How to Do Something Your Don Know: How to Treat Seasonal Affective Disorder

Seasonal Affective Disorder (SAD) occurs when a person experiences depressive symptoms during specific times of the year, usually in the winter months. Symptoms typically begin in the fall when daylight decreases, and subsides in the spring with the return of longer days. People with SAD experience depressive symptoms, including difficulty sleeping, sadness, low energy levels, irritability, and an inability to concentrate. Because SAD is associated with low light levels that occur during the winter months, light therapy is a primary course of treatment for sufferers. In addition, SAD may be treated with the help of antidepressant medication, therapy, and lifestyle adjustments, including exercise and dietary changes.

EditSteps

EditSeeking Professional Help

See your doctor. Make an appointment with your doctor to diagnose the condition and discuss options for treatment. The doctor may do a physical exam, as well as ask you some questions about your moods and habits. Your doctor may ask about:
- Your symptoms and any patterns to them (for example, if they occur around the same time every year).
- Your sleeping and eating habits.
- Your lifestyle. It will be important to note if you work varied or night shifts, for example.
- Your personal and family history. Your doctor may want to know if you have any previous history with depression, or if it runs in your family.^[1]
- Be sure to raise any additional concerns with your doctor, even if your behavior or emotions don’t correlate with seasonal affective disorder, so your doctor can rule out any other concerns. For example, you could say, “I’m feeling pretty depressed, but I also feel very anxious and have trouble sleeping some nights.”
Consider an antidepressant. Your doctor may recommend medication if your symptoms are severe. Usually a combination of medication and other treatments are recommended since the medication may not completely eliminate the problem.
- Wellbutrin is the only drug approved by the FDA to treat SAD, but other antidepressants may be used depending on your health history and the effectiveness of the medication. Sometimes antidepressants work differently in different people.^[2]
- Other antidepressant medications that could be prescribed include SSRIs (selective serotonin reuptake inhibitors) like Prozac or Paxil.^[3]
- You may be asked to start taking an antidepressant before your symptoms begin (for many people, SAD starts in the fall). Your doctor may also suggest taking the antidepressant after your symptoms go away (for many people, this is in the springtime). Your doctor may also recommend a longer-term course of treatment.^[4]
- Understand that it can be a few weeks on an antidepressant before you notice any changes in your mood. Keep in mind that you and your doctor may also have to experiment with a few different antidepressants in order to find the most effective medication for you.^[5]
- If the idea of taking prescription medication doesn’t work for you, get tested for vitamin D deficiency, which affects many people with SAD. If appropriate, you may benefit from vitamin D supplementation.^[6]
See a therapist. Psychotherapy can be beneficial for most people with seasonal affective disorder when used in conjunction with other treatments. Some thoughts and behavior can worsen symptoms, and a therapist can help you address these. Your therapist can also teach you some coping strategies and how to manage stress.^[7]
- Your therapist may use cognitive behavioral therapy (CBT) techniques that help you identify and change negative thoughts and behaviors that may be making your symptoms worse.^[8]
- Ask your doctor for a referral to a therapist who specializes in SAD. You could also search online for a therapist near you, or ask for a referral through your community health agency.

