SAD, Don’t Let it Get You Down

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The clouds, rain, fog and shorter days have made their annual return to the Willamette Valley. And with them come, for some of us, bouts of the “winter blues.” While it is normal for everyone to feel down every once in a while, persistent depression might be a sign of Seasonal Affective Disorder or SAD.

SAD is a type of major depressive disorder that is usually associated with winter, but it can occur during summer. The symptoms appear when the season changes and may occur again every year in some people.
It is no longer classified as a separate mood disorder, but it is a “specifier” added to the primary diagnosis of major depression. This can help narrow down what treatments might work best for a given patient.

The cause of SAD is unknown, but it probably has a large genetic component, as is the case in other types of depression. Other risk factors include living far from the equator (as we do in Oregon), having another mood disorder, and being female, though males might exhibit more severe symptoms.
These symptoms include having less energy, sleeping more than usual, overeating, craving carbohydrates and gaining weight, in addition to depression, anxiety, hopelessness, social withdrawal and difficulty concentrating. In the summer variety, people may have insomnia, have a poor appetite and exhibit weight loss.

Treatment includes light therapy, medications, psychotherapy, and exercise.

Light therapy
Though there has not been much research on light therapy, it appears to help most people in relieving SAD symptoms. But before considering light therapy or purchasing a light therapy box, talk to your doctor or mental-health provider to ensure it is right for you and to make sure the light therapy box is of high quality.

Medications
Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe. Antidepressants commonly used to treat SAD include Paxil, Zoloft, Prozac, and Effexor.

Psychotherapy
Psychotherapy can help you identify and change negative thoughts and behaviors that may be making you feel worse. You can also learn healthy ways to cope with SAD and manage stress.

Exercise
Regular physical exercise, especially outdoors, helps relieve stress and anxiety, both of which can increase SAD symptoms. And being more fit can make you feel better about yourself, which can lift your mood.

When To See a Doctor
If you feel down for days at a time and you can’t seem to get motivated to do activities you usually enjoy, see your doctor. This is especially vital if your sleep patterns and appetite have changed or if you are having feelings of hopelessness, have suicidal thoughts, or drink alcohol for comfort.
In other words, don’t blithely reject that yearly “down” feeling as merely a case of a seasonal funk that you must endure by yourself. Take the action to get the help you need so your mood and motivation remain steady throughout the year.

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Jean Pointon, M.D., is a psychiatrist at The Corvallis Clinic. She can be reached at
541-754-1288.

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