Sleep Aides: First Day of Wintering Seasonal Affective Disorder (SAD) – Symptoms and Treatments

Today is the first day of winter at approximately 12:47pm on December, 21 2009. Some people are celebrating the winter solstice while others are wrestling with the winter blues. As the sun light changes with the seasons, 10% of Americans suffer from Seasonal Affective Disorder or SAD. SAD cause’s people to experience sleep problems as well as depression and women are far more susceptible these symptoms than men, as they sleep more during the winter months.

According to the Mayo Clinic’s website they state the specific cause of seasonal affective disorder remains unknown. It's likely, as with many mental health conditions, that genetics, age and, perhaps most importantly, your body's natural chemical makeup all play a role in developing the condition. A few specific factors that may come into play include:

• Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may disrupt your body's internal clock, which lets you know when you should sleep or be awake. This disruption of your circadian rhythm may lead to feelings of depression.
• Melatonin levels. The change in season can disrupt the balance of the natural hormone melatonin, which plays a role in sleep patterns and mood. Talk to your doctor to see whether taking melatonin supplements is a good option.
• Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in seasonal affective disorder. Reduced sunlight can cause a drop in serotonin, perhaps leading to depression.

Signs and symptoms of SAD may cause depression and may worsen if not treated. These may include:

• Suicidal thoughts or behavior
• Social withdrawal
• School or work problems
• Substance abuse
In order to help your doctor understand and diagnosis your conditions gather some of the following information to help you to prepare for your appointment, and what to expect from your doctor.

What you can do:

• Record your symptoms so that you can tell your doctor or mental health provider exactly what they are (feeling down or lack of energy, for example).
• Write information about your depression patterns, such as when your depression starts and what seems to make it better or worse.
• Make a note of any other mental or physical health problems you have, as both can affect mood.
• Write down any major stressors or life changes you've had recently.
• Make a list of all medications, as well as any vitamins or supplements that you're taking.
• Write down questions to ask your doctor.

Seasonal affective disorder is considered a subtype of depression or bipolar disorder. Even with a thorough evaluation, it can sometimes be difficult for your doctor or mental health provider to diagnose seasonal affective disorder because other types of depression or mental health conditions may mimic seasonal affective disorder.

To be diagnosed with seasonal affective disorder, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.

The following criteria must be met for a diagnosis of seasonal affective disorder:

• You've experienced depression and other symptoms for at least two consecutive years, during the same season every year.
• The periods of depression have been followed by periods without depression.
• There are no other explanations for the changes in your mood or behavior.
Scientists believe that individuals suffering from SAD are more sensitive to light changes. Your doctor can treat SAD as follows:

Light therapy - In light therapy, also called phototherapy, you sit a few feet from a specialized light therapy box so that you're exposed to bright light. Light therapy mimics outdoor light and appears to cause a change in brain chemicals linked to mood. This treatment is easy to use and seems to have few side effects.

Although light therapy is widely used and appears to be helpful, it isn't clear how light therapy works and how effective it is in treating seasonal affective disorder. Before you purchase a light therapy box or consider light therapy, talk to your doctor or mental health provider to make sure it's a good idea and to make sure you're getting a high-quality light therapy box.

Medications - Some people with seasonal affective disorder benefit from treatment with antidepressants, especially if symptoms are severe. Medications commonly used to treat seasonal affective disorder include:

• Bupropion. An extended-release version of the antidepressant bupropion (Wellbutrin XL) may help prevent depressive episodes in people with a history of seasonal affective disorder.
• Other antidepressants. Antidepressants commonly used to treat seasonal affective disorder include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor).

Your doctor may recommend starting treatment with an antidepressant before your symptoms typically begin each year. He or she may also recommend that you continue to take antidepressant medication beyond the time your symptoms normally go away.
Keep in mind that it may take several weeks to notice full benefits from an antidepressant. In addition, you may have to try several different medications before you find one that works well for you and has the fewest side effects.

Psychotherapy - Psychotherapy is another option to treat seasonal affective disorder. Although seasonal affective disorder is thought to be related to biochemical processes, your mood and behavior also can add to symptoms.

Psychotherapy can help you identify and change negative thoughts and behaviors that may be making you feel worse. You can also learn healthy ways to cope with seasonal affective disorder and manage stress.

Especially if your seasonal depression symptoms are severe, you may need medications, light therapy or other treatments to manage seasonal affective disorder. However, there are some measures you can do on your own that may help, such as:

• Make your environment sunnier and brighter. Open blinds, add skylights and trim tree branches that block sunlight. Sit closer to bright windows while at home or in the office.

• Get outside. Take a long walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun. Even on cold or cloudy days, outdoor light can help — especially if you spend some time outside within two hours of getting up in the morning.
• Exercise regularly. Physical exercise helps relieve stress and anxiety, both of which can increase seasonal affective disorder symptoms. Being more fit can make you feel better about yourself, too, which can lift your mood.

Several herbal remedies, supplements and mind-body techniques are commonly used to relieve depression symptoms. It's not clear how effective these treatments are for seasonal affective disorder, but there are several that may help. Keep in mind, alternative treatments alone may not be enough to relieve your symptoms. Some alternative treatments may not be safe if you have other health conditions or take certain medications.

Nutritional and dietary supplements used to treat depression include:

• St. John's wort. This herb has traditionally been used to treat a variety of problems, including depression. It may be helpful if you have mild or moderate depression.
• SAMe. This is a synthetic form of a chemical that occurs naturally in the body. SAMe hasn't been approved by the Food and Drug Administration to treat depression in the United States. However, it's used in Europe as a prescription drug to treat depression.
• Melatonin. This natural hormone helps regulate mood. A change in the season may change the level of melatonin in your body. Some people try taking melatonin supplements, but discuss this with your health care provider first before doing so.
• Omega-3 fatty acids. Omega-3 fatty acid supplements have been shown to relieve depression symptoms in some studies. Sources of omega-3s include fatty, cold-water fish, such as salmon, mackerel and herring. Flaxseed, flax oil and walnuts also contain omega-3 fatty acids, and small amounts are found in soybean and canola oils.

SAMe and St. John's wort can interact with medications for other conditions, especially antidepressants. Talk to your doctor before trying either of these remedies to make sure they're safe for you.

Mind-body therapies that may help relieve depression symptoms include:

• Acupuncture
• Yoga
• Meditation
• Guided imagery
• Massage therapy

There's no known way to prevent the development of seasonal affective disorder. However, if you take steps early on to manage symptoms, you may be able to prevent them from getting worse over time. Some people find it helpful to begin treatment before symptoms would normally start in the fall or winter, and then continue treatment past the time symptoms would normally go away. If you can get control of your symptoms before they get worse, you may be able to head off serious changes in mood, appetite and energy levels.

Personally I love the winter because us vamps can stay up longer, it the summer when we experience RSAD or Reverse Seasonal Affective Disorder. People also suffer from RSAD too, but more on that later. Right now I just want to celebrate the winter solstice...big party tonight...it's the longest night of the year!
Good Evening
Rose Sheepskill