Seasonal Affective Disorder (SAD)

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

What is the treatment for seasonal affective disorder?

In addition to being key in the prevention of seasonal affective disorder, regular exposure to light that is bright, particularly fluorescent lights, significantly improves depression in people with this disorder when it presents during the fall and winter. The light treatment is used daily in the morning and evening for best results. Temporarily changing locations to a climate that is characterized by bright light (such as the Caribbean) can also be effective. Light treatment has also been called phototherapy. Individuals who suffer from seasonal affective disorder will also likely benefit from increased social support during vulnerable times of the year.

Phototherapy is available in the form of light boxes, used for approximately 30 minutes daily. The light required must be of sufficient brightness, approximately 25 times as bright as a normal living room light. The light does not need to be actual sunlight. It seems that it is quantity, not necessarily quality of light that matters in the phototherapy of seasonal affective disorder. The most common possible side effects associated with phototherapy include irritability, insomnia, headaches, and eyestrain.

Antidepressant medications, particularly those from the selective serotonin reuptake inhibitor (SSRI) group of medications, have been found to be effective in treating seasonal affective disorder that occurs during summer as well as that which tends to occur during the fall or winter. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), and vortioxetine (Trintellix). Common side effects for this class of medications include insomnia, nausea, diarrhea, and many can cause decreased sex drive or performance. As with any other mood disorder, psychotherapy tends to accentuate the effectiveness of medical treatment and therefore should be included in the approach to addressing this disorder. In individuals who are perhaps vulnerable to the development of bipolar disorder, either light therapy or antidepressants can cause a manic episode as a side effect.

Since stimulant medications like modafinil (Provigil) may be a helpful addition to other treatments for seasonal affective disorder, other stimulants like methylphenidate (Ritalin) may play a future role in addressing this disorder. Acupuncture may be a viable alternative intervention to antidepressant medications, particularly in pregnant women, for whom medications should be used with particular caution.

Determined to be equally effective as phototherapy or antidepressant medication in addressing seasonal affective disorder, cognitive behavioral therapy (CBT) is another viable option for treating this illness. This form of psychotherapy involves the therapist working with the client to help the depression sufferer identify and understand ways of thinking that may be obstacles to improving their mood, thereby increasing the ability of the person with seasonal affective disorder to alleviate symptoms.

Chronotherapy, which uses environmental input to affect biorhythms, is thought to be a helpful aspect of treatment for seasonal affective disorders, as well as for other kinds of depression. This treatment uses methods like controlled sleep deprivation to affect the seasonal affective disorder sufferer's brain chemicals in a positive way.

Lifestyle changes that can help decrease the symptoms of seasonal affective disorder include increasing time spent outdoors, more physical exercise, and maintaining eating habits that are high in lean proteins, fruits, vegetables, and complex carbohydrates while decreasing the intake of refined sugars and other carbohydrates. Remedies that do not necessarily require the involvement of a health-care professionals, or so-called home remedies, include vitamin D supplementation and taking melatonin in the evenings.

Medically Reviewed by a Doctor on 10/31/2016

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