SEASONAL AFFECTIVE DISORDER PART 2

Updated: Dec 30, 2020

SYMPTOMS & PREVENTION



TAKE NOTICE


If you start to notice that you have way less energy, are moodier than usual and have a hard time carrying out your regular task load at the same time each year, it is worth talking to your doctor or therapist about it.


There is also a self-assessment tool called the “Seasonal Pattern Assessment Questionnaire” (the SPAQ), which Dr. Norman Rosenthal and his colleagues developed for the National Institute of Mental Health.


Dr. Rosenthal and his colleagues, spent over 25 years researching SAD, it’s causes, it’s symptoms and it’s treatments. Click here fore more information on the SPAQ.


One of the major critiques of his assessment tool is that people have a hard time remembering their symptoms and their timelines from year to year.


There is a simple resolution for that and it can also help your doctor determine whether there is more going on besides for SAD… Keep a daily mood and symptom journal!


It can include more than just symptoms. It can also be really helpful to track what activities might have helped alleviate symptoms. Another benefit is that it can help you notice if each year gets progressively worse or symptoms last longer. Your journal could also help your doctor notice other latent disorders or illnesses lurking beneath the surface - ones that might be highly treatable if caught on time.


Your symptoms may not seem overly disruptive at first, but they are certainly worth noting if they are out of the norm.


Symptoms can include:

  • Consistent low mood

  • Loss of interest in activities you generally enjoy

  • Problems staying on task or focusing on work that you would normally complete with little challenge

  • Inability to wake up on time to work or school consistently

  • Missing a lot of work, school or other commitments

  • Low energy or feeling draggy

  • Sleeping way less or way more than usual

  • Drastic changes in appetite or weight

  • More easily aggravated

  • Crying a lot or moods shifting regularly

  • Increased thoughts of worry, panic or negativity

  • Feelings of hopelessness, worthlessness or excessive guilt

  • Regular thoughts about death or suicide (this one is serious, so call your local emergency number if its really consistent or make an appointment with your doctor if it is only ideation)


If these sound familiar to you, don't brush them off.


Being proactive about self-care during more challenging seasons could prevent symptoms from worsening and becoming more than just seasonal.


There is always a chance that your symptoms are not SAD but indicate that you might be having an adverse reaction to a medication you are taking, there are problems with a combination of medicines you are taking, or that you are experiencing a completely unrelated medical concern. It is important to get a checkup to determine if there are no other potential reasons for your symptoms. Don't self-medicate.


Regardless of the reasons why you are suffering, it can’t hurt to take proactive care of your health and wellbeing in general.


Continue to notice how your mind and body are feeling.


Keep a journal. Ask for help. Be proactive.



HOW CAN I BE PROACTIVE ABOUT SAD?


While treatments for SAD are still under scrutiny, there is certainly enough evidence to support a combination of the following treatments (even if most of the evidence is anecdotal). I’ll explain briefly what the science is behind each one, but most of them have inconclusive reasoning behind them at this point and are largely based on logic and testimony.


Light therapy (phototherapy)


Light therapy is a popular treatment for SAD because it is thought to help regulate the body’s circadian rhythm by mimicking outdoor morning light.


Researchers believe that using a light box for 20-30 minutes each morning induces a chemical reaction in your brain that can help to stabilize mood. There is sufficient anecdotal evidence (and clinical trials in the works) to suggest that the prolonged darkness of winter days is one of the leading contributing factors to winter SAD. Many people leave for work before the sun comes up and return after sun-down, which means they are not really seeing the light of day for a good few months.


A Note of Caution: People who also have other diagnosed mental or physical illnesses can have adverse or even harmful effects to light therapy. Click here for more info or talk to your doctor before use.


One more thing… Most light boxes are not UV in nature and is not a source for vitamin D production. As you can see there are other potential benefits, but vitamin D is not one of them.



