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)
QuickTimeª and aH.264 decompressor
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