DOWNLOAD PDF WHY SO SAD? DAILY AND SEASONAL RHYTHMS

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1 Chapter 1 : Why so SAD? - The ADD Lab Seasonal affective disorder spikes in winter, when sensitive individuals wither from a lack of sun, but experts say some people experience summertime SAD, when rays are almost omnipresent. Fatigue and lack of energy; reduced sex drive Use of drugs or alcohol for comfort Feelings of sadness, hopelessness, and despair As with depression, the severity of SAD symptoms can vary from person to personâ often depending on genetic vulnerability and geographic location. To be clinically diagnosed with seasonal affective disorder, you need to have experienced these cyclical symptoms for two or more consecutive years. If You Are Feeling Suicidal But you will feel better. If you are feeling suicidal, know that there are many people who want to support you during this difficult time, so please reach out for help. Causes of seasonal affective disorder While the exact causes of seasonal affective disorder are unclear, most theories attribute the disorder to the reduction of daylight hours in winter. The shorter days and reduced exposure to sunlight that occurs in winter are thought to affect the body by disrupting: The longer nights and shorter days of winter can disrupt your internal clockâ leaving you feeling groggy, disoriented, and sleepy at inconvenient times. During the short days and long nights of winter, however, your body may produce too much melatonin, leaving you feeling drowsy and low on energy. A deficit may lead to depression and adversely affect your sleep, appetite, memory, and sexual desire. Instead of being attributed to shorter days and reduced sunlight, experts believe that summer SAD is caused by the oppositeâ longer days and increased heat and humidity, possibly even an upswing in seasonal allergies. Many summer SAD symptoms are the same as those for winter depression, although there are some differences. As with any form of depression, there can be many different causes and contributing factors for seasonal affective disorder. Always consult your doctor for an accurate diagnosis and see the lifestyle changes outlined below for help to boost your mood and manage your depression symptoms. Risk factors Seasonal affective disorder can affect anyone but is most common in people who live far north or south of the equator. Other risk factors include: While 3 out of 4 sufferers of SAD are women, men often experience more severe symptoms. In most cases, winter SAD is first diagnosed in people aged 18 to 30 and is less likely to occur as you get older. Seasonal bipolar disorder The changes in seasons can trigger mood changes in some people with bipolar disorder. Spring and summer may trigger symptoms of mania or hypomania, while the onset of fall and winter can bring on symptoms of depression. While the depression symptoms of SAD and bipolar disorder can look alike, there are significant differences, especially when it comes to treatment. See Bipolar Disorder Signs and Symptoms. Self-help for SAD tip 1: Seasonal depression can make it hard to motivate yourself to make changes, but there are plenty of steps you can take to help yourself feel better. By adopting healthy habits and scheduling fun and relaxation into your day, you can help lift the cloud of seasonal affective disorder and keep it from coming back. Whenever possible, get outside during daylight hours and expose yourself to the sun without wearing sunglasses but never stare directly at the sun. Sunlight, even in the small doses that winter allows, can help boost serotonin levels and improve your mood. Take a short walk outdoors, have your coffee outside if you can stay warm enough. Increase the amount of natural light in your home and workplace by opening blinds and drapes and sitting near windows. Regular exercise can boost serotonin, endorphins, and other feel-good brain chemicals. In fact, exercise can treat mild to moderate depression as effectively as antidepressant medication. Exercise can also help to improve your sleep and boost your self-esteem. The Mental Health Benefits of Exercise: For Depression, Anxiety, and Stress Find exercises that are continuous and rhythmic. The most benefits for depression come from rhythmic exercise-such as walking, weight training, swimming, martial arts, or dancing-where you move both your arms and legs. Aim for 30 to 60 minutes of activity on most days. Even something as simple as walking a dog, for example, can be good exercise for you and the animal, as well as a great way to get outdoors and interact with other people. Reach out to family and friendsâ and let them help Close relationships are vital in reducing isolation and helping you manage SAD. It may feel more comfortable to retreat into your shell, but being around other people will boost your mood. Call or an old friend to meet for coffee. Or reach out to someone newâ a work colleague or neighbor, for example. Most of us feel Page 1

