Affinity Health Plan

  • Dealing with Seasonal Affective Mood Disorder

    January 05, 2015

    Seasonal Affective Disorder

    Seasonal Affective Mood Disorder (SAMD) is not just the holiday or post-holiday blues.  It is a major form of depression that seriously affects the lives of six to ten percent of the population, according to Dr. Elisabeth Hager, psychiatrist with Beacon Health Strategies. Another 10 to 20 percent have mild cases of the disorder that are not as disruptive, she said. Dr. Hager explains that this disorder is real because imaging studies show the specific brain changes.

    While both the holiday blues and Seasonal Affective Mood Disorder have to do with feeling down, the first is a feeling that will pass, while the other will reoccur.  "SAMD is a subtype of a major depression," says Dr. Rekha Rao, who is also a psychiatrist with Beacon Health Strategies.

    This illness is recognized in patients who have had episodes over two or more years. Also, as the name states, this disorder has to do with the seasons. While symptoms can happen at other times in the year, SAMD is best known for occurring in the fall when the sun sets earlier.  "It begins in early October to late November and resolves itself in February to mid-April," Dr. Rao says. The other striking feature is that it's more apt to happen to people in their forties. "Very few people are diagnosed after reaching 55 years of age," she said, adding, "people just age out of it."

    The doctors explained that individuals can get through SAMD by themselves if their symptoms are mild and not causing major problems in their daily life. What is important is recognizing the disorder. If it persists, see your doctor for advice.

    Symptoms

    • Depression is the major symptom of the fall/winter disorder. "The person would have a loss of interest in things, would be oversleeping and have trouble concentrating," says Dr. Hager.
    • Eating is another key sign of this disorder. "People with SAMD tend to overeat and crave carbohydrates," Dr. Hager said.  Carbohydrates include potatoes, yams, pasta, breads, cookies and cake.
    • Summer Seasonal Affective Mood Disorder is the lesser seen disorder. "The person would have difficulty sleeping, eating and would have an increase in anxiety," says Dr. Hager. She cautioned that these symptoms can go from mild to severe. "On the severe end, it can end in suicide. It is important not to underestimate the illness."

    Treatment

    Seasonal Affective Mood Disorder can be treated. More importantly, those who have mild symptoms can do a lot to help themselves feel better. Still, if the depression gets worse or if feelings of suicide creep in, immediately go to an emergency room. The following treatments, either used individually or in combination, can ease the symptoms.

    • The light box. The light box mimics daylight. Users turn it on an hour or two before dawn and sit a foot or two away from it. "Don't look into the light," says Dr. Hager, who suggests reading while it's in use. Researchers think it changes brain chemicals and improves mood. "Patients do experience a decrease in symptoms," she says, adding, "people do respond to it." Dr. Hager warns against using tanning beds as a substitute.  "Tanning beds have high UV rays and will damage skin and eyes," she said. What's more, she stresses that tanning beds don't work on mood disorders.
    • Cognitive behavioral therapy. This is a type of "talk therapy" with either a psychiatrist or psychologist that aims to reduce negative thinking and bad thoughts. "Negative thoughts keep you trapped in depression," Dr. Hager says.
    • Exercise. Exercise releases brain-making opioids that make people naturally feel better. "It's a natural high," says Dr. Hager.
    • Dietary changes. Cravings for potatoes, yams, rice, pasta, and breads may be strong, but cutting out these and other carbohydrates is needed to improve your mood.
    • Stop drinking alcohol and/or smoking marijuana.  Alcohol interferes with sleep, and the chemical compounds in marijuana can have a bad reaction in the brain. "While at first they help, over time these substances will interfere and will throw your nervous system off," she said.
    • Dietary supplements. Omega-3 DHA and EPA are dietary supplements that are used to improve thinking, behavior and mood. "They decrease depression and cognitive problems in thinking and concentrating," says Dr. Hager. She explained that studies in Iceland, where it is dark and cold for months at a time, showed that the Icelanders have lower rates of depression. "It was because of the fatty acids in fish," says Dr. Hager. While salmon, tuna, sardines, mackerel, and trout are good sources of fatty acids, the doctor warns against eating too much of these or taking a lot of supplements. She points out that fatty fish have heavy metals in them, which in large amounts could harm a person. With supplements, Dr. Hager says, "there are no standards for amounts of active ingredients so it's not clear how much you might be taking."
    • Prescription medicine. It is used either when other treatments fail or do not completely solve the problem, according to both doctors. However, in certain situations, an antidepressant such as Prozac can be very helpful, they said.

    For those who have a mild case of SAMD and are managing it on their own, Dr. Hager says to establish and stick to a normal, consistent sleep cycle. Also, don't wear yourself out. "Be realistic about what you can and cannot do," she adds.

    Keep in mind that although this problem is seasonal, it is important to seek treatment if needed, and not to hold onto the idea that "this will pass."

    Drs. Elisabeth Hager and Rekha Rao are psychiatrists working for Beacon Health Strategies. Dr. Hager specializes in geriatric psychiatry and addiction medicine. She has a private practice in Rochester, NY.  Dr. Rao specializes in in geriatric psychiatry and practices at a community mental health clinic in Portsmouth, NH. 


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