A Guide to Seasonal Affective Disorder Treatments
Bright light therapy
Light therapy, a common and low-risk treatment for Seasonal Affective Disorder (SAD), involves exposure to a high-intensity fluorescent bulb, typically in the form of a commercially available "light box." These devices disperse light, filtering out harmful ultraviolet rays, and are used daily for 30 to 60 minutes, usually in the morning. Patients can engage in various activities during therapy, such as reading or exercising. It's generally safe, but individuals with eye conditions or light-sensitive medications may need clearance from an eye specialist before starting. Another option is dawn simulation, which gradually introduces a weaker light as patients wake. Studies indicate that both bright light therapy and dawn simulation are effective treatments for SAD, with results comparable to antidepressant therapy, offering a promising approach to alleviate symptoms.
Read more about bright light therapy and how it can help winter depression and more!
Vitamin D Deficiency and Insufficiency: Unraveling the Connection
Vitamin D deficiency is highly prevalent in Canada and has been linked to depression and other mental disorders. Studies indicate that maintaining adequate levels of vitamin D may have a role in both preventing and supplementing the treatment of depression. Additionally, there is a notable correlation between depression and vitamin D deficiency, suggesting that lower vitamin D levels are associated with higher rates of depression.
Research on Seasonal Affective Disorder (SAD) indicates that vitamin D supplementation and improved 25-OH D levels may lead to more favorable depression scale scores, though larger trials are necessary for conclusive evidence. Vitamin D status is assessed through a blood test to determine the appropriate dosage for supplementation.
Aerobic Exercise for SAD: Moving Towards Well-Being
A simple way to help with Seasonal Affective Disorder (SAD) is exercise. Things like biking, running, or swimming can make a big difference for your mental health. The important part is to enjoy what you're doing, not just focus on what's considered the best. Keep it simple: move around and do things that make you happy and you can keep up with. Also, exercising with others can make it even better. You can find a friend to exercise with, join classes, or go to community centers. Walking outside with a friend is great too. Studies comparing exercise to light therapy found that exercise can really help make depression less severe. Doing exercise outside or combining it with light therapy might be helpful, but we need more research to be sure. Don't forget the social part of exercise, like talking to others. Even though we might not fully understand how it all works, everyone agrees that exercise, an additive benefit when it's social, can really help with depression, including SAD.
Therapy: Behavioral activation
Cognitive behavioral therapy (CBT) is often the recommended approach for addressing seasonal affective disorder, with a specific focus on behavioral activation due to the decline in energy and motivation associated with depression. The main idea behind behavioral activation is to identify and modify patterns of behavior that reinforce or contribute to negative emotions, with the goal of increasing positive and adaptive behaviors..
So in addition to engaging in group or individualized therapy these techniques help us to stick with routines that will benefit our mood such as sleep schedules, eating habits, screen time, and social connections. Particularly in colder, darker regions during the winter, behavioral activation therapy aids individuals in staying active and venturing outdoors, even when it may not initially seem appealing.
Sleep Hygiene
Winter depression often involves disruptions in circadian rhythms, leading to sleep issues. Maintaining good sleep hygiene, including a regular sleep-wake cycle (go to bed and wake up at the same time every single day, yes that includes weekends) and avoiding prolonged use of screens before bedtime (ideally 1-2 hours before bed). Other things to consider
Avoiding alcohol before bed (or minimize or abstain in general)
Exercise or move regularly
Avoiding caffeine after lunch
Sleep only as much as you need to feel rested, then get out of bed
Avoid checking your phone the instant you wake up in the morning
Use the bedroom only for sleep and sex
Don’t go to bed hungry
It's important to remember that if you have been struggling with sleep that sleep hygiene is often not enough ALONE but can be effective as an additive benefit. If you are struggling with insomnia more assistance may be needed but nailing down these basic sleep hygiene is crucial for long term success.
Daily Walks Outside: Nature's Antidote to Winter Blues
In a three-week study, patients with SAD experienced greater improvement from daily walks outside than from artificial light therapy. Even on cloudy days, the natural light intensity outdoors provides a significant boost. This outdoor activity not only benefits physical health but may also include elements of behavioral activation.
A Mindful Approach to Combat SAD
Mindfulness-Based Cognitive Therapy (MBCT) involves cultivating mindfulness skills to prevent the recurrence of depression. Preliminary studies suggest its efficacy in managing SAD, offering a holistic approach to mental well-being. Engaging in mindfulness practices doesn't necessarily require committing to a full 8-week course. Simple yet impactful activities, such as daily check-ins, staying present through brief breathing exercises, or utilizing meditation apps with sessions ranging from 1 to 5 minutes, can make a significant difference (Apps: InsightTimer, Headspace, WakingUp, Calm)
For those open to a more structured learning experience from the comfort of their homes, consider exploring a comprehensive mindfulness course. This course offers a formal yet accessible way to delve into mindfulness, providing valuable tools to navigate the winter months with greater resilience and mental clarity.
Social Support: A Pillar of Winter Resilience
Managing the challenges of Seasonal Affective Disorder (SAD) becomes more manageable with the backing of a social network. Establishing relationships with friends, family, or engaging in support groups offers emotional aid during the difficult winter season. Integrating social support with mood-enhancing activities, like group workouts or communal strolls, can amplify the overall positive influence. Formulating plans for social involvement, even when motivation is lacking, contributes to a more resilient winter experience.
Pharmacology
While various treatments can significantly enhance mood during the winter months, another option for addressing Seasonal Affective Disorder (SAD) involves the use of antidepressant medications, such as SSRIs. Medications always remain a viable choice.
In the realm of SAD treatment, antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs) and extended-release bupropion, offer effective options either alone or in conjunction with talk therapy. By altering brain chemicals related to mood and stress, antidepressants typically take 4 to 8 weeks to manifest their effects, with improvements in sleep, appetite, and concentration preceding mood enhancement. Given the link between SAD and serotonin activity, SSRIs play a crucial role in uplifting mood. The FDA-approved extended-release bupropion, taken consistently from fall through early spring, is recognized for preventing the recurrence of seasonal depressive episodes. When considering these treatments, individuals are advised to engage in open discussions with healthcare providers to navigate potential side effects and make informed decisions about their mental health journey.
Multifactorial approach required
As we unravel the intricate tapestry of Seasonal Affective Disorder, it's clear that various factors contribute to its onset and persistence. From circadian rhythms to vitamin D, exercise, and therapy, a multifaceted approach is essential in managing SAD. Recognizing the signs, understanding the causes, and exploring diverse treatment options provide a roadmap towards brighter and more resilient winters.
When dealing with Seasonal Affective Disorder (SAD), it's important to understand your emotions from a broader perspective and consider a mix of approaches. Mental health is influenced by various factors, so a comprehensive assessment is crucial. This involves checking for deficiencies through bloodwork and discussing potential causes. There are many options to improve mood, and if you're struggling, don't hesitate to reach out. Book a meet-and-greet call to start a conversation about finding the right support for your mental well-being.
References
National Center for Complementary and Integrative Health
Vitamin D and Depression: Where is all the sunshine
Effect of Vitamin D supplementation
Seasonal affective disorder and engagement in physical activities