2 awkward about reaching out, but be the one to break the ice. Join a support group for depression. Being with others who are facing the same problems can help reduce your sense of isolation and provide inspiration to make positive changes. Meet new people with a common interest by taking a class, joining a club, or enrolling in a special interest group that meets on a regular basis. Helping others is one of the best ways to feel better about yourself, expand your social network, and overcome SAD. Eat the right diet Eating small, well-balanced meals throughout the day, with plenty of fresh fruit and vegetables, will help you keep your energy up and minimize mood swings. While the symptoms of SAD can make you crave sugary foods and simple carbohydrates, such as pasta and white bread, complex carbohydrates are a better choice. Foods such as oatmeal, whole grain bread, brown rice, and bananas can boost your feel-good serotonin levels without the subsequent sugar crash. Foods rich in certain omega-3 fats â such as oily fish, walnuts, soybeans, and flaxseedsâ can also improve your mood and may even boost the effectiveness of antidepressant medication. Take steps to deal with stressâ by making time for fun Whatever the time of year, too much stress can exacerbate or even trigger depression. Figure out the things in your life that stress you out, such as work overload or unsupportive relationships, and make a plan to avoid them or minimize their impact. Accessing the Relaxation Response Practicing daily relaxation techniques can help you manage stress, reduce negative emotions such as anger and fear, and boost feelings of joy and well-being. Try yoga, meditation, or progressive muscle relaxation. Do something you enjoy or used to every day. Having fun is a great stress buster, so make time for leisure activities that bring you joy, whether it be painting, playing the piano, working on your car, or simply hanging out with friends. Treatment for seasonal affective disorder: Light therapy aims to replace the missing daylight of winter by exposing you to bright light that mimics natural outdoor light. Light therapy has been shown to be effective in up to 85 percent of SAD cases. While tanning beds generate sufficient light, they should never be used to treat SAD as the UV rays they produce can be harmful to the skin and eyes. Light therapy has to be continued daily throughout the winter months to be effective. Starting light therapy before the onset of symptoms in the fall may even help prevent seasonal affective disorder. There are two different ways of administering light therapy. A light box delivers light that with up to ten times the intensity of normal domestic lighting. In most cases, you simply sit about 12 inches in front of a 10, lux light box for 15 to 30 minutes each morning. The light box emits a controlled amount of white light, with harmful ultraviolet UV rays filtered out. Most people notice an improvement in their SAD symptoms after a few days and experience the full antidepressant effect in about two weeks. A dawn simulator is a device that gradually increases the amount of light in your bedroom in the morning to simulate the rising sun and wake you up. The light gradually increases, just as natural sunlight does, over a period of 30 to 45 minutes. Instead of waking in darkness, you wake to what looks like a sunny morning. This can help reset your circadian rhythm and improve your mood. Light therapy for seasonal affective disorder: What you need to know Light therapy involves daily sessions of sitting close to a special light source that is far more intense than normal indoor light. Some people feel better after only one light treatment, but most people require at least a few days of treatment, and some need several weeks. Although professional groups and government agencies endorse light therapy, your insurance company in the U. There are few side effects to light therapy, but you should be aware of the following potential problems: Mild anxiety, jitteriness, headaches, early awakening, or eyestrain can occur. There is evidence that light therapy can trigger a manic episode in people who are vulnerable. While there is no proof that light therapy can aggravate an eye problem, you should still discuss any eye disease with your doctor before starting light therapy. Likewise, since rashes can result, let your doctor know about any skin conditions. Some drugs or herbs for example, St. Cognitive behavioral therapy CBT can be highly beneficial for people with seasonal depression. For many people, CBT can be as effective at treating seasonal affective disorder as light therapy or antidepressants, but without any risky side-effects. However, as with all antidepressants, there may be adverse side effects, including a number of safety concerns specific to children and young adults. Recommended reading Understanding Depression: The many faces of depression and how to find relief â Harvard Medical School Special Health Report Seasonal Affective Disorder â Outlines the diagnostic criteria for winter SAD as well as tips on treatment and how to cope with symptoms. NHS Seasonal affective disorder: When winter brings the blues â Causes and treatment for winter SAD. Mayo Clinic Page 2

3 Seasonal affective disorder: Harvard Health Publications Light Therapies for Depression â Discusses using and buying a dawn simulator or light box, including price guides and comparison of different units. Page 3

4 Chapter 2 : Explainer: what is seasonal affective disorder? This study may change the way we treat SAD and other seasonal circadian rhythm disorders. We currently treat these disorders mainly by trying to get the circadian rhythm back in sync. People use daily exposure to bright lights and melatonin supplements in the evening to mimic the physiological effects of warmer seasons. These functions are primarily regulated by the circadian clock, a cluster of nerves located on the hypothalamus in the brain. Abrupt shifts in routine, such as shift changes, or travel resulting in jet lag can alter the sleep cycle and have a detrimental effect on normal circadian rhythms. Additionally season changes, which are accompanied by a decrease in the number of daylight hours, can negatively impact the function of the circadian clock, primarily the secretion of melatonin to induce sleep. If the alterations in biological rhythms are strong enough they may lead to mood disorders including mild depression and seasonal affective disorder. The following is an analysis of the relation of biological rhythms to mood disorders. The goal is to identify and describe the various cycles that exist within the body to maintain a harmonious rhythm, including circadian rhythms, chronobiological factors, and biopsychosocial rhythms, specifically their relation to the seasons. Once an understanding these rhythms has been gained it is possible to determine external factors, which act to significantly, disrupt their harmony. Finally by relating the function of biological rhythms to the psyche, specifically their impact on mood and personality it is possible to show how a shift can result in a disorder. In addition to reviewing the stated relationships this analysis will also cover methods of preventing and treating mood disorder that result from changes in biological rhythms. Biological Rhythms By taking the two words and breaking them down into their separate meanings a definition of biological rhythms evolves as, life which involves a recognizable pattern of change over time. There are two major categories of biological rhythms, endogenous, and exogenous. Endogenous rhythms come from within and are regulated by the organism itself, for example the body temperature cycle. Exogenous rhythms are the result of external factors, such as a change in the seasons, or the transition from day to night. Environmental stimuli that help to maintain these cycles are called zietgebers, which comes from German and translates as "time givers. There are four categories of biological rhythms that extend beyond just classifying them based on internal and external sources. This system maintains that criteria, but extends to include the duration of the cycle as a defining factor. The resulting categories are circadian rhythms, diurnal rhythms, ultradian rhythms, and infradian rhythms. Circadian Rhythms Circadian rhythms are defined as an endogenous rhythm pattern that cycles on a daily approximately 24 hour basis under normal circumstances. The name circadian comes from the Latin circa dia, meaning about a day. Due to the large amount of control of the circadian rhythm cycle it is often referred to as the pacemaker. Two specific forms of circadian rhythms commonly discussed in research are morning and evening types. There is a direct correlation between the circadian pacemaker and the behavioral trait of morningness-eveningness Duffy et al. People considered morning people rise between 5 a. The majority of people fall somewhere between the two types. Evidence has shown that morning types have more rigid circadian cycles evening types, who display more flexibility in adjusting to new schedules Hedge, Diurnal Rhythms Diurnal rhythms are an extension of circadian rhythms. Simply put the diurnal cycle is identical to the circadian cycle, with the one additional corollary that it must be in sync with the day and night cycle. In other words, for an individuals circadian rhythms to become diurnal that subject must be awake and functioning normally during daylight hours and sleeping during night hours on a fairly consistent basis. Note that it is possible to have a circadian cycle without being diurnal but not visa versa. Ultradian Rhythms Ultradian rhythms are defined as an endogenous rhythm pattern that occurs on a shorter time scale than circadian rhythms. As a result of the brief cycle time the frequency of occurrence is much higher. A prime example of an ultradian rhythm is feeding patterns. For the average person this cycle repeats about 3 times a day. Unlike diurnal rhythms ultradian rhythms are share no overlapping relationship with circadian rhythms. Infradian Rhythms Infradian rhythms are defined as an endogenous rhythm pattern that has a cycle duration longer than circadian rhythms, that is more than 24 hours per cycle. Due to the longer time frame for each cycle the frequency of occurrence in these cycles is lower than that of the circadian rhythms. The female Page 4

