When it comes to finding good information on Seasonal Affective Disorder, I have referred clients to the website at Columbia University among other sites. SAD is associated with social withdrawal, weight gain, reduced productivity and increased need for sleep, especially oversleeping in the morning. When symptoms are severe, seeking a consultation can be an important first step.
SAD symptoms are mediated by the ‘ internal clock’ located in the suprachiasmic nucleus of the hypothalamus. Light signals, detected in the retina of the eye help to keep the internal clock synchronized to a 24 hour rhythm. Internal clocks can become dysregulated for a number of internal and external reasons:
Internal Causes of Dysregulation of the Internal Clock:
- Change in health (possibly low vitamin D levels, hormone disorders)
- Depression
- Insomnia
External Causes of Dysregulation of the Internal Clock:
- Low angle of the sun after October
- Level of snow cover and reflected light
- Cold temperature and impact on activity level
Treatment for SAD:
Following an evaluation, it is important to correct any internal or external factors contributing to SAD symptoms. Depression, residual depressive symptoms, hormone dysregulation, vitamin deficiencies, lack of exercise and insomnia may require psychiatric evaluation and treatment. Medications for Depression such as Buproprion (Wellbutrin) can be effective in counteracting lethargic depressions and can often be successfully added to existing antidepressant treatment and/or used at a lower dosage with good benefit. Keeping up with simple exercise, changing the way one thinks about winter (Cognitive Therapy) and supplementation with Vitamin D3 3000 IU’s especially between the months of October and April can help. Treatment with light therapy is also an option. While units can be costly, there are some variables to consider when purchasing a light:
- Is the unit designed for Seasonal Affective Disorder?
- White light is better studied then blue light units
- Panels lighting may be more effective then directed light associated with eye wear or very small units.
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