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For many, the winter months mean cosy fires and festive evenings, but for one in three people it signals the beginning of an almost unbearable season, and a depression that only lifts when spring is on the horizon. For those who think they may be suffering from Seasonal Affective Disorder, here's our guide to the illness and the first steps to overcoming it.
Seasonal Affective Disorder, sometimes known as 'winter depression', is a pattern of depressive behaviour that is repetitive in nature, coming and going with the changing of the seasons. That is, feelings of depression or low mood that will arrive in late autumn and ease again in spring, often disappearing by summer.
The cause of Seasonal Affective Disorder is thought to be a lack of exposure to natural daylight that then has a knock on effect on hormone production and the body's internal clock. Less exposure to sunlight is thought to lead to higher levels of melatonin and lower levels of seratonin, and since these hormones affect sleep and mood respectively...well, you can see where this is going. The resulting imbalance means increased lethargy and feelings of depression.
Symptoms of Seasonal Affective Disorder can include all or a combination of the following symptoms. For the most part, they are similar to depression, the difference with SAD being that they tend to occur repetitively every season:
"You have the right to feel well, both in mind and body."
There are some online tools that can help to give you an idea of whether you may be affected by the disorder - SAD UK have a self-test on their site, and NHS Choices has a depression self-assessment. While a test should never replace a visit to the doctor, for some, taking one is the wake up call that encourages a visit to their GP, so even though they're certainly not a definitive diagnostic tool, they can be a catalyst for seeking help.
SAD can be difficult to diagnose in some people, because the symptoms often mirror those of regular depression. The key factors in diagnosing the illness are its repetitive nature (returning each autumn/winter) and the way it eases or disappears in the warmer, lighter months.
Because of its transient nature, there is a social stigma associated with the condition, and many people with SAD go undiagnosed, despite it being a legitimate and widely recognised medical disorder. So, if you're struggling to cope through the winter months, it's important that you see a health professional who can assess you and arrange treatment accordingly.
NICE guidelines dictate that SAD is, for the most part, treated in the same way as depression, and there are a range of things you can try in order to ease the symptoms. In extreme cases, doctors will sometimes issue anti-depressants (often SSRIs, which boost seratonin levels) to combat SAD, but more often one or more of these approaches will be tried first.
Lots of sufferers wake up and come home from work in the dark, which means there's very little time to get outdoors, stay active and enjoy the daylight. But it's important to take every opportunity to be outside during the day, even for half an hour at lunchtime. Go for a walk, a gentle run or, at the weekend, a bike ride, tennis, an exercise routine in the garden - whatever you can manage. The endorphins produced by physical activity, combined with the extra sunlight, could help to lift your mood.
A balanced diet
There's a tendency for SAD sufferers to reach for carb-laden, stodgy foods come winter, and while it may feel comforting at the time, sticking to a healthy, balanced diet will help to fight the lethargy associated with the condition.
Seek out light
No, we haven't come over all New Age - we mean just that. Sit in well-lit areas of your house, or arrange to sit near a window at work. Seasonal Affective Disorder is thought to be caused by a lack of sunlight, so seeking out as much as you can during daylight hours makes perfect sense, no?
Cognitive Behavioural Therapy
Your doctor may refer you for this behavioural therapy that focuses on changing the way we think and react to situations. The Royal College of Psychiatrists found evidence to suggest that this type of therapy could not only ease the symptoms of SAD for some people, but could actually prevent the them showing up again the following winter.
"I have just ordered a SAD lamp for the first time. My sister in law has one, and she says that it helps enormously."
If you suffer from severe winter depression, your GP may also recommend using something called a light box, which simulates exposure to the light your body is missing out on in the winter months (but without the harmful UV rays). Used for a short time each morning, light boxes can help to stimulate production of seratonin and repress the production of melatonin. It's important to use a light box that is certified for medical use though, and if you're not sure about splashing out on one to begin with you can even rent one to see if it helps with your symptoms.
There's lots of information available to guide you in finding the right light box for you.
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