Seasonal Affective Disorder: Causes and Treatments

Seasonal affective disorder (SAD) is a distinctive mood disorder with strong onset in the fall and winter and mild relief in the spring and summer. The pathogenesis is related to the circadian clock disturbance caused by the decrease in the duration and intensity of sunlight.

seasonal affective disorder

Seasonal Affective Disorder usually has its onset of symptoms at specific times of the year

What is Seasonal Affective Disorder?

Seasonal Affective Disorder (SAD) is a mood/emotional disorder that occurs at specific times of the year. This syndrome is characterized by typical depressive symptoms appearing in the fall-winter and the condition tends to decrease slightly in the spring-summer. However, some patients experience depression in the winter and hypomanic episodes in the summer.

As is known, affective disorder is a type of mental disorder characterized by low or excessively high mood. The disease is divided into different types according to the presentation and time of onset. Those cases that start at a specific time of year are called seasonal affective disorder or seasonal depression (for those with only depression).

According to statistics, about 6% of the US population faces seasonal affective disorder and the disease mainly affects adolescents and young people. The pathogenesis is related to the intensity and duration of sunlight. As a result, SAD is more common in people who live far from the equator – especially those with long winters. Similar to other emotional disorders, the rate of women suffering from this syndrome is about 3-4 times higher than that of men.

Signs of seasonal affective disorder

Seasonal affective disorder usually begins in the fall and winter and subsides in the spring and summer. However, there are also cases of onset of depression in winter and mania in summer. This condition is called bipolar disorder or manic-depressive illness (a fairly common emotional disorder alongside depression).

seasonal affective disorder

SAD is characterized by sadness, depression, low energy, and a complete loss of interest in things

Seasonal affective disorder symptoms that occur in the fall-winter:

  • Anxiety, sadness, and depression most of the day. Most patients cannot explain why they have these negative emotions.
  • Decreased interest or complete loss of interest in life issues, including activities that were previously enjoyed.
  • Crying for no apparent reason.
  • Mood instability, difficult to control and sometimes angry, irritable before things are not too serious.
  • Difficulty concentrating, slow thinking, loss of agility and flexibility as before.
  • It is difficult to maintain work and study performance.
  • The body has reduced energy, excessive fatigue and it is difficult to complete tasks at work. In addition, patients also need great motivation to be able to perform daily activities such as personal hygiene, cooking, cleaning the house, etc.
  • Excessive sleepiness, sleep a lot but sleep is often not deep, sleep is restless and wake up in the middle of the night.
  • Tends to be withdrawn and aloof from others. People with SAD often lock themselves in their rooms and spend time sleeping or sitting still for many hours.
  • Perceiving themselves as worthless, weak, lacking in confidence and sometimes guilty, despite the fact that the patient did absolutely nothing wrong.
  • Severe cases can cause the patient to form thoughts and attempt suicidal behaviors.
  • People with seasonal affective disorder often have anorexia or overeating, especially preferring foods high in sugar and starch.

In the spring-summer, seasonal affective disorder symptoms tend to be mild:

  • Difficulty sleeping, insomnia
  • Worried
  • Sad
  • Tired body, tired
  • Anorexia
  • Sometimes there is agitation, temper and anger
  • Weight loss

In addition, some patients may also experience the onset of manic symptoms in the spring-summer season. Mania is an elevated mood that is the exact opposite of depression. As a result, some patients will experience the following symptoms:

  • Optimism, fun, excitement and excitement
  • Increase physical activity
  • Reduced need to eat and sleep
  • Sometimes too hyperactive
  • Difficulty controlling emotions and behaviors
  • Increased self-confidence, sometimes exaggerating one’s abilities and appearance

During the manic phase, the patient increases creativity and sensitivity, so he can complete tasks at work. In particular, the patient loves the emotions that mania brings and thinks he is in the best mental state. However, there are also many cases of mania that cause agitation, aggression, ostentatious behavior, and indecent behavior.

Causes of seasonal affective disorder

Currently, the exact cause of seasonal affective disorder (SAD) is unknown. Experts believe that SAD is the result of many factors, including genetic factors and imbalance of neurotransmitters inside the brain. For seasonal affective disorder, the intensity and duration of sun exposure are also important factors in the pathogenesis.

Causes and factors that increase the risk of seasonal affective disorder:

1. The sun decreases in intensity and duration of light

Sunlight is an important factor affecting the biological clock. In autumn-winter, the duration and intensity of the sun’s illumination is significantly reduced, especially for people living in areas far from the equator. This condition causes a series of reactions in the body such as decreased vitamin D synthesis, changes in the endogenous substances inside the brain and most importantly, an increase in the hormone melatonin.

seasonal affective disorder

The decrease in sun exposure time and intensity is a key factor in the pathogenesis of SAD .

