SAD is a form of depression that occurs in the fall and winter months, probably in response to the fewer hours of daylight. Symptoms usually begin in late fall or early winter and go on until the following summer. A less common type of SAD, summer-onset depression, usually begins in the late spring or early summer and continues until the following winter. Between four percent and six percent of people in the United States are believed to suffer from SAD. Another 10 percent to 20 percent experiences a milder form of winter-onset SAD. This disorder is more common in women than in men. Although some children and teenagers are affected, SAD usually occurs in people between 18 and 30 years of age.
SAD has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and a lack of sunlight in winter. Just as sunlight affects the seasonal activities of animals, SAD may be an effect of this seasonal light variation in humans. As seasons change, people experience a shift in their biological internal clock or circadian rhythm that can cause them to be out of step with their daily schedule.
Sad feelings don’t have to take over your mood or ruin your day. You can do things to help yourself feel better. You can do things to prevent sad feelings from sticking around too long or becoming too strong.
Those with SAD may not experience every symptom. For example, energy level may be normal while carbohydrate craving may be extreme. Sometimes a symptom is opposite the norm, such as weight loss as opposed to weight gain. In a small number of cases, annual relapse occurs in the summer instead of the fall and winter, possibly in response to high heat and humidity. During this period, the depression is more likely to be characterized by insomnia, decreased appetite, weight loss, and agitation or anxiety.
People with SAD tend to sleep more, be less productive at work, have less energy for recreational activities, including sex, and feel down in the dumps for no particular reason. They tend to eat more (especially sweets and starches) which, together with a low activity level, may lead to winter weight gain. Generally, the SAD months are November through March, January and February being the worst. Of course, this reflects the population average. At the extremes, annual SAD relapses can begin as early as August and end in January, or they can begin as late as January and last through June. SAD could be an explanation for the above symptoms, even if you experience them beginning in, say, October.
The symptoms of SAD that occurs in the summer are typically somewhat different from the more common type of winter seasonal depression. They include anxiety, insomnia, irritability, agitation, weight loss, poor appetite and increased sex drive.
Most people with SAD are women whose illness typically begins in their twenties, although men also report SAD of similar severity and have increasingly sought treatment. SAD can also occur in children and adolescents, in which case the syndrome is first suspected by parents and teachers. Many people with SAD report at least one close relative with a psychiatric condition, most frequently a severe depressive disorder (55 percent) or alcohol abuse (34 percent). Some patients begin to slump as early as August, while others remain well until January. Regardless of the time of onset, most patients don’t feel fully back to normal until early May. Depressions are usually mild to moderate, but they can be severe. Very few patients with SAD have required hospitalization, and even fewer have been treated with electroconvulsive therapy.
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