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December brings with it a flurry of things to be grateful for: the first snowfalls, the holiday season, time with family and friends, and a reprieve from the hustle and bustle that characterizes most every other month of the year. But for people who suffer from seasonal affective disorder, December can also mean the beginning of an annual depression that starts when winter first flexes its icy grip on the human psyche.

Defined as a type of disorder in which recurrent episodes of depression occur in the same season of every year, seasonal affective disorder has one of the most fitting acronyms of any ailment: SAD. Sometimes referred to as “winter blues,” there are two types of SAD, with the most common being characterized by a seasonal pattern of depression that begins in the winter and lasts until spring. The other, much less common condition, typically begins in late summer and is triggered by changes in the amount of sunlight that a person inputs.1

Though contingent on external factors for its existence, SAD has similar symptoms to any other type of depression: feelings of hopelessness, hypersomnia or oversleeping, appetite loss or cravings for sweets and starchy foods, weight gain, low energy levels, fatigue, withdrawal from friends and family, irritability, decreased physical activity and, at its worst, thoughts of suicide.2

While the exact cause of the disorder is unknown, one of the most popular theories is related to the amount of melatonin in the body. When darkness increases, the body produces more melatonin, a hormone that regulates sleep. As winter days become longer, melatonin production increases, leading people to feel sleepier and more lethargic. Research suggests that the modification of melatonin by exposure to bright light actually mediates the effects of SAD.3



Treatment varies from person to person, but there are a number of options available to sufferers. The first solution, light therapy, relates to the melatonin production theory. It has proven effective for people with SAD to expose themselves to intense artificial lights for about a half hour a day, which is reported to help about 60-80 percent of people with the ailment. Other options include medication, counselling and self-help like meditation and breathing exercises.4 

The statistics for this disorder are somewhat alarming. Currently, SAD is estimated to affect 10 million Americans, while another 10-20 million are said to have a mild form of the disorder, with symptoms presenting more often in women than men, and six percent of people requiring hospitalization for treatment every year. In Canada, SAD affects about two-to-three percent of the population, with another 15 percent becoming slightly depressed when the cold season dawns.

Though December is celebrated for a laundry list of positive and welcome changes, seasonal affective disorder is certainly not one of them. As more people report dealing with this insidious ailment, the hope is that discussion about the topic continues, new ways to treat the disorder are discovered, and an increase in community resources are deployed, especially around the holiday season. 

References:
  1. Psychology Today: Seasonal Affective Disorder. https://www.psychologytoday.com/ca/conditions/seasonal-affective-disorder
  2. CAMH: Seasonal Affective Disorder. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/seasonal-affective-disorder
  3. Melatonin in seasonal affective disorder and phototherapy. https://www.ncbi.nlm.nih.gov/pubmed/3462335
  4. Canadian Mental Health Association: Seasonal Affective Disorder. https://cmha.bc.ca/documents/seasonal-affective-disorder-2/

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