EditUsing Light Therapy

Purchase a light box for light therapy. The most common treatment for SAD is light therapy. Your doctor may recommend you try light therapy as your primary treatment for SAD, or to use it in conjunction with other therapies. There are many different kinds of light boxes available. When selecting yours, you may wish to keep the following in mind:
- Look at light intensity. The lower the lux measurement of the light box, the longer you will need to sit near the box to gain antidepressant benefits. For example, a 2500-lux box may require as much as two hours a day of treatment, while a 10,000-lux box may only require that you sit near it for 20-30 minutes. The 10,000-lux light box is currently the clinical standard.^[9]
- Consider your budget. Lower lux light boxes will likely be less expensive, but they will also require greater time commitment to treat SAD.
- The FDA does not regulate light boxes. Be aware of claims companies make about treatment of SAD.^[10]
- You can buy light boxes online, or get them at some drug stores. Keep in mind that most insurance plans do not cover their purchase. You may be able to get the cost reimbursed through your flexible spending account, however, if your doctor writes you a prescription for one.^[11]
Sit by your light box. In order to reap the benefits of light therapy, position your light box between 16 and 24 inches from your face. For a 10,000 lux box, you will likely use it for 20-30 minutes once a day, but confirm with your doctor and read the manufacturer’s instructions to determine the amount of light exposure you need.^[12]
- Do not stare directly at the light box. Doing so may cause eye damage. Use it while you are reading or catching up on work.
- Keep your eyes open. You get almost no benefits by just exposing your skin to the light. If the light is too bright for your eyes, talk to your doctor about other treatment options.^[13]
- Use it in the morning. Studies have shown light box treatment to be more effective if done in the morning. Plus, nighttime usage can stimulate your brain to make you feel more awake, making falling asleep difficult.^[14]
Brighten your environment. Find ways to make your environment more sunlit. Open your curtains, sit by a window, or even paint your walls a lighter color to help boost your mood.^[15]
- You may wish to trim a tree or bush on your property that is reducing sunlight into your home.
- Consider removing window awnings during the winter to get more light in your home.
- Bringing plants into your home can also create an uplifting environment. Some people with SAD dedicate a room in their home as a greenhouse. This can create a natural space that lifts your mood.^[16]
Spend time outside. Get outside as much as possible and get natural light exposure. Any exercise you get will also be beneficial and mood-boosting.
- You could try taking a walk at lunchtime when the sun is at its highest point, to maximize your light exposure.^[17]
Take vacations. If it is feasible, take a vacation to a sunnier destination during the winter. You may even consider temporarily relocating to a sunnier place during the winter, if you find that your SAD is severe.^[18]
- When looking for a vacation spot to deal with SAD, the amount of sunshine is what matters more than the temperature. But since most people enjoy being out in the warm sunshine, you may wish to look for a vacation spot closer to the equator, where temperatures are warmer and day length does not vary much.
- You could even consider switching seasons by heading to the other side of the equator. Winter in the northern hemisphere is summer in the southern hemisphere, and vice versa. You will enjoy warmer temperatures and longer days.

EditImproving Diet and Exercise

Exercise. Develop or maintain a regular exercise routine for mood-boosting benefits. Not only will you feel better physically, but exercise will also signal your brain to release feel-good neurotransmitters like endorphins, that will improve your mood. Exercise can also improve your immune system health as well, which also helps fight depression.^[19]
- Exercise outside if possible. Try to get some natural light exposure if you can. If the weather keeps you indoors, try doing your workout in a sunny spot near a window.
- Consider exercising at least thirty minutes a day for three to five days a week to help improve depression symptoms. But if you are not in shape or do not have enough time, even small amounts of exercise can reap benefits.^[20]
- Find an exercise routine you enjoy. You will be more likely to keep it up long-term. Running, strength training, yoga, tai chi, or walking are all good suggestions for a depression-fighting fitness program.^[21]
- The moist heat of a swimming pool, steam room or sauna can be comforting and help you combat SAD as well.
Research dietary supplements. You may find some over-the-counter vitamins or natural remedies to be effective in treating your seasonal affective disorder. However, be sure to do your own research and communicate with your doctor and pharmacist about all supplements you are taking. Many dietary supplements can interact with other medications.
- Vitamin D can help ease symptoms of SAD. During the winter, people do not receive as much vitamin D from sun exposure, so stores of vitamin D go down. Some studies have shown benefits to taking vitamin D during the winter.^[22] Make sure you talk to your doctor about an appropriate dosage of vitamin D, as too much can build up in your system and cause vitamin D toxicity.^[23]
- St. John's wort has been shown to be helpful in the treatment of SAD.^[24]
- Studies show that omega-3 fatty acid supplements can relieve depression symptoms in some people. Omega-3s help maintain healthy levels of dopamine and serotonin in the brain--low amounts of these neurotransmitters can cause depression. You can get omega-3 fatty acids in supplement form, and you can also eat foods with high amounts of omega-3s in them. Sources of omega-3s include fatty, cold-water fish, such as salmon, mackerel and herring. It is also found in flaxseed, flax oil and walnuts.^[25]
Change up your diet. What we eat can have a huge impact on our moods. If SAD is already wreaking havoc on your moods, you want to consume foods that will help stabilize them. Make sure you aren’t overindulging or not eating enough -- both too much and too little food can also have an impact on how you feel.
- Avoid sugar and refined carbs that can send your blood sugar on a roller coaster ride, affecting your mood. Instead, eat whole grain carbohydrates like oatmeal and whole-grain bread.
- Eat a serving of protein three times a day. Protein helps stabilize your appetite.
- Eat four cups of vegetables a day.
- Keep your energy levels up by eating smaller meals more frequently. Eat fruit, beans, and vegetables, which help maintain energy levels.
- Avoid caffeine, which suppresses serotonin production.^[26]
- Probiotic foods such as yogurt and sauerkraut can help regulate your digestive tract, which has a role in producing neurotransmitters.