Debunking Seasonal Affective Disorder (SAD) Treatments Myths
April 10, 2020
We all know about, or have experienced, the feeling of the `winter blues”. That sad, cold feeling when the soft, sunny warmth of summer is consumed by the frosty hand of winter.
It is natural to feel these kinds of effects with the change in temperature, shorter days, and less outdoor activity. But for some individuals, these seasonal effects aren’t just inconveniences, but inhibit their everyday life.
Seasonal Affective Disorder (SAD) is a type of depression that's related to these changes in the seasons. It begins and ends at about the same times every year, usually starting in late fall and ending in early spring. Sufferers experience mood fluctuations into the winter months, low energy, and can feel moody.
Other symptoms of Seasonal Affective Disorder include feeling hopeless, sluggish, low energy, losing interest in activities, Hypersomnia, changes in appetite, difficulty concentrating, weight gain, social withdrawl, and, in the worst cases, thoughts of suicide.
Unfortunately, some people are also more susceptible to experiencing these symptoms. SAD is recorded to be diagnosed four times more in women than in men, and, for obvious reasons, those that live in the northern regions of the world far from the equator. In addition, those who already experience depression or have a family history of depression or bipolar disorder are more likely to experience SAD.
According to research, it is possible that people with SAD may have more trouble regulating serotonin, one of the key neurotransmitters involved in mood. With higher levels of serotonin transporters in the winter months, less of the neurotransmitter is left in synapse, causing such low moods. People with SAD also may produce less Vitamin D. Vitamin D is believed to play a role in serotonin activity. Vitamin D insufficiency may be associated with clinically significant depression symptoms.
So it might not just be a “seasonal funk”. And there are steps you can take to keep your mood and motivation steady throughout the year. But it can be hard to parse out which treatment myths from medicine.
To help, here are 3 Seasonal Affective Disorder myths debunked, and some actual seasonal depression treatments for those experiencing SAD.
Myth #1: Tanning Helps Alleviate Symptoms
We all know being in the sun lifts our mood, but does it really help with seasonal depression?
Why is tanning so bad? We all love to have a summer glow, and often we are willing to go to extreme lengths to get it. We not only lay out in the sun for hours, applying low SPF sunscreen for that perfect tan, but we flock to indoor tanning beds during colder months to get that “base tan” before we hit the beaches for vacation.
However, the problems with tanning, both in tanning beds and outside, are serious and can affect our health for the rest of our life.
According to the American Academy of Dermatology, skin cancer is the most common cancer in the United States. And The Skin Cancer Foundation says that those who use indoor tanning beds at least one time before the age of 35 increase their risk of developing skin cancer by 75%-- which is alarming!
Tanning doesn’t just give us sunburn and skin cancer, though. It can also damage our eyes and give us what is called Photokeratitis. According to the FDA, it is thought of as sunburn to the cornea (in the winter, we call it “snow blindness”), which is caused by intense UVC and UVC exposure to the eye. Certain types of tanning beds can cause this, and symptoms involve tearing, pain, swollen eyelids, and hazy or decreased vision.
For Photokeratitis (unlike skin cancer), treatment is easy and the eyes usually regains sight within 24 to 48 hours due to the cornea’s ability to heal quickly.
While doctors recommend exercise to alleviate seasonal depression symptoms, and during the summer we might feel less down due to warmer temperatures and sunnier days, but tanning’s effects on depression directly carry many more risks than benefits.
Treatment #1: Lightbox Therapy
You might have never heard of it, but it could just be the thing to cure your SAD
Tanning may be ineffective in the long run, consider the possibility of the safer, doctor prescribed option of lightbox therapy, sometimes called Phototherapy, a therapeutic practice that softens the symptoms of seasonal depression by exposing individuals to light via a special box or lamp.
This form of therapy has been around for years, and the device itself comes in the form of a lamp or a box, producing effects almost identical to natural light that can trigger chemicals in the brain that help regulate your mood.
It is considered a highly safe treatment option due to its use of narrow band ultraviolet B band light, which supplies the most therapeutically beneficial type of ultraviolet light while minimizing the risk of skin cancers and dermatological damage that can occur from tanning.
The ultraviolet band B light also has been found to treat and limit symptoms of a number of skin conditions, such as psoriasis, vitiligo, atopic dermatitis, leukoderma, hand dermatitis, alopecia areata, and certain hypersensitivities and allergic reactions.
In general, the light box should be exposing individuals to at least 10,000 lux of light and emit as little UV light as possible and are recommended to use the device within the first few hours of waking up for no more than a half hour with their eyes open.
