Seasonal Affective Disorder SAD

Seasonal Affective Disorder (SAD) is a mood disorder associated with specific periods of the calendar year. SAD is more commonly found in geographic locations with long winter seasons with shorter daylight hours, less sunlight, and longer nights. This lack of sunlight has been directly connected to mood changes in a variety of populations and is most common at latitudes that experience less light during the winter seasons. In addition, some mood changes have been associated with the summer months in specific geographic areas.

This paper will explore the diagnosis and assessment of Seasonal Affective Disorder, including the differentiation of the physical and emotional causes for the mood changes that occur. The paper will also explore the common treatment methods, including behavioral, pharmacological, and biopsychological, attempting to identify the preferred methods of treatment and data regarding the efficacy of the methods (.

According to the American Psychiatric Association's (APA) DSM-IV, SAD is not a separate mood disorder but the term is "specifier," for seasonal patterns of major depressive episodes that can occur in individuals with major depressive and bipolar disorders.

According to the APA (1994) a diagnosis of SAD must meet the following criteria: " Regular temporal relationship between the onset of major depressive episodes and a particular time of the year (unrelated to obvious season-related psychosocial stressors) Full remissions (or a change from depression to mania or hypomania) also occur at a characteristic time of the year Two major depressive episodes meeting criteria A and B.

In last two years and no nonseasonal episodes in the same period Seasonal major depressive episodes substantially outnumber the nonseasonal episodes over the individual's lifetime (APA, 1994)." It has been estimated that SAD affects 4 to 6% of the population, with 10 to 20% of people suffering "subsyndromal features." Women are slightly more likely to develop symptoms of SAD, and the risk seems to decrease with age. Seasonal Affective Disorder can be treated with psychotropic medications, light therapy, and psychotherapy interventions, including cognitive behavioral therapy.

Light therapy is conducted with a 10,000 lux light box that can simulate daytime sunlight. The light is believed to trigger the release of serotonin, the substance that regulates mood. Patients have therapy sessions starting at 10-15 minutes per day, and this slowly increases to 30-40 minutes. Studies have shown light therapy to be effective in elevating mood in patients during winter months, and the side effects are minimal. The use of antidepressant medication in cases of SAD is typically centered on common SSRI medications used for general depressive disorders.

There is some concern, however, that the relationship between SAD and bipolar disorders may contraindicate the use of light therapy or SSRI medications, as both treatments can trigger manic episodes in patients with bipolar disorder. Clinicians who are treating individuals with evidence of bipolarity should be particularly cautious about the use of therapies that can trigger mania. These patients typically require a combined therapy that includes a mood-stabilizing agent (Saeed & Bruce, 1998).

Many psychologists and researchers have noted that psychosocial and behavioral issues may also be linked to SAD, and they promote the use of therapeutic interventions, including cognitive behavioral therapy. These researchers argue that seasonal mood changes may also be attributed to social and familial issues connected to a variety of key holidays and celebrations. Alcoholism and binge drinking both present possible causative factors for SAD, as consumption of alcohol often increased during the December holidays and through the end of the year.

As a depressant, alcohol can affect mood, and may trigger a depressive episode or intensify one that is already present. Researchers note that many individuals may experience stress or sadness associated with the December holidays, and this may account for some of the seasonal mood changes that people experience. Many psychologists have questioned the validity of SAD, as a light-related phenomena.

Studies suggest that therapeutic interventions, such as traditional talk therapy and cognitive behavioral therapy (CBT) can ease the symptoms of seasonal depression because seasonal mood change are connected more with emotional factors that simply access to UV. These experts tend to minimize the role of light therapy in Seasonal Depressive Disorder, and, instead, focus on social-emotional behaviors., such as avoiding isolation and employing behaviors that support improved mood. This includes overarching concerns about the increase in alcohol and substance use.

Researchers note that areas in high latitudes tend to have less daylight, but also colder weather. The weather changes are accompanied by snow and many conditions that may limit outdoor activities or travel, increasing isolation and decreasing outdoor activities. Thus, a compelling argument has developed focusing on the behavioral connections to SAD. What complicates this issue is that isolation and a lack of outdoor activity may often increase alcohol and substance use, both of which can trigger physical and emotional symptoms of depression.

In addition, research suggests that some clinicians may mistake symptoms of ADD or ADHD, especially restlessness and irritibility, as depression. It is quite possible that individuals with ADD and ADHD may experience intensified symptoms during winter months if the spend more time inside due to cold weather. Many individuals with ADD and.