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As the holidays approach, we often ask ourselves some serious questions:
People often think that it is normal to feel sad during the holidays, especially when they have to spend the holidays alone or if they dread being around extended family. This time of year can also mean the end of seasonal employment or trigger unpleasant memories or anniversaries. Your feelings may not be related to your social circumstances, but actually be a bona fide, diagnosable mood disorder. Seasonal Affective Disorder (SAD) is a form of major depression that has a seasonal pattern. It tends to develop as fall arrives.
With colder temperatures, sunrise starting later and sunset occurring earlier, as well as an increased preference to stay indoors, we spend less time under the rays of a healing sun. Without adequate exposure to ultraviolet (UV) light from the sun, the human body reduces its ability to manufacture and maintain adequate levels of the hormones in the brain that keep us happy. Low hormone levels can cause changes in sleep patterns, changes in appetite, low energy levels, decreased interest in normally pleasurable activities and decreased concentration. People who experience five or more of these symptoms for at least two weeks should consider being evaluated by a psychiatrist for a possible mood disorder.
Seasonal Affective Disorder usually presents in mid-October and moves into remission by April. This diagnosis is more common in the northern states, but should not be overlooked or ignored in patients living in the South. Some patients with a pre-existing diagnosis of depression or bipolar disorder might see some worsening or emergence of prior symptoms. The most common symptoms associated with SAD are increased sleep and appetite. This is what triggers and continues the weight gain.
Therapists, primary physicians and other behavioral health professionals should refer their patients for psychiatric evaluation/consultation when they see a change, either gradual or sudden, in their client’s mood. The referring professional should notify the psychiatrist of current treatment formats. This will ensure timely assessment, diagnosis and treatment.
The treatment options for SAD are antidepressant therapy (e.g. Wellbutrin XL or SR formulation), UV lamp therapy, individual therapy for teens and adults, and play therapy for children. With combination therapy, treatment outcome is more likely to be positive.
Dr. Maxine Minto is a child, adolescent and adult psychiatrist in Lake Mary. She has been practicing psychiatry in Central Florida since 1997. A Diplomate of the American Board of Psychiatry and Neurology, she is a graduate of the University of Miami School of Medicine. Her background includes serving as a medical director in clinical settings such as acute inpatient units, inpatient residential care, partial hospitalization and outpatient services.