Light boxes are designed to be safe and effective, but they aren't approved or regulated by the Food and Drug Administration (FDA) for SAD treatment, so it's important to understand your options.
Studies have shown that short exposure to light treatment improves depression scores in patients with seasonal affective disorder, making it a safer, more effective treatment option than tanning. You can even buy a light box without a prescription! Though, getting approval from your doctor is recommended, and most health insurance plans do not cover the cost.
Myth #2: Seasonal Depression Only Occurs in the Winter
It may not be safe to assume your seasonal depression symptoms will fade after winter.
It’s true that during the cold winter months, individuals are more susceptible to experiencing symptoms of Seasonal Affective Disorder due to shorter days, cold temperatures, and less direct sunlight and outdoor activity. However, remember that it’s called “seasonal” not winter-- meaning even during the summer individuals can feel down or low energy.
Sunlight is believed to be the key to understanding summer SAD, also called MDD (Major Depressive Disorder) with a seasonal pattern. For individuals experiencing this, too much sun may be the culprit to their decreased mood.
Too much sun can negatively affect melatonin production, the hormone that regulates our sleep cycle. With such long days in June, July, and August, the sun can disrupt our circadian rhythm and create a hormone imbalance. It is also found that those living with MDD with seasonal patterns are anxious and angry.
This is a kind of atypical depression where people tend to gain weight and sleep more during a period of the year where others are more active. Symptoms also include hypersomnia, daytime fatigue, overeating, lethargy, decreased sexual interest, and hopelessness.
Treatment options vary, and often involve seeking our cooler climates for a short period of time (air conditioned rooms, temperate locations). However, dark rooms are also available to sufferers. Instead of light therapy, individuals with summer-onset MDD with a seasonal pattern are often advised to spend more time in dark spaces and carefully time their light exposure during the day.
Treatment #2: Psychotherapy & TMS
Professional help may be the route for those who are unable to solve their seasonal depression on their own.
Managing stress, anxiety, or depression on your own can be quite difficult. Talking to a healthcare provider about your symptoms may be the best, most effective treatment option for some in learning how to stay positive and keeping healthy coping strategies.
There are all kinds of therapy to help those suffering from depression, and cognitive behavioral therapy (CBT) is one form that has been shown to be quite beneficial. CBT helps seasonal depression sufferers replace negative thoughts, feelings, and behaviors with positive thinking and actions.
In addition, transcranial magnetic stimulation (TMS) treatment has been shown to help individuals overcome severe depression, anxiety, PTSD, OCD, and other brain and mood issues. TMS has some serious benefits and may just be an effective form of treatment for those suffering from seasonal depression.
Myth #3 : More Vitamin D
Supplements like vitamin D have not been found to significantly alter the effects of Seasonal Affective Disorder
Vitamin D, a fat-soluble vitamin, can be found in salmon, canned tuna, cows milk, egg yolk, and mushrooms. In other foods, it is added. We can also get vitamin D from ultraviolet rays, when sunlight hits the skin and vitamin d synthesis is triggered.
Sometimes, individuals will take Vitamin D if they do not consume these vitamin rich foods, like vegans, vegetarians, and those with a lactose intolerance.
Some studies conducted in the past few years have drawn correlations between lower vitamin D levelsorrelations between lower vitamin D levels and depression. However, this does not mean that low levels of vitamin D are the cause of the illness, only that they existed at similar times, potentially due to the lack of sun exposure by depressed individuals.
And in fact, one study conducted in 2014 showed that there were “no significant between-group differences” in those individuals with SAD who took vitamin D and those who didn’t.
There is no doubt that vitamin D should be an essential part of our diets, and that there are real benefits to letting your skin absorb essential UV rays to trigger vitamin D production. However, the jury is still out on whether it is a viable option for seasonal depression treatment.
Treatment #3: Pharmaceutical Options
While nutritional supplements might not be super effective, antidepressant medications prescribed by your doctor can be.
Antidepressants are a more certain route for those experiencing symptoms that are detrimental to their well being or safety. They can lighten the effects of seasonal depression and offer clarity during a time of year that may seem cloudy or hopeless.
Before seeking medication, it is crucial to start a conversation with your doctor about which antidepressants are right for you. Your doctor may give you a prescription for a short period of time until symptoms dissipate, or they may recommend a longer dosage sequence to target a more serious, possibly underlying mood disorder.
There are many kinds out on the market, some for broad issues and some for specific symptoms. Determining the right medication will help you achieve better results and get well sooner.
Stop SAD + Take Back Your Life
Now that we know what is myth and what is medicine, you can move forward with finding the best treatment options for your depressive symptoms. Don’t let seasonal depression limit your ability to enjoy life.