Melatonin is a hormone produced by the pineal gland every night to relax muscles and induce sleep. When the duration of the sun’s rays decreases, the pineal gland tends to secrete more of this hormone than usual. Therefore, in the autumn and winter, people tend to sleep more and are not as active and bustling as in the summer.

Obviously, the weather has a significant effect on mood. For people with pre-existing psychological problems such as emotional disturbances, the phenomenon of reduced light intensity and duration is the trigger factor for symptom flare-ups. Therefore, most patients experience drowsiness, sleep a lot, pessimism, sadness and loss of energy in autumn and winter.

2. Imbalance of neurotransmitters

Emotionally disturbed patients always have an imbalance of neurotransmitters. These substances govern emotions, thoughts, behaviors and the functioning of organs in the body. However, for a number of reasons, people with emotional disorders often have unstable endogenous substances, and this condition is also influenced by weather factors.

Experts found that in the autumn and winter when the sun reduces the time and intensity of sunlight, the body will reduce the synthesis of vitamin D. This is an important vitamin for the skeletal system and nerve cells. Vitamin D deficiency leads to a decrease in the synthesis of serotonin – a neurotransmitter that plays a role in stabilizing mood, creating feelings of euphoria, optimism and joy.

Low serotonin is closely related to emotions such as sadness, anxiety, stress, despair, pessimism, depression, etc. In normal people, the weather also reduces the concentration of neurotransmitters. this, but not significant. So in winter, people are often more sensitive and easily upset than other times of the year.

3. Heredity

Like other mental disorders, seasonal affective disorder is linked to genetic factors. Most patients with this syndrome have a relative with depression, SAD, bipolar disorder, or a similar affective disorder.

seasonal affective disorder

Similar to other mental disorders, seasonal affective disorder is also highly heritable

Experts have yet to find a genetic disorder for seasonal affective disorder (SAD). However, people with this syndrome always have a decrease in serotonin at the synaptic cleft. Therefore, experts support the theory that these pathological genes regulate how the brain works, so people with a family history of the disease will be at higher risk.

4. Coping with pre-existing trauma

People who have faced pre-existing trauma are at increased risk of emotional disturbances in the fall and winter. Traumatic events have significant psychological effects.

This condition combined with the changes in neurotransmitters and the hormone melatonin in the fall and winter will make the mood unstable. So if you’re dealing with pre-existing trauma, symptoms of seasonal affective disorder may flare up in the fall and winter.

5. Risk factors

To date, experts have not found the full cause of seasonal affective disorder. However, several factors have been identified that may increase the risk of the disease including:

  • Diet low in vitamin D
  • Do housework, less exposure to the sun
  • Living with someone with seasonal affective disorder (SAD) for a long time even though they are not related by blood also increases the risk of the disease.
  • Disruption of biological clock due to unhealthy eating and living habits
  • Live in areas far from the equator
  • Introverted, shy, lacking in self-esteem and anxious
  • Suffering from long-term stress due to academic pressure, work, family conflicts and financial problems

The risk of seasonal affective disorder (SAD) decreases with age. The majority of patients have onset of the disease during adolescence and early adulthood.

The effects of seasonal affective disorder

Seasonal affective disorder (SAD) also causes certain effects on patients’ lives and health. The extent of the impact of this pathology depends on the specific condition. However, if left untreated, SAD will cause many serious consequences such as:

Seasonal affective disorder

If not treated early, SAD can become so severe that patients develop suicidal thoughts and behaviors

  • Difficult to maintain work and study efficiency
  • For patients presenting with summer mania, heightened emotions and behaviors can lead to agitation. This condition causes many problems in life, and at the same time increases conflicts, conflicts and sometimes acts of violence.
  • Living in isolation, seclusion and reduced interaction with society.
  • Facing the risk of unemployment due to emotional and behavioral instability.
  • Substance abuse, alcohol use.
  • Difficulty making friends and maintaining long-term relationships.
  • In the worst case, the patient will develop suicidal thoughts and attempt suicide.

The risk of suicide in patients with seasonal affective disorder (SAD) is relatively high – especially in cases of substance abuse and alcohol use. However, with early examination and treatment, patients can stabilize their lives and restore social skills.

Diagnosis of seasonal affective disorder (SAD)

Seasonal affective disorder (SAD) is diagnosed by clinical presentation. In addition, the doctor will also order some laboratory tests to rule out physical diseases and addiction syndromes.

Essentially, seasonal affective disorder is a subgroup of depression or bipolar disorder (depending on the patient’s symptoms). Therefore, the doctor will use the diagnostic criteria of these 2 diseases to make a definite diagnosis. Patients were diagnosed with seasonal affective disorder (SAD) only when seasonal onset symptoms occurred for at least 2 consecutive years.

Seasonal affective disorder treatments

Similar to other emotional disorders, SAD needs to be treated and managed to avoid serious complications. Besides pharmacotherapy and psychotherapy, patients will be treated in combination with light therapy. The majority of patients actively treated have positive results and can stabilize long life.

