Seasonal Affective Disorder is Prevalent in the Fall and Winter

Seasonal Affective Disorder or SAD is synonymous with seasonal depression or anxiety. Seasonal depression is a term which describes an environmental issue that brings on a depressive episode, anxiety or panic attacks; in this case-the changing of the seasons. Most sufferers from seasonal affective disorder seem to experience this as the days get shorter approaching the winter season, this is seasonal affective disorder or also referred to as seasonal adjustment disorder. Some people will get these anxiety or depressive episodes during any or all changing of the seasons. One such person described his episodes with seasonal affective disorder as this: "it is as if one day I notice that the sun is hanging in the sky differently, and then I notice my surroundings look different, and I get anxious and then a panic attack comes on me.”

We don't know exactly why the changing of the seasons has this impact on the mental conditions (seasonal affective disorder) of certain individuals but the occurrences happen too often to write them off as fluke occurrences. The DSV-IV-TR doesn't acknowledge seasonal affective disorder as a unique disorder but considers SAD as major depression or bipolar disorder, similar post-partum depression or other "kinds" of depression. Yet up to 9% of certain populations on the East Coast in some cases will suffer with seasonal affective disorder. As a Scottsdale Psychiatrist, I treat many people who formerly resided in parts of the country where they were prone to seasonal affective disorder. Many of them tell me that they no longer have these incidents since moving to the Sunshine State; however, people can still have episodes of seasonal affective disorder in Arizona. 

Seasonal Affective Disorder is Considered Major Depression, Bipolar I and Bipolar II in The DSM IV

According to the DSM-IV-TR criteria, Seasonal Affective Disorder is not regarded as a unique disorder. It is called a "specifier" and may be applied as an added description to the pattern of major depressive episodes in patients with Major Depressive Disorder, Recurrent, and patients with Bipolar I Disorder or Bipolar II Disorder. None the less seasonal affective disorder is a unique phenomenon.

The "Seasonal Pattern Specifier" must meet four criteria: depressive episodes at a particular time of the year; remissions or mania/hypomania at a characteristic time of year; these patterns must have lasted two years with no non-seasonal major depressive episodes during that same period; and these seasonal depressive episodes out number other depressive episodes throughout the patient's lifetime.

How this seasonal affective disorder is categorized can in one sense be seen as an issue of taxonomy. SAD is often triggered by situations that are benign, which are the appearance of depression as the seasons change. Situational depression on the other hand, is triggered by traumatic stress in one’s life that is short lived, and subsides as the situations that brought on the disorder are no longer present. As a matter of importance, healthy emotional individuals will have feelings of anxiety and depression during trials and tribulations in their lives. I say this to those who are experiencing some anxiety or depression due to a job loss, the outlook on the economy or geo-political situation, maybe a death in the family or divorce. If you are going through these trials and don't experience some anxiety or depression you aren't in touch with the world news or your emotions! Don't panic, if the symptoms persist for a period after the circumstances have diminished, you may wish to consider an evaluation.

Rather than trying to understand the causes and classify seasonal affective disorder or SAD as its own disorder, it might be best to take a pragmatic approach and learn to cope, avoid, and treat the condition as major depressive disorder and or generalized anxiety disorder or GAD.

For those who suffer from seasonal affective disorder in areas of the world where the winter seasons are long and dark, light therapy seems to hold the disorder at bay as well as treatments with melatonin. In other conditions it might be best to learn what the triggers are and when one feels them coming on, go immediately to their doctor and get started on some or increase their anti depressants medication or anti-anxiety medications. It is much easier to prevent an episode of major depression or anxiety than to wait for its full manifestation before dealing with the disorder.

Knowing the signs of seasonal affective disorder we can then learn some ways of avoiding it: 1. Acknowledge and learn what triggers it in your life brings on these episodes. 2. Prepare for it. 3. Change your environment to possibly avoid future occurrences. Sometimes just knowing that you have the extra "meds" in your purse or wallet is enough to preclude the anxiety attack without having to ever resort to using the medication. If the short cold days of winter tend to bring on a depressive episode; put your lights and appliances on timers so you don't go home to a dark house. Keep the TV and or radio on as well. Take vitamins, eat well and exercise during these periods and stay positive. Our emotions follow our thoughts and our emotions can be responsible for the amount of neurotransmitters on our systems that keep our moods stable. These lifestyle changes will sometimes keep these seasonal changes from sending you into an anxiety, panic attack, depressive episode, or episode of seasonal affective disorder. Always keep your doctor informed as well so he or she can be there to help you; your support network is key. Stay close to your friends.

This article on seasonal affective disorder is for informational purposes only and not meant to diagnose or treat any mental illness and written by Marie Gronley MD. Dr. Gronley is a Scottsdale psychiatrist and you may visit her website for more articles of interest.