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Seasonal Affective Disorder- SAD winter blues

Seasonal Affective Disorder (SAD) describes a type of depression with a seasonal pattern, usually occurring during winter.

Seasonal Affective Disorder- SAD winter bluesA lack of light is thought to affect the part of the brain that rules sleep, appetite, sex drive, mood and activity levels. Patients experience lethargy and a craving for sugary snacks.

In 1984 psychiatrist Norman Rosenthal first used a term that changed the way people thought about winter. He included the term in a paper he co-wrote following a move from the warm climate of Johannesburg in South Africa to the north-eastern US, with its more severe winters.

“It took about three years of seeing the winters alternating with the summers,” Rosenthal, who lectures at Georgetown University in Washington, says. “It was a sort of given that people were grouchy in the winter, not so happy.”

But the work of Rosenthal and others established that there was more to it than that for some people. The cultural idea of many people being less happy in winter was not to obscure the fact that for a smaller group of people something more serious was happening. “It becomes a medical thing when it has consequences in people’s lives, like not being able to get to work or their quality of life going down the drain,” says Rosenthal.

SAD has been accepted as a condition by many. The NHS offers advice, And it has also gained significant currency in popular culture – with the term being widely used by laymen.

In the UK the term was first used by the Times in 1988, in a piece highlighting a link between afternoon shift workers and a lack of daylight. Since then it has gradually filtered into common parlance. According to Google Trends the term is still much more commonly searched for in Canada and the US, with the UK third.

Rosenthal admits the acronym, which suggests the kind of feeling sufferers get, was chosen to make a maximum impact on the media. It seemed to work.

Rosenthal suggests that 6% of people in the US suffer from the most acute form of SAD and that another 14% get winter blues. A study found the severest form affected just 1.5% in the southern state of Florida, which averages seven hours of sunshine a day even in winter, rising to almost 10% in the northern state of New Hampshire, which gets just four hours daily in November and December.

Rosenthal advocates the use of electric lights, among other methods, to offset the effects of SAD, including in the UK, whose population spends a “long time in gloom” in winter, as much because of large amounts of cloud as the shortness of the days.

Light therapy is long established, the ancient Greek physician Hippocrates advocating healing properties in exposure to the sun. From the late 1800s heliotherapy, or phototherapy, became popular. Some tuberculosis-infected children from slums, where little sunlight was available, were taken to retreats where they could spend as much time outdoors as possible.

Light treatment has been used for other ailments. In 1903 Faroe Islands physician Niels Ryberg Finsen was awarded the Nobel Prize for inventing an ultraviolet lamp for tuberculosis of the skin.

But in 2009 the National Institute for Health and Care Excellence ruled there wasn’t enough evidence to justify the NHS in England spending money on this type of treatment for depression. The guideline is currently under review.

Rosenthal says a lack of direction from above means doctors are not asking patients the right questions, such as whether the symptoms they describe are seasonal or year-round. “I’ve just come to terms with the limits of my ability to persuade people about SAD,” he says. “People have to find out about it to some extent on their own.”

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