Everyone is jolly — planning holiday parties, drinking eggnog and wrapping gifts — everyone, that is, except you. So, why do you feel so blue?
The good news is that it’s not all in your head. In fact, you may have a highly treatable medical condition — seasonal affective disorder, or SAD as it is often called by physicians. “SAD is actually a reaction to a decreased amount of light during the day,” said Pamela J. Szeeley, M.D., a psychiatrist at Cooper University Hospital. “People’s natural biorhythms, or circadian rhythms, can be affected by decreasing daylight, which could then cause SAD.”
A circadian rhythm is the body’s 24-hour clock telling it to wake or sleep. SAD is linked to biochemical changes in the brain prompted by the shorter days. In people with SAD, a shift in their circadian rhythms may occur, triggering their symptoms. Another factor could be melatonin, which is a sleep-related hormone.
“Generally, melatonin is lower in everyone this time of year, but in certain people, it can cause SAD, especially people who have a history of depression or are under a lot of stress,” Dr. Szeeley said. The mechanism is unclear.
Symptoms usually disappear in the spring and summer and generally mood is normal. Most people with SAD are women, who often start developing symptoms in their 20s. Experts believe between 10 percent and 20 percent of Americans may suffer from mild symptoms associated with the disorder.
Symptoms usually begin in October or November and subside in March or April. Most patients don’t start feeling back to normal until May. Usually depressions in people with SAD are mild or moderate, when overlaping with another psychiatric condition, such as anxiety disorders.
The characteristics may include:
- Daytime fatigue.
- Carbohydrate craving.
- Weight gain.
- Decreased sexual interest.
- Suicidal thoughts.
- Lack of interest in normal activities.
- Social withdrawal.
“How your symptoms affect you each year depend on what is going on in your life. If you hit the lottery, you have a new boyfriend and you move into a new house, you won’t notice it as much. Like all mood disorders, it fluctuates with what is going on in your life,” Dr. Szeeley said. Stress, on the other hand, may worsen your SAD symptoms.
Is it holiday depression?
SAD is not the same as holiday depression. The difference, Dr. Szeeley notes, is the timing and other contributing factors.
“Holiday depression usually refers to a low mood that occurs around the holidays and is usually related to too much work to do, especially for women who tend to take on most of the responsibility for taking care of everyone,” she says.
Holiday depression also may affect people who have ongoing family discord or estrangement. The holidays, which are focused on togetherness and family, may call attention to these issues. Having unrealistic expectations this time of year may intensify your feelings; however, your case of the blues may go away in January. People with SAD usually don’t start feeling better until the spring.
How is SAD treated?
Bright fluorescent light has been shown to reverse symptoms in 80 percent of people. The treatment uses an artificial equivalent of early morning full daylight. Dr. Szeeley suggests you spend about 60 minutes under this light every day. She says it’s fairly easy to find light boxes to purchase through the Internet. A box with 2,500 lux to 10,000 lux would be sufficient. Sometimes antidepressants are used for more severe cases.
To make an appointment with a Cooper University Hospital physician at an office near you, please call 1-800-8-COOPER to speak with a member of our physician referral and information service.