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Changing SAD to Glad

If you and your doctor have settled on a diagnosis of SAD to explain your symptoms – the moodiness, the lack of energy, the lingering depression that comes on when the weather changes – it means you have met the following criteria, established by the Diagnostic and Statistical Manual of Mental Disorders (DSM):

  • You’ve endured depression and other symptoms for at least two consecutive years, always during the same season each year.
  • There are no other ways to explain the changes in your mood and behavior.
  • The episodes of depression are followed by depression-free times (the symptoms come at a specific time and then go away, returning only about the same time a year later).
We have discussed in some length how to prepare for the first appointment with your physician if you suspect that  seasonal affective disorder underlies your depression.  Now let’s have a look at the treatment options:
  • Light therapy.  Treatment for SAD often includes light therapy, though bipolar disorder must be absolutely ruled out first.  Light therapy (or an antidepressant) can trigger manic episodes.  Light therapy is also called phototherapy. During treatment, you will sit a few feet from a specialized light therapy box, exposing you to bright light that mimics outdoor light.  Light therapy is SAD’s initial treatment of choice.  It generally works within a a day or two, has few side effects and appears to cause a change in brain chemicals related to mood.  It really works for many people suffering SAD symptoms.  You can purchase a light therapy box for home use.  Just be sure to get the okay from your doctor or mental health provider first, and hold out for a high-quality light therapy box.
  • Medications.  Those with severe symptoms often benefit from antidepressant treatment.  The antidepressants most commonly used to treat seasonal affective disorder include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor).  The extended-release version of bupropion (Wellbutrin XL) could help ward off episodes of seasonal depression for those with a history of seasonal affective disorder.  You may have to try different medications before finding the one that works best for you.  And remember that it sometimes takes a few weeks before the full benefits are felt.  The doctor may want to start an antidepressant treatment before your symptoms generally begin each year.  And he or she may want you to stay on the medication beyond the time your symptoms typically go away.
  • Psychotherapy.  Even though seasonal affective disorder is believed to be related to brain chemistry, your mood and behaviors contribute to the symptoms.  Here is where psychotherapy may be able to help.  It will guide you in identifying and changing negative thoughts and behaviors that are making you feel even worse.  And you can then find some healthy ways to cope with stress and manage your seasonal affective disorder more successfully.
There are also some home remedies and lifestyle adjustments that you might try:
  • Get outdoors.  You know how much better you feel when you get outside and play!  So take good, long walks.  Eat your lunch on a park bench and get a bit of sun.  This is not just for bright and sunny days, either.  Outdoor light can help even on cloudy or cold days.  Even better: spend some time outside within two hours of waking up in the morning.
  • Exercise regularly.  Here it is again, that recommendation to exercise every day.  You know that physical exercise helps reduce anxiety and relieve stress – both contributors to making SAD symptoms even harder to manage.  When you feel fit and physically sound, you feel better about everything, yourself included.  This all puts you in a better frame of mind, a better mood.  
  • Make your surroundings bright and sunny.  Cold weather makes us want to crawl in a dark and cozy cave sometimes, but resist!  Open your blinds; add skylights.  Sit near sunny windows while at the office.  You might even trim back any bushes or tree branches that block the sun from your windows at home.  Stay in the light.  And if you’re worried, be sure your moisturizer has sun protection built in!  
Next up, alternative medicine and SAD, some coping tricks and some thoughts on prevention.

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