What can I do about SAD?
What can I do about SAD?
The nights may be starting to draw out again (just) but January is still one of the darkest, greyest months of the year.
In January 2013 there were just 37.3 hours of sunshine, according to the UK Met Office (the average for the month is only 44.7 hours) and so far in 2014 the outlook isn’t exactly sunny either, what with the Armageddon style floods and storms that hit in the early days of the New Year.
Apart from making most of us feel just a bit down in the dumps ,the lack of sunlight at this time of year can also have more serious implications for your health too and play havoc with your mood. In some cases this can lead to you developing a type of depression called Seasonal Affective Disorder or SAD.
What is SAD?
‘SAD is a syndrome which means it is a collection of varied symptoms,’ says Dr Lars Davidsson, a consultant psychiatrist at the private Anglo European Clinic in London’s Harley Street.
‘The most distinctive symptom is depression which stops you leading your normal life - you may not be sleeping normally, be unable to concentrate at work, have less energy and a lower sex drive and be increasingly reclusive socially.
‘You may also notice changes in your eating habits – either a tendency to overeat , particularly carbohydrates - such as chips, bread, potatoes, crisps and chocolate or a loss of appetite.
‘These symptoms will normally have begun in the late autumn and will not start to lift until the lighter evenings in the Spring.’
How common is it?
SAD affects around two million people in the UK and 12 million across Northern Europe. Around 17 per cent of the population suffer a less serious type of seasonal depression called the winter blues, the symptoms are similar but not so severe and disabling and won’t stop you functioning normally in the same way that SAD will.’
What causes SAD?
SAD is linked to light deprivation in the dark winter months – it is more common in Northern hemisphere countries such as the UK and Scandinavia. Scientists believe it is triggered by insufficient light reaching the hypothalamus, an area of the brain that controls the release of a brain chemical called serotonin which boosts mood. The same area also regulates our appetite and sleep patterns.
But why doesn’t everyone get it?
‘There is believed to be a genetic element to SAD,’ explains Dr Davidsson.‘Some people are just more susceptible to lack of sunlight. It definitely runs in families just as ordinary depression does.’
Researchers at the University of Virginia published a study recently which suggests this could be down to a genetic mutation of receptors in the eye. They found that patients with SAD had lower levels of a receptor that helps regulate alertness and the body clock rhythm.
‘Treatments for SAD include antidepressant medication, psychological therapies including Cognitive Behavioural Therapy and mindfulness and light therapy, ‘ says Anne Farmer, psychiatry professor emeritus at King’s College, London.
Light therapy: ‘Exposure to bright light with a special lamp in the late autumn and winter months is believed to be an effective therapy for preventing and lessening the severity of SAD ', says Professor Farmer.
‘A bright sunny day has about 100,000 LUX (a measure of brightness ) - most SAD lamps have around 10,000 LUX.The advice is to use the lamps daily for varying periods, depending on light intensity in autumn and winter, but also in summer if there is no sun.’
The National Institute of Clinical Excellence does not recommend SAD lamps though as it says there is not enough clinical evidence to support their use. The Seasonal Affective Disorder Association, a charity, does however recommend them.
Cognitive Behavioural Therapy: ‘CBT may be just as effective as antidepressants in milder cases of SAD’, says Professor Framer.’ It teaches strategies for dealing with problems. CBT can help you to change how you think and how you react to day to day events better.’
‘ hese changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.
Your GP should be able to refer you for a course of CBT (usually about six weeks) on the NHS but waiting lists can be long in some areas of the country.
Mindfulness: ‘ This is another psychological therapy which is available on the NHS in some areas of the UK. It teaches you to live in the moment and not worry about the past or fret about the future,’ says Professor Farmer. ‘ It combines meditation, breathing techniques and paying attention to the present moment – it can help people change the way they think, feel and act.’
Antidepressants: ‘ Selective serotonin re-uptake inhibitors (including Prozac) can help boost serotonin levels and lift mood,' says Professor Framer.’ But they do take 4 to 6 weeks to have an effect so it’s best to start taking them as early as possible in late autumn.’
Prevention and Self Help
- Get outside in daylight during the winter: ‘Aim to get outside when the sun is at its stongest at around midday – just exposing yourself to sunlight can boost your mood‘, says Professor Farmer.'Stroll around the park or walk around the block in your lunch hour to soak up some natural daylight – as there is evidence that exercise helps with SAD symptoms too.'
- Book a winter holiday in the sun: ‘ If you can afford it, a break in a hot country in the depths of winter could help lift your depression, ‘says Professor Farmer. ‘ If you can afford one holiday a year it makes sense to take it when your SAD symptoms are at their worst between December and the end of February.’
- Use a SAD lamp before the clocks go back: ‘ Start using your SAD lamp before the nights draw in at the end of October when the clocks go back,' says Professor Farmer.’Anecdotal evidence suggests that can prevent SAD or at least lessen the severity of your symptoms. Keep using it throughout the winter though.’
- Try other light therapy gadgets: You can now buy "daylight" alarm clocks which wake you slowly with light and goggles which bathe your eyes in high intensity light.