Treatments for seasonal affective disorder (SAD):

1. Light therapy

Light therapy (light therapy) is the mainstay of seasonal affective disorder (SAD). In this therapy, the patient will be exposed to artificial light with characteristics similar to sunlight. The purpose of light therapy is to regulate melatonin production, increase vitamin D synthesis, and improve serotonin levels.

When the neurotransmitters return to equilibrium, the symptoms of seasonal affective disorder (SAD) will be markedly reduced. Patients need to do this therapy every day and each session usually lasts from 30 to 60 minutes. Usually, the symptoms will subside quickly after just a few sessions. However, patients must maintain light therapy throughout the autumn and winter to avoid recurrence.

What is seasonal affective disorder?

Light therapy is the preferred treatment for seasonal affective disorder

Artificial light can damage the eyes, so during the treatment, the patient will be wearing safety glasses and applying some moisturizer to reduce skin irritation. However, people who are using drugs to treat rheumatism, have porphyria, etc. are usually not allowed to do this method.

For SAD patients who present with summer mania, phototherapy can cause mood swings and transition to manic episodes. In this case, the doctor will monitor the patient throughout the treatment to avoid unfortunate situations.

Light therapy is highly effective in treating seasonal affective disorder. Possible side effects are usually not serious, including trouble sleeping, headache, eye irritation, nausea, skin rash, dark skin, etc. If this method gives good results, patients do not necessarily use drugs.

2. Pharmacotherapy

Those who do not respond or respond poorly to light therapy will be considered for the use of drugs. Similar to other emotional disorders, patients with SAD will be prescribed antidepressants and sedatives (if needed).

seasonal affective disorder

Patients with seasonal affective disorder will be prescribed medication when responding poorly to light therapy

In the case of patients with manic manifestations in the spring – summer, the drug is used only for a short time to avoid triggering a manic state. In addition, the family also needs to closely monitor the patient while taking the drug to avoid unexpected situations. Because in the initial period of use, antidepressants can increase suicidal thoughts and behaviors.

In addition to the above drugs, some patients will be considered for low doses of vitamin D for 3 months to stabilize neurotransmitters in the brain. In addition to improving mood, supplementing with vitamin D also helps patients improve their health and improve sluggishness and fatigue due to the effects of seasonal affective disorder.

3. Psychotherapy

Psychotherapy has an important role in the treatment of mental disorders, including seasonal affective disorder (SAD). This therapy helps patients regulate their emotions, thoughts, and behaviors more appropriately. At each specific stage, the specialist will consider applying the corresponding psychotherapeutic method.

The role of psychotherapy is to help reduce drug dependence and help patients be more active in life. If depression is present, this therapy helps patients improve self-esteem, find joy and excitement in life. In a manic state, the therapist helps the person to become aware of the consequences of impulsive behaviors and learn how to manage extreme emotions.

In addition, psychotherapy also helps patients relieve negative emotions and stress in the healthiest way. In particular, stress is a trigger for SAD and mental disorders. Therefore, psychotherapy also plays a role in preventing disease recurrence and contributing to better disease management.

Patients with seasonal affective disorder will face many troubles in life. During therapy, experts will also help patients gain the necessary skills to face and overcome stressful situations and easily integrate and interact with people. Psychotherapy also directs the patient to a healthy lifestyle, away from alcohol and stimulants.

Measures to take care of seasonal affective disorder

Seasonal affective disorder (SAD) is a chronic mental disorder that has a wide range of effects on health and well-being. For more effective disease control, patients should combine medical treatment with the following care measures:

seasonal affective disorder

Increasing sun exposure significantly reduces symptoms of seasonal affective disorder

  • Do some relaxing and stress-reducing therapies such as reflexology massage, meditation, music therapy, nourishing breathing, aromatherapy, etc.
  • Take advantage of natural light by participating in outdoor activities, open windows, draw curtains and cut down trees so that light can enter the living space. Increasing sun exposure can significantly reduce symptoms of seasonal affective disorder.
  • Add foods rich in vitamin D to your diet to improve serotonin levels, thereby helping to lift your mood. In addition, the patient also needs to ensure a regular diet and the menu must provide enough essential nutrients.
  • Do not use alcohol, tobacco and stimulants.
  • It is recommended to use teas that increase concentration and alertness to reduce excessive sleepiness such as green tea, black tea, mint tea, ginger tea, etc.
  • Set aside 30 minutes a day for exercise. This is an effective measure to help lift emotions and reverse the physical symptoms of seasonal affective disorder.
  • You can join clubs for people with seasonal affective disorder to share, empathize, and gain experience in managing the illness.

Seasonal affective disorder (SAD) is a specific type of mood disorder with symptoms that begin mainly in the fall and winter. Although the cause is unknown, active treatment is of great help in symptom control and disease management. In addition, the patient should also work to overcome this syndrome with self-improvement measures.

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