
“If a person is experiencing depression that is more than just sadness from ordinary life circumstances, it would be good to see either a physician, psychologist, or a psychiatrist to have some assessment,” he said. “In terms of treatments, the same treatments that are effective for nonseasonal depression are also beneficial for seasonal depression.”
Though psychological treatment for SAD can include psychotherapy or antidepressant medication, emerging medical movements are beginning to also treat the disorder through other, less invasive means.
“For seasonal depression, light therapy is specifically helpful,” Hale said. “Light therapy consists of exposure to a very bright light source for 30 minutes when one first wakes up in the morning.
“The light has to be brighter than pretty much any standard light fixture is in a person’s home or office. Typically, a person buys what is commonly referred to as a “brightlight” — lights that are made for the purpose of light therapy.”
Light therapy often fits into patient’s daily routines, Hale said.
“You don’t need to look into the light for 30 minutes, you just need to be facing it,” he said. “You could be reading or eating breakfast or shaving or what have you; as long as you are facing it and you are close enough to it. You have to be, ideally, 18 inches from the light.”
The therapy is not limited to those with diagnosed SAD, Hale said.
“Most people think light therapy is just for those with seasonal depression, but it turns out that the research on light therapy shows that it’s just as good for ordinary, nonseasonal depression as it is for seasonal depression,” he said. “I was surprised when I looked at the research several years ago and discovered that.”
MOVEMENT AND STILLNESS
A low cost alternative to medication is exercise, Hale said.
“Exercise is a powerful antidepressant and a powerful anti-anxiety medicine,” Hale said.
“My own informal observation is — not on the basis of research, but just what I see in my practice — exercise is about as powerful in its antidepressant and anti-anxiety effects as medication or psychotherapy are.”
The opposite of movement can also be effective in treating SAD, Hale said.
“Similarly, mindfulness meditation turns out to also be as powerful,” Hale said. “Mindfulness and mindfulness meditation have become much more in-culture in the past five to 10 years. For the past 30 years around the country there have been courses in mindfulness meditation-based stress reduction. Over the past 20 years, there have been a number of good quality research studies on the effect of those courses on depression and anxiety.
“The studies show that mindfulness meditation are as powerful as medication or psychotherapy for treating depression or anxiety.”
While mind-body treatments enjoy support from a growing body of research, they are far from a cure-all, Hale said.
“A caveat: if someone has major depression where they are really having difficulty functioning because they are so depressed, or they are having suicidal thoughts, then mindfulness is probably not going to be as effective as medication would be,” he said.
For those interested in trying mindfulness meditation for themselves, Ransom Memorial Health is sponsoring a “Stress Management Program based in Mindfulness Meditation” course starting 6:30 p.m. today at RMH, 1301 S. Main St., Ottawa, and running through Feb. 27. The course is taught by Hale, who himself has practiced mindfulness meditation for 30 years, he said.
“The hospital is being amazingly generous to the community in offering this at a highly subsidized cost, so that it can be as widely available as possible,” Hale said. “And of course, the course is not specifically for someone with depression — this is for everybody, because everybody is stressed. At this point we have a handful of slots left; all are welcome.”