5 menstrual cycle is an example of an infradian rhythm. It is a cyclical biological event that occurs in a fairly regular pattern on a monthly basis. Similar to the ultradian cycle the infradian rhythms are not directly linked to circadian and diurnal rhythms. By reviewing the function of these various biological rhythms it is clear to see that a majority of our physiological systems, and behaviors are directly controlled or influenced by these patterns. The question that arises is what external factors help to establish biological rhythms? Additionally what happens if the cycle is altered by a change in those external factors? In the following sections the answers to those questions will be explored, specifically as they related to mood disorders. Factors Influencing Biological Rhythms The major biological rhythms discussed thus far are primarily endogenous, or internal in nature. That is to say they originate from within the organism. Theoretically if we could isolate an individual from all outside influences it would be possible for their biological rhythms to normalize and occur on a strict schedule. In reality, however, we are subjected to a wide variety of changing stimuli all the time. It is not surprising then, that some of these changing stimuli have been shown to influence the regularity of our biological rhythms. The Circadian Clock In the physical sense circadian cycles are controlled by the circadian clock, a cluster of approximately ten thousand nerve cells located on the suprachiasmatic nuclei SCN found on the hypothalamus in the brain. It is not uncommon for the circadian clock to be disrupted temporarily, events such as changes in work schedule from day to night, changing time zones also referred to as jet lag and to some extent old age can impact the consistency of circadian rhythms. Influence of Light Light is an important factor for maintaining biological rhythms. The circadian clock relies heavily on changes in light to determine transitions from night to day. During periods of darkness the SCN clock sends out the hormone melatonin, which induces sleep. It is plain to see how changing work schedules from the day shift to the night shift would create the need to reverse this process, which takes time and will in turn disrupt normal rhythmic patterns. Circadian rhythms in shift workers were shown to adjust an hour or two per day Hedge, This means that it could take over one week for an individual to fully adjust to an 8-hour shift change. During winter months there are fewer daylight hours, as a result the level of melatonin secretion increases along with the number of hours of darkness. Disruptions in Feeding Cycles Previously it was mentioned that ultradian rhythms regulate short-term patterns, such as feeding cycles. Crystal has shown that behavior related to feeding is indeed caused by a biological rhythm and not external environmental cues. In order to do so he first showed that there was an increase in anticipatory activity before food was presented when a regular feeding schedule was used on rats. The schedule was made to extend beyond a hour period in order to rule out time of day and environmental cues such as sunlight. It was shown that the anticipatory activity still increased even when food was withheld. Although it has been shown that the circadian clock, located on the SCN is apparently not responsible for regulating feeding intervals, the studies conducted on rats showed that rats on a feeding cycle between 22 and 26 hours the circadian range where better able to anticipate food arrival than rats fed on schedules outside this range, including 7 and 34 hour intervals. Based on this information it can be shown that a drastic change in meal times would have a similar effect on the ultradian rhythms as a change in work shift has on circadian rhythms. A stand out among those currently being researched is caffeine. A series of experiments on caffeine revealed differences in the effects of the drug depending on time of day. This finding suggests that low impulsives and high impulsives differ in the phase of their diurnal rhythms, which resulted in a difference in the effects of caffeine. By establishing an understanding of the environmental factors that influence biological rhythms it is possible to begin drawing connections between the resulting shifts and mood disorders. It is important to note also that a significant shift must occur before a mood disorder, or any other mental or physical health problem will develop. The question that arises is when do health problems, specifically mood disorders; develop as a result of shifts in biological rhythms, and what combination of environmental factors leads to those shifts? Furthermore, what can be done to prevent mood disorder causing shifts, and how can existing mood disorders of this form be treated? Mood Disorders and Biological Rhythms Mood disorders are characterized by opposite polar moods: There are a variety of unipolar mood disorders, which involve mania or depression, and bipolar disorders, which are characterized by both mania and depression. Sleep and Depression As previously discussed the circadian clock is responsible for controlling sleep patterns. Melatonin secretion from this region of the brain actually induces sleep. Commonly depressed patients experience a wide Page 5

