by Dr. Adam Seigers, Medical Health Contributor
Seasonal affective disorder (SAD) is a common pattern of seasonal depression. In its most common form called “the fall blues” it starts predictably in the fall months lasts throughout the winter and then resolves in the spring.
It is suspected that as many as one in ten people suffer from the condition with those in the northern latitudes being disproportionately affected.
The condition is more common in women and usually has an age of onset in the mid-twenties.
The exact cause is not known although some experts suggest altered melatonin metabolism or circadian rhythms.
Melatonin is a hormone produced by the pineal gland; a small gland shaped like a pinecone, weighing about as much as a grain of rice and located within the brain. This small gland is responsive to light.
At times, with increased light such as in the summer, melatonin production is reduced, in effect promoting wakefulness. In animals, this variation influences hibernation, sexual activity, sexual development and metabolism.
It wouldn’t be unreasonable to suspect that melatonin metabolism in humans could therefore influence seasonal affective disorder, but studies in this regard are lacking.
Scientists do however suspect that serotonin may play a causal role in SAD. Studies have suggested that people with SAD generally have lower serotonin levels and lower serotonin activity.
As with most diseases, treatment for SAD centers on the proposed pathophysiology. This mainly involves increasing serotonin levels and optimizing light levels.
Similar to how we might manipulate a chicken’s body to lay eggs by using an artificial light source, humans too can use artificial light to reduce the severity of seasonal affective disorder.
Light therapy using at least 10,000 lux for 30 min/day most days of the week is usually adequate to cause resolution of depressive/lethargic symptoms within days to weeks.
Light is best used in the morning, need not be full spectrum, and should be allowed to shine directly into the eyes.
In addition to light therapy, prescription medications, which increase serotonin levels, can also be helpful.
These medications can be used seasonally and when used in such a fashion decrease relapses by about fifty percent. For more information please contact your primary care provider.
Adam Seigers, MD is a Board Certified Internal Medicine Physician who works at the Faxton St. Luke’s Boonville Medical Office.
— Dr. Adam Seigers is a physician with Faxton St. Luke’s Adirondack Community Physicians (ACP) Boonville Medical Offices on Route 12.
