Seasonal Affective DisorderIt’s Not Just the Winter Blues

Judith Gusky Counseling Services

September 27, 2010

What is SAD? Subtype of depression

– Seasonal onset & remission of symptoms Winter SAD Summer SAD Reverse SAD Subsyndromal SAD

Oct Jan April July Oct

Winter Summer

Depression AnxietyHypomania

Reverse

Sym

ptom

s

Winter Blues

Symptoms of Major Depression

Mood Pleasure Appetite Weight Sleep Physical

Sad, anxious, empty

Feelings of guilt, worthlessness, hopelessness

Irritability, restlessness

Suicidal thinking

Loss of interest in activities

Reduced sex drive

Social withdrawalIncreased

DecreasedIncreased

DecreasedIncreased

DecreasedFatigue

Trouble concentrating

Persistent aches or pains

XPoor concentr

XFatigue

Physical

XInsomnia

XHypersomnia

Sleep

XLoss

XGain

Weight

XDecrease

XIncrease

Appetite

XDecrease

XIncrease

XDepressed

XAnxious

Symptom Winter SAD Summer SAD

Mood

Pleasure

Symptoms of Winter SAD

Depressed mood Loss of pleasure in things previously enjoyed Social withdrawal Increased appetite (carbohydrate craving) Weight gain Hyper-somnia Fatigue Trouble concentrating

Not “Winter Blues”Significant impairment in daily activities

Causes of Winter SAD

Lack of sunlight– Shorter days (seasonal)– Latitude– Cloud cover

Decreased serotonin levels– Altered brain chemicals

(neurotransmitters)

Cloudiest Cities

Pittsburgh 203 cloudy days per year (59%)

Yuma, AZ 52 cloudy days per year (14%)

Latitude and Winter SAD

No Winter SAD at equator

Winter SAD increases with latitude but only to a point

Winter weather and cloud cover also key factors

Iceland

Japan

SiberiaAlaska

New Hampshire

Florida

• Stockholm• Helsinki• Oslo

Equator

75°

60°

30°

9.216.53.8

3.97.114.0

0.9

1.4

9.7

New York City4.7

Pittsburgh: 40° Latitude 1.427°Σαρασοτα, Φλοριδα

4.740°Νεω Ψορκ Χιτψ

9.742°Νασηυα, Νεω Ηαµπσηιρε

3.959°Στοχκηολµ, Σωεδεν

7.159°Ηελσινκι, Φινλανδ

14.59°Οσλο, Νορωαψ

3.864°Ρεψκϕαϖικ, Ιχελανδ

16.564°Σιβερια

9.265°Φαιρβανκσ, Αλασκα

0.935°Ναγοψα, ϑαπαν

ΣΑ∆(% οφ σαµπλε)

ΛατιτυδεΛοχατιον

Explaining SAD Circadian Rhythm

– A 24-hour cycle (rising/setting of sun)

Circannual Rhythm– A yearly cycle, e.g. bird

migrations, animal hibernation, SAD

Biological Clock– Internal mechanisms that

control the rhythm or timing of biological functions, e.g. sleep cycles (animals), photosynthesis (plants)

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are needed to see this picture.

Synchronizing Our Biological Clock

Daylight alternating with darkness is not the source of human circadian rhythms

It only synchronizes our internal biological clock to the 24-hour cycle

Human circadian rhythm is 24.5 hours

What does it mean to be out of sync?

Shift work Jet lag Seasonal slow down

– Waking up in dark– Getting home in dark

How do I know if I have SAD?

Symptoms– Significant impairment

Seasonal recurrence– Fall onset– Spring remission

Diagnosis– Mental health professional– Self-assessment

Seasonal Pattern Assessment