6 variety of sleep disorders. It should come as little surprise then that there is a connection between disruptions of the circadian cycle and depressive disorders. Generally a decreased amount of deep sleep per night comes just before the onset of depression. Therefore a drastic change in sleep schedule caused by extensive occurrences of jet lag, or multiple shift changes may result in a disruption of circadian rhythm function. In order to help prevent disruptions in the circadian sleep cycle it is important to maintain a regular sleep schedule, which includes retiring and waking at approximately the same time each day, and sleeping a consistent number of hours each night. This is especially important for people with morningness tendencies because their circadian cycles are less adaptable to changes in behavior. Seasonal Affective Disorder In recent years psychologists have recognized the impact of seasonal changes on mood and behavior. Individuals who suffer from seasonal affective disorder show signs of depression during the fall and winter months when there are fewer hours of sunlight each day. Persons suffering from seasonal depression generally show an increase in appetite and hypersomnia, which oddly is opposite of the behavior normally associated with most other forms of depression. This behavior is consistent with research conducted on animals and may be related to baser survival instincts. The explanation behind this theory is that like some animals people may have a natural tendency towards increasing fat stores in the body during the winter, as well as sleeping more often in order to preserve energy levels. Several more recent studies suggest that suffers of seasonal affective disorder display disturbances in their circadian cycles, as indicated by less consistent rhythm patterns. Though the effects of light exposure are not completely understood it has been shown that the presences of either natural or artificial light seems to work towards correcting circadian disturbances caused by seasonality. Conclusion There are four types of biological rhythms that regulate cycles within the body. The primary type, circadian rhythms, controls performance, endocrine rhythms, behavior and sleep timing, and is regulated by the circadian clock, a collection of nerves located on the hypothalamus. Diurnal Rhythms are a specialized form of circadian rhythms, which are closely synchronized with day and night cycles. Both cycles have a duration of approximately 24 hours. Ultradian rhythms are biological rhythms, which operate on a shorter time scale than circadian rhythms, feeding schedules for example. Infradian rhythms are those with cycles longer than 24 hours, the most commonly studied example is the human menstrual cycle. Although all of these biological rhythms are controlled internally there are a number of external factors that are capable of influencing their regularity. Some of the most prominent examples are exposure to light, specifically the changes caused by seasonal transitions, alterations in work shift which change sleeping schedules, jet lag, and caffeine. With the exception of light affects the other influencing factors cause sleeping patterns to change. Due to the fact that circadian rhythms can only shift one to two hours each day drastic changes in sleep patterns can have a detrimental effect on the circadian clock. Seasonal changes cause an alteration in the amount of light that individuals are exposed to. Page 6

7 Chapter 3 : 12 Ways to Ease Seasonal Depression Symptoms Everyday Health The medical term for this is Seasonal Affective Disorder (SAD), a condition caused by a mã lange of changes in our biological clocks, serotonin levels, and melatonin production, all of which. While many of us look forward to seasonal festivities, millions can also expect feelings of depression, fatigue, irritability and poor sleep. SAD occurs most frequently in populations furthest from the equator. Symptoms include feelings of hopelessness, low concentration, sluggishness, social withdrawal, unhappiness and irritability. Circadian rhythms Decades of research has uncovered the culprit behind SAD: Trapped by our body clocks. Circadian rhythms are entrainable, that is, they can be reset based on an external influence like light. The human sleep cycle is an example of a circadian rhythm and is shifted based on light levels. This is why we experience jet lag after travelling across time zones. Similarly, seasonal changes can affect circadian rhythms, due to shorter days and loss of daylight in winter months. Daylight and your brain Although most people are able to adapt to the change in seasonal light levels, what makes some vulnerable to seasonal depression? To understand how sunlight affects mental health, we need to first understand how our brains use sunlight to modulate certain behaviour and hormonal processes. In humans, the hormone melatonin is an marker of external darkness. When darkness descends, melatonin is secreted from a structure called the pineal gland, a pine cone-shaped endocrine gland located in the center of the brain. This gland modulates sleep patterns in both circadian and seasonal rhythms. The secretion of melatonin from the gland corresponds to the length of darkness; as the nights get longer, melatonin secretion follows suit. The timed production of melatonin is controlled by another area in the brain â the suprachiasmatic nucleus SCN of the hypothalamus. The hypothalamus is the primary hormone-producing structure of the brain, controlling body temperature, sleep, circadian rhythm, moods, sex drive, thirst, hunger, and the release of other hormones. It maintains an autonomous signal which operates on an approximate hour cycle. Even outside the body, as seen in the laboratory, SCN neurons will continue their circadian cycling. The SCN regulate sleep cycles, alertness, hormone levels, digestive activity, body temperature and immune function. The eyes have it Many studies have cited disruption in the circadian control center as a contributing factor to several mood disorders, including major depressive disorder and bipolar disorder. The light therapist is in. Light therapy image via www. Light boxes provide relief to many, and come in a few varieties. Typically light boxes are advertised as broad spectrum light sources, which is pure white light. Some light boxes can also give full spectrum light, which has a broader range of wavelengths, including infrared to near ultraviolet light, and everything in between. Although full spectrum light boxes provide a source closest to that of natural sunlight, they usually come with a screen to protect against UV rays. In this way, it is often preferable to use a broad spectrum light box to avoid UV ray exposure. The use of light as a treatment indicates that it is not only the SCN implicated in the onset of this disorder, but there may be a contributing cause related to how we process light in the eye. In fact, various studies have pointed to mutations in a retinal pigment called melanopsin as a source of SAD. More than meets the eye. Laitr Keiows, CC BY-SA Melanopsin is a molecule which absorbs light in the eye, and through a chemical change, can translate external light levels into messages for the brain. Unlike rod and cone cells, melanopsin is found in specialized cells of the eye which react slowly to changes in light, and are known to regulate the timing of circadian rhythms. Whereas rods and cones are responsible for the detection of motion, color, images and patterns, studies have shown that melanopsin-containing cells contribute to various unconscious responses of the brain to the presence of light, including circadian rhythms. Overall, melanopsin can translate messages directly from the eye to the SCN. This in turn influences the production of melatonin. The SCN not only projects to the pineal gland, but has wide-ranging connections to other important areas in the brain. So if there is disruption in melanopsin in the eye, which is passed on to the SCN, the potential exists for many areas to be affected. Though SAD is not fully understood, genetic research into melanopsin, as well as hypothalamic genes associated with serotonin production, holds promise. In the meantime, the use of antidepressants, therapy, and artificial light may help SAD sufferers through the upcoming dark months. And with holidays approaching, spending time with family, friends and good food is Page 7

