Seasonal affective disorder (SAD), also known as winter depression, winter blues, summer depression, summer blues, or seasonal depression, is a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or summer, spring or autumn year after year.
Specifically, some emerging evidence suggests that seasonal affective disorder may be associated with alcoholism and attention-deficit/hyperactivity disorder. Seasonal affective disorder often can be treated with light therapy, which appears to have a low risk of adverse effects. Light therapy is more effective if administered in the morning.
Age was directly correlated with the frequency of seasonal affective disorder, and the rate was higher in post-Qubertal girls. Differences between the subjects with and without identified cases of seasonal affective disorder were seen in the symptom endorsement patterns, particularly for "feel worst," "least energy, " "most irritable, " and "socialize least.
In fact, for any given winter, patients were most frequently treated with light therapy alone, which suggests that light therapy might be regarded as a treatment of choice for most patients with seasonal affective disorder. Nevertheless, the observation that the majority (63%) of continuing light users had, at some point, also required supplemental antidepressant medications corroborates clinical impressions that light therapy alone may not be sufficient in any given winter in a patient's course of treatment.
At least Ms. Adair knows what she has: summer SAD, also known as reverse seasonal affective disorder. About 5 percent of adult Americans are thought to have winter seasonal affective disorder; researchers estimate that fewer than 1 percent have its summer variant.
Because it is a fairly esoteric condition whose origins are unknown, many people who become depressed in the summer may not realize they have SAD. They may simply think of their bouts of depression as new events rather than parts of a pattern.
If the melatonin remedy holds up in larger studies, it could become the treatment of choice. Simply taking a few pills each day would greatly simplify the treatment of winter depression, which most commonly requires patients to sit in front of a light box that simulates sunlight for about an hour upon awakening every morning. For some people with winter depression, Dr. Lewy said, his studies suggest that melatonin alone might work; for others, the needed lift may come from the popular hormone and light treatment.
In fact, it is well known that some mood disorders are more prevalent at certain times of the year. Seasonal affective disorder peaks in the fall and winter, coinciding nicely with the holiday season. And a significant number of Americans suffer from S.A.D. The estimated prevalence is 3 to 8 percent, with higher rates in the more northern latitudes.
Lots of other people in dark bedrooms are asking themselves the same question, but it gives me no comfort to know that as many as 14 million Americans experience full-blown cases of seasonal affective disorder at this time of year, with as many as 33 million more suffering from milder symptoms. We are the ones who may have less energy, more crankiness and annoyingly cheerful spouses.
While I can’t attest to suffering the depression of Seasonal Affective Disorder, there are times when its cousins — low energy, fatigue and disengagement — have rapped their knuckles at the door. And it is possible to be plagued by some instinctive fear that as the light dims, so too will perception, thought, appreciation. So I consider getting a S.A.D. lamp, with a spectrum of light calculated to put right one’s rhythms and chemistry when they go awry in winter from lack of light exposure.
If true, this would make SAD a disturbance in the circadian rhythm, the 24-hour pattern that normally aligns the sleep-wake cycle with all the other bodily rhythms. Dr. Lewy suggests that with the delayed dawn and shorter days of fall and winter, the rhythms of people afflicted with SAD drift out of phase with the sleep-wake cycle, as if they had traveled across many time zones.
For the millions of Americans who suffer from mild to severe winter blues — a condition called seasonal affective disorder, or S.A.D. — bright-light therapy is the treatment of choice, with response rates comparable with those of antidepressants. “Your natural clock is usually longer than 24 hours, and you need light in the morning to set it and keep it on track,” said Dr. Alfred Lewy, a professor of psychiatry at Oregon Health and Science University and an expert on seasonal depression and light therapy.
As daylight wanes, millions begin to feel depressed, sluggish and socially withdrawn. They also tend to sleep more, eat more and have less sex. By spring or summer the symptoms abate, only to return the next autumn.
Once regarded skeptically by the experts, seasonal affective disorder, SAD for short, is now well established. Epidemiological studies estimate that its prevalence in the adult population ranges from 1.4 percent (Florida) to 9.7 percent (New Hampshire).