Lighten Up

Karen James of JCS says light and stress-relieving therapies are keys in helping to fend off SAD. David Stuck
Karen James of JCS says light and stress-relieving therapies are keys in helping to fend off SAD.
David Stuck

Thanksgiving and Chanukah have just passed, the days are still short, and it often seems as if the sun is on sabbatical. That can make even the cheeriest person slow down and want to sleep a little more. But for some people, the lack of sunlight during fall and winter can lead to feeling seriously blue and even depressed.

Seasonal affective disorder, known as SAD, is more than just the winter blues or a mild funk. SAD is depression with all of its accomplices.

The JT caught up with Karen James, manager of Jewish Community Services therapy services to learn more about it.

JT: What are the symptoms of SAD?
James: [The emotional symptoms are] hopelessness, anxiety, loss of interest in previously enjoyed activities. Physical symptoms include appetite changes, weight gain and a feeling of lethargy or “heaviness.” People also tend to withdraw and isolate.

How long does it last?
SAD typically lasts for months or the season and then lifts, and mood is back to normal. To formally make the diagnosis, mental health professionals look for a pattern of recurrence for two years in the same season … and also look at all other potential causes for the mood problem.

Does SAD occur only in the winter?
There is a summer condition with some similar symptoms, but generally [those sufferers show] more anxiety or agitated feelings.

How does one get this? Is it inherited?
Like with many mental health issues, direct causes are not known. Probably

the usual unfortunate “trifecta:” genetic predisposition, which is not exactly the same as inherited; your body’s particular genetic makeup; and perhaps being female. … A risk factor can actually be living far from the equator.

Scientists think it is related to our biological clocks.

How is it diagnosed? What should people watch for?
Always start with a medical evaluation for possible physical causes. The doctor could rule out  reaction to a medication, interactions of medications, thyroid conditions or a sleep disturbance. Next, watch for that pattern of recurrence and the rhythm of the seasons. Never ignore a lowered mood, because moods can continue to deteriorate and put someone at risk in many ways. Moods affect relationships, job performance and can cause substance abuse or suicidal thoughts. Also, watch for changes in sleeping and eating habits and the lack of interest or social withdrawal.

Aside from moving to a sunnier place, how can one be treated for this?
There are generally three approaches to actual treatment after the initial thorough evaluation with a mental health professional: light therapy, psychotherapy and antidepressant medications. Keeping regular healthy habits is important, too, and some alternative medicine may be a good companion activity to working with a mental health professional. … Vacations to warmer and sunnier places cannot generally be “prescribed” but can be helpful.

What is light therapy?
Light therapy, also called phototherapy, is a way to supplement the decreased light of the wintertime. After you and your mental health provider have determined this is a good approach, you can purchase a light box with a very bright light that imitates the sun. Generally people sit in front of these specially designed devices for about 30 minutes daily. Sometimes a person may feel some improvement after a few days, but it generally three to four weeks.

Talk about the other treatments.
In milder cases, increasing your daily exposure to sunlight may be helpful, particularly in the morning. Inc-reased brightness of your surroundings from artificial lighting, or letting natural light in, can help some people. In general, make your world brighter through light  but also by continuing your activities and seeking the support of others. Regular exercise has good effects and can relieve stress and anxiety. Stress-relieving therapies can assist in coping and recovery, such as yoga, meditation or massage therapy.

Can spending more time outdoors in the winter be effective? Is there a difference between types of light?
Exposure to the sun during the winter season can be helpful, especially within a few hours of awakening. It is thought that this gives the body cues to regulate.  Remember that light therapy is more than just using brighter light bulbs in your lamps at home. It is the use of a light box with very bright light — perhaps 10,000 lux* — used consistently and in a structured way.

Can an individual who suffers from SAD treat it on his or her own?
That is a little risky, unless it is extremely mild.  It is certainly difficult to diagnose on your own. It is even complicated for the mental health professionals. … Because SAD is sometimes present with those who have bipolar disorder, it is especially important to address all other issues.  Once the diagnosis is made and effective treatment begun, the person may be more independent in their ongoing treatment of the disorder. It isn’t always a problem that can be “cured,” so some people keep light boxes and begin treatment early in the fall to decrease or ward off the symptoms.

Do people with SAD get it every year or can it be prevented?
The pattern for recurrence is at the same time of year and for a similar amount of time. Some people begin an antidepressant each fall to avoid the symptoms if they have not been able to completely control the disorder.

How can JCS help?  
Professionals can help in educating a client and family about the disorder, supporting them during the medical evaluation and helping to establish coping patterns and habits that
increase a client’s resilience. JCS psychiatry can also help in the diagnosis and treatment of SAD and can follow people who seek medication for the symptoms. The psychotherapy approach focuses on learning to accept the disorder and to work with one’s thoughts and feelings to address it more effectively.

*Lux is the SI unit of luminance and luminous emittance.

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