8 something we can all benefit from. Page 8

9 Chapter 4 : Seasonal affective disorder - Wikipedia If so, you might have seasonal depression, also known as seasonal affective disorder (SAD). Seasonal depression is a mood disorder that happens every year at the same time. Seasonal Affective Disorder For those suffering from seasonal affective disorder SAD, the disdain towards winter goes far beyond wet socks from slushy sidewalks. Winter depression grips its victims on an annual basis from about mid-october through March. Symptoms range in severity, but generally include low energy, irritable mood, fatigue, and strong cravings for carbohydrates, making weight gain common. The cause of SAD is not fully understood, but is most likely due to a combination of factors associated with low light. Winter means shorter days and more time spent in doors, which equates to less sun exposure. We really begin to understand the relation between SAD and light when we look at rates of occurrence as we traverse north from the equator. At the equator, where the days and temperature stay constant throughout the year, there is virtually no SAD. The further north you go, the days on average become shorter and colder during the winter months, and rates of SAD rise correspondingly. Insufficient Light Disrupts Brain Function Humans may not produce energy from sunlight, but we have more in common with the plant kingdom than most realize. Numerous sunshine modulating processes occur in the body. In fact, the pattern of daily functional changes that occur in the body, called the circadian rhythm, uses light as a major indicator for what is occurring outside. The brain detects light levels in the environment through the retina of the eyes, and changes hormonal expression in the body reflexively. It makes sense that in low light the body will produce hormones associated with sleepiness, whereas in bright light, it produces hormones associated with wakefulness. But what happens when there is a disparity between the environmental cues the brain receives and the tasks necessary to fulfill your day? Things get out of whack! When the circadian rhythm is disrupted the biochemical environment of the body becomes confused, and negative symptoms can occur. This type of disruption is particularly the case in SAD, where low light exposure means hormones of sleepiness are being produced during daytime hours, making us irritable, fatigued, and even depressed. Inappropriate secretion of melatonin is believed to play a major role in the development of SAD. Melatonin, a hormone produced in dim light by the pineal gland, is supposed to rise in the early evening hours to elicit sleepiness, peaking around midnight, and falling towards the morning to permit wakefulness. The involvement of serotonin in SAD is also suspected. Serotonin is a neurotransmitter that stimulates the body during the day. At night time, serotonin is converted to melatonin. Thus, when melatonin is being produced incorrectly during the day, it can lead to serotonin deficiencies. People with SAD are found to have a lower than normal level of daytime serotonin 2. Becoming Less SAD Treatment of SAD focuses on providing the body what is necessary to establish a properly functioning circadian rhythm, and making life more tolerable when feeling down. Light Therapy If the natural environment is not providing you with enough light to keep your bio-rhythms stable, you should make an artificial environment that does. Light therapy is perhaps the most important therapeutic intervention for those suffering from SAD. It greatly reduces depressive symptoms, and even corrects winter hormone imbalance 4. And luckily, the days of sitting in front special full spectrum lamps at set times of the day are over. A person can fill their environment with sunshine mimicking light by simply putting full spectrum bulbs in to their living spaces workplace, home, which are readily available in the marketplace. Take ultimate control of your environment by simulating the entire day. Surround yourself in full light from waking until 6pm, and then gradually dim the light to darkness at 10pm. This will ensure your circadian rhythm is producing the correct hormones at the correct times, without restricting normal activity. Melatonin If you have read the article up until now, you may be surprised to learn that taking supplemental melatonin will improve SAD. It comes down to timing. Having melatonin levels too high at the wrong time can be detrimental, whereas having high melatonin at the right time can be corrective. Because it modulates the hormones associated with SAD, it has potential benefit in more severe depressive symptoms, especially when used in conjunction with light therapy. Preventing Vitamin D Deficiency. While the research is not definitive, it appears that vitamin D supplementation may be beneficial for the treatment of SAD. Running Away from Depression Literally, run. Page 9

