Demystifying Seasonal Affective Disorder (SAD)

Understanding and Managing Winter Blues

As the winter season approaches, many people experience shifts in mood and well-being. In this article, we explore Seasonal Affective Disorder (SAD) and provide insights into understanding and managing this seasonal mood disorder.

1. Recognizing the Holiday Blues vs. Seasonal Affective Disorder (SAD):

• The holiday blues are situational and tied to specific events, while SAD is a distinct subtype of major depression.
• SAD symptoms must align with the seasons for two consecutive years, often lasting several months.

2. Two Types of SAD:

• Fall-Onset SAD (Winter Depression):
  • Symptoms include oversleeping, increased appetite, weight gain, low energy, and social withdrawal.
• Spring Onset SAD (Summer Depression):
  • Symptoms involve trouble sleeping, poor appetite, weight loss, restlessness, agitation, and anxiety.

3. Understanding the Causes of SAD:

• Disrupted Circadian Rhythm:
  • Reduced sunlight in fall and winter can disrupt your body’s circadian rhythm, affecting sleep and mood.
• Serotonin Activity:
  • Sunlight influences serotonin activity, and low serotonin levels are linked to depression.
• Melatonin Levels:
  • SAD is associated with high melatonin levels, contributing to fatigue, especially in winter SAD.

4. The Role of Vitamin D:

• Vitamin D deficiency can result from reduced sunlight exposure during winter months.
• While not proven to cause depression, low vitamin D levels are linked to mood changes.
• Adequate vitamin D levels are essential for overall well-being.

5. Vitamin D3 vs. Vitamin D2:

• Vitamin D3 is synthesized in the skin through sunlight exposure and is better absorbed by the body.
• Vitamin D2 can be obtained from plant sources and is less efficient at raising vitamin D levels.

6. Light Therapy for Winter SAD:

• Using a light therapy box with an intensity of 10,000 lux can help alleviate symptoms of winter SAD.
• Light therapy mimics the effects of natural sunlight and can regulate circadian rhythms.

7. Seek Professional Guidance:

• If you suspect you have SAD or related mood disorders, consult a healthcare professional for proper evaluation and treatment.
• Antidepressants and other therapies can be effective for managing SAD symptoms.

Understanding the nuances of Seasonal Affective Disorder (SAD) can empower individuals to navigate the challenges of the winter season more effectively. Recognizing the differences between holiday blues and SAD, exploring the two SAD subtypes, and considering the role of serotonin, sunlight, melatonin, and vitamin D can lead to informed decisions about mental health management. Light therapy and professional guidance are valuable options for those dealing with SAD, ensuring a brighter and more balanced winter season.

Light Box Options

References

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Lewy AJ, Lefler BJ, Emens JS, Bauer VK. The circadian basis of winter depression. Proc Natl Acad Sci U S A. 2006 May 9;103(19):7414-9. doi: 10.1073/pnas.0602425103. Epub 2006 Apr 28. PMID: 16648247; PMCID: PMC1450113.

Fonte, A., Coutinho, B. Seasonal sensitivity and psychiatric morbidity: study about seasonal affective disorder. BMC Psychiatry 21, 317 (2021). https://doi.org/10.1186/s12888-021-03313-z

Less SERT in spring and summer

Berger M, Gray JA, Roth BL. The expanded biology of serotonin. Annu Rev Med. 2009;60:355-66. doi: 10.1146/annurev.med.60.042307.110802. PMID: 19630576; PMCID: PMC5864293.

Light Therapy Inhibits SERT

Harrison SJ, Tyrer AE, Levitan RD, Xu X, Houle S, Wilson AA, Nobrega JN, Rusjan PM, Meyer JH. Light therapy and serotonin transporter binding in the anterior cingulate and prefrontal cortex. Acta Psychiatr Scand. 2015 Nov;132(5):379-88. doi: 10.1111/acps.12424. Epub 2015 Apr 17. PMID: 25891484; PMCID: PMC4942271.

Vitamin D3 vs D2

Radicioni, M., Caverzasio, C., Rovati, S. et al. Comparative Bioavailability Study of a New Vitamin D3 Orodispersible Film Versus a Marketed Oral Solution in Healthy Volunteers. Clin Drug Investig 42, 151–161 (2022). https://doi.org/10.1007/s40261-021-01113-7

Yang D, Gouaux E. Illumination of serotonin transporter mechanism and role of the allosteric site. Sci Adv. 2021 Dec 3;7(49):eabl3857. doi: 10.1126/sciadv.abl3857. Epub 2021 Dec 1. PMID: 34851672; PMCID: PMC8635421.