Why Seasonal Affective Disorder develop in Summer | Real Causes & Diagnosis: Seasonal affective disorder (seasonal depression, SAD) is one of the variants of depression in which episodes of the disorder occur during certain seasons — more often in winter and less often in summer.
Seasonal depression is a fairly common disorder. Thus, according to various sources, from 4 to 6% of people suffer from winter depression, another 10–20% of people may show borderline or moderate mood swings .
In winter, many people “fall” into a kind of “hibernation”. They constantly want to sleep, they do not want anything, do not be happy, their appetite increases and, of course, their weight increases. And the person does not understand what is happening to him, thinks that the whole problem is a lack of vitamins, frequent stresses, excessive fatigue. And do not even suspect that all these manifestations may be signs of seasonal depression.
- Why is developing
- Risk factors
- Features of therapy
- Drug therapy
- Drug-free methods
Depending on when an exacerbation of the disease is observed, in the summer or in the winter, there are 2 models of depressive disorder:
Winter depression begins to appear in autumn or early winter, its symptoms persist until late spring or early summer.
Summer depression is much less common. It begins in early summer or late spring, and passes only in the fall.
In the diagnosis of seasonal depression, it is noted whether there is a relationship between exacerbations of the disorder and seasonality. The psychosocial factor for this disease is not so important. The normalization of the mental state (or the appearance of signs of mania, hypomania) is also observed in certain seasonal frames and is not associated with external influences.
Why is developing
The exact causes of seasonal affective disorder have not been established. However, thanks to numerous studies, it was possible to detect some patterns:
People with seasonal affective disorder may experience problems with regulating the level of the main neurotransmitter responsible for mood — serotonin. In patients with SAD, serotonin levels during the winter months are 5% higher than in summer. In this regard, there is a higher content of proteins transporting this neurotransmitter, while the amount of serotonin in the synapse decreases.
People with seasonal depression have increased melatonin production. This substance is produced in the dark and is responsible for adjusting sleep. At a time when the length of the day is shortened, the production of melatonin increases. As a result, the person feels constant drowsiness, circadian rhythms are disturbed.
Another feature that has been discovered is a reduction in vitamin D production. It is assumed that there is a relationship between the plasma concentration of this vitamin and serotonin activity. That is why clinically significant depressive symptoms can occur if there is insufficient vitamin D production.
There is even a theory that winter depression is a kind of “hibernation” into which women fall. It is an evolutionary advantage of the representatives of the weaker sex. In winter, women have decreased libido and, consequently, the risk of becoming pregnant. In the summer, activation occurs, the chances of getting pregnant, carrying out and having a baby increase. And, as you know, babies born in spring are stronger and healthier.
Not all people are equally predisposed to the development of this affective disorder. Most prone to:
Female representatives: seasonal depression in women occurs 4 times more often than in men.
People living far from the equator: the disorder is much more common in people living in the south or north of the equator.
Persons with hereditary predisposition, even in other types of depression, and not just seasonal.
Young age is a risk factor, because episodes of seasonal depression are much more common in young people than in mature or elderly. The debut of the disease in most cases is observed in 18-25 years. Even cases of seasonal affective disorder in children and adolescents are described. With age, the risk of seasonal depression decreases.
If a person suffers from any affective illness, for example, bipolar affective disorder , then his condition may worsen (exacerbation is observed) in certain seasons.
Seasonal affective disorder is not special in its symptoms. This is a type of depression in which depressive symptoms occur, recurring at certain times of the year.
The diagnosis of seasonal affective disorder is to detect typical depressive symptoms that coincide with specific seasons (in winter or summer) and occur for at least 2 years.
As a diagnostic criterion, not only the seasonality of exacerbations is significant, but also the time of onset of remission or the onset of symptoms of mania (hypomania) – in seasonal affective disorder, it is also possible to determine a clear correlation.
If a person suffers from a depressive disorder for a long time, then there are more chances to detect the cyclical nature of the onset of depressive episodes, a clear relationship with certain seasons.
Typical symptoms of seasonal depression:
decreased mood, which persists most of the day and occurs almost every day;
chronic tiredness ;
feeling of worthlessness or hopelessness;
loss of interest in all that was interesting before, brought pleasure;
repeated thoughts of death or suicide;
feeling of lethargy or increased anxiety.
A number of symptoms are more characteristic of the winter variant of depressive disorder, among them:
excessive appetite, moreover, a person constantly wants to eat precisely food rich in carbohydrates;
increased food intake leads to weight gain;
reduced sexual desire;
there is a need to spend time alone;
reduced social activity.
Characteristic clinical features of summer depression:
Features of therapy
The treatment of seasonal depression should be a specialist – a psychiatrist or psychotherapist. Only doctors of this profile can choose a competent and safe therapy.
The choice of treatment depends on the severity of seasonal affective disorder, the symptoms prevailing in the clinical picture of the disease.
The main types of treatment for seasonal depression are:
pharmacological therapy use of drugs);
use of vitamin D.
All of these diagnostic methods can be used individually or combined.
Drug treatment of seasonal affective disorder has its own characteristics.
Experts have concluded that the winter version of the disorder responds well to treatment with antidepressants from the group of monoamine oxidase inhibitors – pyrazidol, metralindol. Also shown is light therapy and psychotherapy.
The treatment of summer depression is similar to the treatment of non-seasonal affective disorders; all the same groups of antidepressants are effective – for example, SSRIs (fluoxetine, citalopram, etc.).
Indications for the medication treatment of seasonal depression are:
the positive effect of pharmacological treatment during previous episodes of the disorder;
high suicidal risk;
pronounced violations in the professional or social activity of a person;
recurrent severe or moderate depressive episodes;
patient’s personal desire.
Drug treatment allows in a relatively short time to stop the symptoms of the disease, to return to a full life. The choice of the drug, the selection of effective dosage should be a psychiatrist. Only he can determine which drug will help the patient, while not burdening him. Any adjustments in treatment, be it an increase or decrease in dose, must be agreed in advance with the doctor.
There is no clear evidence that vitamin D supplements are effective in treating seasonal depression. However, given that in winter the body lacks the production of vitamin D, many experts recommend these drugs.
Another effective therapeutic method that I described in the article on non-drug methods of treating depression is light therapy. This technique has been used since the 80s. of the last century.
The main idea of light therapy is to compensate for the lack of sunlight, observed in the autumn and winter months, with daily exposure to bright artificial light. The ultraviolet rays of cold-white fluorescent light are most often used for this procedure. During the procedure, a person needs daily, for 20-60 minutes, preferably in the morning, to be under the influence of ultraviolet rays.
Among psychotherapeutic methods, cognitive-behavioral psychotherapy is preferred. During the sessions, they reveal negative thoughts and then transform them into positive ones. This allows you to concentrate on more pleasant and attractive actions, it helps to cope more easily not only with the winter itself, but also with manifestations of depressive disorder. After all, it is not the frustration itself that is important, but the thoughts of a person, his attitude to life and the world around him, actions.