10 Or do anything active. Daily aerobic exercise is repeatedly shown as one of the most effective ways to regulate the circadian rhythm, treating and preventing depression. Symptoms of depression that can accompany severe seasonal affective disorder including hopelessness, social withdrawal, and suicidal ideation are very serious. People suffering from depression should seek help from a qualified health practitioner immediately, as many effective treatment options exist. Page 10

11 Chapter 5 : WHY SO SAD? MUSCLE INSIDER Seasonal affective disorder (SAD) is a type of depression that's related to changes in seasons â SAD begins and ends at about the same times every year. If you're like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. In addition to holidays and parties, there are often outdoor sports and winter vacations to enjoy. Winter also brings its own seasonal pleasures, like snowmen, knitted socks and cozy long evenings by a fireplace. However, some people do not get the same joy out of the cold-weather months as the rest of us. For people affected with seasonal affective disorder SAD winter can be a months long ordeal of fatigue and depression. What is this devastating disease? Why do some people fall prey to it while others can simply enjoy the colder season of the year? What is Seasonal Affective Disorder? Seasonal affective disorder is more than just the winter blues. Along with feelings of sadness and hopelessness, they suffer fatigue, fuzzy thinking, changes in eating habits and even sleep disturbances. Scientists and doctors believe that circadian rhythm dysregulation is a critical part of developing SAD. As the days grow darker and shorter, we lose one powerful cue for our internal clocks: The bleak and dim light of winter is not enough to help some people keep their circadian rhythms on track. As a result, their internal clocks become increasingly dysregulated, leaving their sleep cycles, appetites, and emotions in disarray. Living far from the equator in a place with long, dark winters is the major factor causing seasonal affective disorder. However, not all or even most people who live in these areas get the disorder. Your geographical location is the most important variable in whether you develop this disease. If you live in an area such as Florida or the Mediterranean, where winter still has plenty of sunlight, you will still get enough natural sun to keep your circadian rhythm on track. People who live near the equators in Alaska or Siberia, on the other hand, will be at the highest risk. Having a genetic predisposition toward depression also appears to play a role. People who have suffered from other types of mood disorder are at a far greater risk of developing SAD. Even having a relative with a mental illness can increase your chances. People who have this mutation are less sensitive to light and thus need stronger exposures to keep their circadian rhythm on time. People who carry this mutation appear to have a far increased likelihood of developing seasonal affective disorder, with rates exceeding half in some studies. However, none of these risk factors ensures that you will suffer from the winter blues. Even among people who have a genetic predisposition to this disease, some will never develop it. Why are these people protected while others are not? A new study poses this question and finds an interesting answer. The Role of Serotonin Transporters in SAD Serotonin receptors play a vital role in depression and are the target of many popular antidepressant drugs. These transporters remove serotonin, also known as the happiness hormone, from our brain. This housekeeping is important, but it can also contribute to depression. When we remove serotonin too quickly, we are left without its powerful mood boosting effects. Researchers looked at a group of people who had the gene for seasonal affective disorder yet did not have the illness. They found that these people had very interesting serotonin receptor activity. In the winter, their bodies produced fewer serotonin receptors, thus leaving their bodies with far more of this happiness-producing biochemical than others. This study may change the way we treat SAD and other seasonal circadian rhythm disorders. We currently treat these disorders mainly by trying to get the circadian rhythm back in sync. People use daily exposure to bright lights and melatonin supplements in the evening to mimic the physiological effects of warmer seasons. However, medications that affect serotonin also may have a positive effect on SAD. However, there are a few lifestyle changes that can make a huge difference. Keeping your circadian rhythm on its natural schedule will give you the best possible chance of enjoying the cold weather this year. Page 11

