ASK, ANSWER, LEARN
Why do I feel so gloomy in winter, and what can I do?
Connie Hahn, DO answered:An estimated 10% of the population in northern latitudes such as Montana suffers from SAD, or seasonal affect disorder. During childbearing years women outnumber men four to one, but after age 65 the condition affects both sexes equally. Biological causes include theories involving circadian rhythm, retinal sensitivity to light, and brain neurotransmitters such as serotonin. Physicians also consider patients’ vulnerability to stress and if they have a close relative with a history of depression.
Medical diagnosis relies on the presence of two major depressive episodes over the past two years, with a seasonal relationship, along with full resolution of symptoms at a particular time of year, among other criteria.
Today we have good news. Treatment for SAD is very effective. There are three choices that all show equal efficacy: Light Therapy, Medication, and Cognitive Behavior Therapy (CBT) by a licensed mental health professional or psychiatrist. Furthermore, there is evidence that when any or all of these are combined, they work synergistically!
Light therapy, according to the Canadian Consensus Guidelines, is a light source of 10,000 lux of white fluorescent light without ultraviolet wavelengths. It should be positioned 12-18 inches from the skin for 30 minutes every morning. While eyes should be open, it is not necessary to stare into the light. Individuals with preexisting retinal disease first should have an eye exam by an ophthalmologist. After remission of SAD symptoms is achieved, the dose of light can be tapered for the remainder of winter. In following years, prevention can begin in early fall.
If you are interested in medication and/or CBT, it is best to check with your primary care provider for his or her recommendations. It is also thought that CBT acts as prevention in coming winter seasons. By comparison, drug or supplement therapy can act quickly, but are only effective while taken.
More good news is that simple lifestyle adjustments work to prevent SAD. These include 30 minutes or more of aerobic exercise daily, good spiritual health, practicing relaxation and stress management techniques like yoga and meditation, as well as getting outside, even on cloudy days! So don't settle for less that 100% of your full mental health…you're worth it.
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