Vitamin D supplements


As mentioned above, vitamin D is responsible for so many regulatory functions in your body and it is unlikely that you will be getting a sufficient amount from your daily food or sun intake. If you are not spending time outdoors during daylight hours (with sufficient skin exposure), make sure to take a vitamin D supplement unless your doctor says you are nearing toxic levels, which is unlikely, but should be checked anyways. Blood tests are important to rule out other causes for your symptoms anyways.


Medications


Certain antidepressants are commonly prescribed for SAD, especially in more severe cases.


According to the Mayo Clinic, “an extended-release version of the antidepressant bupropion (Wellbutrin XL, Aplenzin) or other antidepressants may help prevent depressive episodes in people with a history of SAD.”


If you notice that your symptoms begin around the same time each year (and you WILL notice better if you start to keep a symptom journal), you might want to ask your doctor if it would be beneficial to start this treatment a few weeks or even months before your symptoms are expected to begin (it can take several weeks to start to notice a difference and even longer to perfect the dosage and to experiment with the right medications that will work best for you. Not everyone responds in the same way, so sometimes there is a bit of trial and error to find the right fit.)


Psychotherapy


In the past Cognitive Behavioral Therapy was known to be the “go-to” psychotherapy treatment method for SAD. Today there is so much more evidence to show success using other modalities as well. Find a therapist that has an assortment of tools at their disposal so that you can figure out what works best for you.


Self Care


There are actually steps you can take to keep your moods more stable throughout the year, and hopefully nip those lows in the bud before they take over your life.


  • Basics: So I love being in Pajamas all day and every day, but "they" say that getting out of bed in the morning and getting dressed can really help you feel like you are taking charge of your life when there is little else you can control. If you are like me (a bit rebellious and not willing to try this one) try to find one or two non-negotiable things you will do every day (over and above brushing your teeth, c’mon that one is too easy...) that can help you maintain some sort of schedule and a bit of control.

  • Make Check Lists: Making short and simple chunked checklists for each day can help you not only get done the things you need to get done, but really help you feel a sense of accomplishment at the end of each day.

  • Keep up Face to Face Social Interactions: Real face to face human connections are said to stimulate the vagus nerve which is a part of regulating your parasympathetic nervous system’s stress responses (fight,flight and freeze). Socializing in real life (As opposed to on social media) improves vagal tone and helps to stimulate and balance the secretion of many wellness hormones. There is nothing that can replace genuine face-to-face connection (which is unfortunate for those of us that hate going outside during winter).[1]

  • Meditation: In the same book I just cited, meditation is not only said to be relaxing but can also help to reverse long-standing mental and physical health issues, even those that are genetic in nature. Obviously there is more to it than that... but you can read the book to find out. A really amazing free meditation and body scan (e-booklet and audio clip) is available on Integrative Psychotherapy’s website.

  • Sleep Schedule: Falling asleep and staying asleep can be a challenge when your circadian rhythm is off. I love the app called Calm (the sleep meditations, not the sleep stories. I find the stories too entertaining and can’t fall asleep listening to them - especially the Scottie Pippin and Matthew McCaunaghay ones.) You might also want to try waking up and going to bed at the same time every day, turning off electronic devices at least 30 mins before bed time (I am totally being hypocritical here) and cutting out the coffee past 1 or 2pm.

  • Stay Hydrated: The cold dry air of winter can zap the moisture out of you faster than in summer months (evident by your dry skin and chapped lips). Drink lots of water and moisturize your skin daily (especially your hands, since all the COVID-prevention sanitizer you use these days can be really drying).

Would love more self-care suggestions too! Feel free to share them below in comments.


CHECK OUT: PART 1: WHAT CAUSES SAD?

PART 2: SYMPTOMS & PREVENTION

PART 3: FAQs

[1] Read the book “Cured: Strengthen Your Immune System and Heal Your Life” by Jeffrey Rediger M.D. for details.

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