12 Chapter 6 : Seasonal affective disorder (SAD) - NHS How to Cope with Seasonal Affective Disorder (SAD) Katie Wells 5 Comments Updated: October 13, This post contains affiliate links Groundhog Day has come and gone, and if you live in the northern parts of the U.S., this is the time of year you may be getting a little weary of cold, snow, and gray skies. Decreased interest in pleasurable activities Problems sleeping â too little, too much, or disturbed sleep Changes in weight â loss or gain Changes in appetite â either overeating, or no interest in food Difficulty focusing on work or other tasks Thoughts of suicide Many of these symptoms can be associated with many types of illness. However, with SAD, they only occur during a specific season. If you have any of the symptoms listed above, it is important to accurately record your symptoms and discuss them with your doctor. People with a family history of SAD or other types of depression may be more at risk of experiencing this condition. Although not all research agrees, some suggests the further you live from the equator, the more likely you are to be affected by SAD. Here are some practical tips to make sure you get the most amount of sunlight possible into your life: Consider pruning any trees, bushes or other foliage that might obscure the sunlight that reaches your windows. Keep blinds open to maximize light, or consider fitting window coverings that allow the light through while maintaining privacy. Think about rearranging the furniture in your home so that your favorite chair or sofa is near a window. Spend regular time outdoors to make sure you get a good dose of natural light every day. Treatment For SAD There are several different ways in which SAD can be treated, and different treatment methods can be used in conjunction with each other to maximize the positive effects: Medication As with many other forms of depression, SAD can respond well to medication, especially if the symptoms are severe. Medications which change serotonin levels, such as selective serotonin reuptake inhibitors SSRIs have been shown in clinical trials to have a significant effect in reducing the symptoms of SAD. These types of medications are now prescribed by doctors as a preventative measure for patients to take before the time of year when their symptoms usually begin. Bupropion has been shown to significantly reduce symptoms, and prevent the recurrence of further episodes of SAD. Light Therapy Also called phototherapy, light therapy involves sitting near an artificial light source which mimics natural outdoor light. Research indicates it is an effective therapy for SAD, and has the advantage that this treatment can be portable, and used, for example, during your working day. Some research studies have suggested that light therapy can be just as effective as antidepressant medications, and observes that the best effects of light therapy are achieved when it is administered morning and evening. Although light therapy has been shown to be an effective treatment, it is important to seek correct medical advice for this treatment. It is important to receive the correct type and level of light, and to make sure there is no exposure to harmful UV rays. The negative effects of light therapy are generally lower than those of taking medication, although they include increased risk of eye strain, macular degeneration, headaches and sleep difficulties. This can help to reduce the intensity of the symptoms and help manage the condition more effectively. In particular, cognitive behavioral therapy CBT has been shown to be effective for reducing the symptoms of SAD, especially when used in combination with light therapy. Exercise has been shown to increase the production and secretion of serotonin in the brain. For many people with SAD, an energetic walk during the day combines the benefits of exercise with an extra dose of natural light. More costly solutions to increase the amount of light in your home include fitting some solar light tubes, or even adding windows or skylights to your home. Other ideas include replacing solid wooden or upvc doors with doors which have glazed panels that allow more light in. Changes to the Working Environment Most of us, however, are at our workplace during the day, during most of the sunlight hours. Although your employer may not be agreeable to fitting skylights or extra windows, it is worth discussing your problem with your boss. Your manager or employer may be able to support you by changing the type of window blinds in your work area to let more light in. Suggest that you change the position or location of your work area to be near â or at least to be facing â a window at work during your affected time. Sometimes people are surprised at how amenable bosses can be to making small changes that to increase your productivity and decrease the risk of employees having to take time off sick. Conclusion The main three points Page 12

13 to take away when considering SAD are: Seasonal affective disorder is a condition which, although rarely life threatening, can be extremely difficult and debilitating for many people through the winter months. It is thought to be linked to several chemicals in the body as well as our natural body clock. Women are at higher risk than men, and the onset of SAD is usually in early adulthood. There are many things you can do to reduce your risk of experiencing SAD, and there are various different treatments available for sufferers. The best things you can do to help avoid and manage SAD are to maximize your natural light exposure, especially during the winter months and take regular exercise. Page 13

14 Chapter 7 : Seasonal affective disorder (SAD) - Symptoms and causes - Mayo Clinic Why so SAD? What is seasonal affective disorder?most cases are related to winter, when days are shorter, nights are longer, and the cold keeps people holed up indoors instead of outside, absorbing. Read now Risk factors There are factors that can affect who gets SAD and who is less likely to have the condition. Sex - females are more likely than males to suffer from SAD, although this may be due to a greater prevalence of depression among women. Males may have more severe symptoms. Geography - some studies suggest that the further someone lives from the equator, the higher the chances of developing SAD. Put simply, those who live in places where days are considerably shorter in winter are more susceptible. Genetics - individuals with a close relative who has or had SAD have a greater risk. Having, or having had depression - people with a history of depression or bipolar depression are more likely to develop SAD than those with no such history. Causes Experts are still unsure of the exact causes of SAD. However, studies have pointed to the following: Circadian rhythm - our body clock. Each of us has an internal body clock that tells us when to be awake and asleep. Less sunlight in the winter is thought to disrupt our circadian rhythm, causing depressive symptoms. Melatonin levels - melatonin is a hormone that influences our sleep patterns and mood. Experts believe that reduced exposure to sunlight through shorter days in winter disrupts our melatonin balance. People with SAD also have decreased serotonin levels during the winter months. The hypothalamus - sunlight is thought to stimulate the hypothalamus, a part of the brain that controls sleep, mood, and appetite, all of which impact on how we feel. Similarly, production of serotonin, a brain chemical neurotransmitter that affects mood, may be affected by low sunlight. Diagnosis The doctor may carry out a physical exam and ask questions covering: How long symptoms have been present, how severe they are, and how they affect daily activities. What eating patterns are like. Sleeping patterns and if they have changed. How thoughts and behaviors change with the seasons. Details about family medical history, such as depression, SAD, etc. As there are several types of depression, diagnosing SAD accurately may take time. There is no medical or laboratory test that can diagnose the condition. The doctor may order some diagnostic tests, including blood tests, to rule out other illnesses or underlying conditions. According to the American Psychiatric Association, people may alleviate SAD symptoms by boosting their exposure to sunlight. For example, going for long walks outdoors when there is still some sunlight could help. Bright light therapy, also known as phototherapy, can help restore circadian rhythm. With this kind of therapy, a person sits in front of a special light for minutes each day. It is important to purchase a light box that is designed for treating SAD. UV lamps, full-spectrum lights, and tanning lamps will not do the same job. In general, light therapy is required from 30 minutes to 2 hours per day, depending on the strength of the light. Doctors say exposure in the mornings tends to give the best results. A similar treatment is known as dawn simulation when a special light in the bedroom is programmed to get slowly lighter in the mornings, to simulate dawn. Experts say this type of phototherapy also helps restore brain chemistry balance. Nobody is sure how all this occurs. Cognitive behavioral therapy CBT is based on the premise that it is how a person thinks and reacts to things that causes unhappiness rather than the situation. For example, if the way a person perceives certain situations can be altered, their behavior will change, and their symptoms will be reduced. CBT usually includes an individual program of self-help, and another for the person and their partner, if appropriate. Sometimes a group program can also be helpful. Medication A doctor may prescribe an antidepressant, usually a selective serotonin reuptake inhibitor SSRI, which raises serotonin levels. Antidepressants do not work straight away; they can take from 10 days to 1 month to work well. Experts say antidepressants for SAD are more effective if taken at the beginning of the SAD season, before symptoms appear. Usually, they are taken daily until springtime. Self-help Some people have found that making their environment sunnier and brighter helps alleviate symptoms. Examples include opening blinds and curtains, trimming trees around the house, and sitting closer to the window during daytime. Even in winter, the sun still comes up, and there is more sunlight outdoors than indoors. So, getting out every day for a long spell in the open air may help. Similarly, exercise is not only good for the health but alleviates symptoms of anxiety and aids proper sleep. Exercises can also help people nurture a better self-image, which Page 14

15 tends to lift their mood. Page 15

16 Chapter 8 : Seasonal Affective Disorder (SAD): What Is It and How to Avoid It? - Health Ambition If shorter days and shifts in weather zap your energy and make you feel blue, you've got classic symptoms of a seasonal mood disorder. Seasonal affective disorder (SAD) is a form of seasonal. Axe content is medically reviewed or fact checked to ensure factually accurate information. With strict editorial sourcing guidelines, we only link to academic research institutions, reputable media sites and, when research is available, medically peer-reviewed studies. Note that the numbers in parentheses 1, 2, etc. The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Our team includes licensed nutritionists and dietitians, certified health education specialists, as well as certified strength and conditioning specialists, personal trainers and corrective exercise specialists. Our team aims to be not only thorough with its research, but also objective and unbiased. February 20, Dr. Axe on Facebook Dr. Axe on Twitter 10 Dr. Axe on Instagram Dr. Axe on Google Plus Dr. Axe on Youtube Dr. Does your motivation to socialize with friends and family or even leave the house disappear when the sun does? You might be suffering from seasonal affective disorder, or SAD. The winter blues are well known and quite common â after all, these months come packed with a lot of holidays that can be emotionally draining. Those who suffer from seasonal affective disorder are actually experiencing a type of depression that rears its head during certain seasons. What Is Seasonal Affective Disorder? SAD is a form of clinical depression that comes and goes in a seasonal pattern. This bout of depression begins and ends around the same time each year 1. About half a million Americans, mainly from northern climates, suffer from SAD in its strictest form each year; interestingly enough, three out of four people with SAD are women. SAD affects people from September to April, with peak read: For most people, their first winter experiencing seasonal affective disorder will occur between the ages of 18 and 30 years old 2, though a change in location, such as a major move later in life, can bring on symptoms. When our circadian rhythms are out of whack, it can affect our levels of melatonin and serotonin. In people with SAD, melatonin, the hormone that makes us feel sleepy, might be produced in higher levels, leading to increased feelings of lethargy. On the other hand, serotonin levels decrease. Serotonin is a hormone that affects our mood and appetite; not having enough serotonin is linked to depression 3. Because seasonal affective disorder seems to be more common in women than men, being female is a risk factor. Additionally, there seems to be a genetic predisposition to seasonal affective disorder, as it often runs in families 4. And, unsurprisingly since seasonal affective disorder is so tied to sunlight, location makes a difference. SAD is more common among people who live far north or south of the equator, thanks to abbreviated daylight winter hours and longer days during summer months. Symptoms of Seasonal Affective Disorder Seasonal affective disorder symptoms vary from person to person. Generally, symptoms might start out mild and become more severe during the peak winter months of December through February. They start to ease up once sunnier spring days begin emerging. People suffering from SAD experience a decrease in energy, trouble sleeping, a loss of interest in activities, difficulty concentrating, depressive feelings, a decreased sex drive, and appetite or weight gain changes â sugar addiction and cravings for carbs and other comfort foods are also common in people with seasonal affective disorder 5. The telltale sign is when you begin experiencing these depressive feelings. Usually, the feelings will begin in September, be at their worse during the peak winter months, and start easing up in March or April. A diagnosis will often not be made until two to three consecutive winter seasons with the symptoms. Your doctor will probably do a physical exam, which might include lab testing to rule out any other health problems, and a psychological evaluation. No one who is in mental pain for so long should have to wait to start feeling better. Luckily, there are several natural, prescription-free remedies you can try. Get a light box If your outdoor hours are limited during the winter months, a light box might be a worthwhile investment. Most people require between 15 to 30 minutes of therapy a day and will start feeling improvements within two to four days, with the full improvement happening within two weeks. Because seasonal affective disorder symptoms will return quickly once light therapy stops, remaining consistent with treatment during the winter months is crucial. Light therapy boxes are available without a prescription, but they can come with side Page 16