Autumn brings cooler weather and colorful landscapes. And, as we move away from summer and toward winter, the days grow shorter, the nights become longer, and, as a result, our exposure to sunlight is reduced.

Along with this seasonal phenomenon, many people experience a change in mood, often referred to as the “winter blues.” This is usually associated with feelings of sadness, tiredness, and perhaps some weight gain. However, for some people, these “blues” turn into a more debilitating state known as Seasonal Affective Disorder (SAD). Their symptoms include depressed mood, lack of energy, increased need for sleep, social withdrawal, reduced or lack of interest in sex, and difficulty concentrating and processing information, especially in the afternoon.

While not completely understood, the causes of SAD are strongly associated with duration and intensity of light to which one is exposed. Symptoms appear in the fall, and may become most severe in January or February. Gradual or marked improvement occurs in the spring.

It is estimated that roughly 6 percent of Americans suffer from SAD, and that 10 to 20 percent may experience milder SAD symptoms. SAD generally has its onset in early adulthood (20’s and 30’s), and is more common among women than men.

Because symptoms of SAD are so similar to those of other kinds of depression, accurate diagnosis depends on whether you have been depressed with SAD symptoms for two consecutive years, during the same season each year. These periods of depression are followed by non-depressive seasons. Also, there are no other apparent explanations for these mood changes.

Although there is currently no “cure” for SAD, there are treatments available to help manage the symptoms. A popular treatment choice is light therapy, in which the patient sits a few feet away from a special lamp (10 to 20 times brighter than ordinary indoor light) for 30 or more minutes per day. This needs to be done daily, from late autumn until springtime. Also, daily one-hour walks outdoors, on sunny (and not so sunny) winter days are found to be helpful, as well.

In some cases, a physician may prescribe anti-depressant medication. SSRI’s (selective serotonin re-uptake inhibitors), such as Paxil or Zoloft, have been found to reduce SAD symptoms. These medications might be indicated when light exposure therapy does not produce significant results, or if the regimen of daily exposure to special lamps cannot be regularly followed.

Although it may seem preferable to choose light therapy over medicine, it is essential to adhere to a strict daily schedule of exposure in order for it to work successfully. This necessitates a major time commitment as well as self-discipline. Also, regular outdoor walks may be limited by severe winter weather, or disability which limits movement, or even work and family responsibilities. Not everyone finds it possible to make sure they have the necessary light exposure every day throughout the winter months.

In any case, an examination by a physician is indicated, so that it can be established that one does, in fact, suffer from SAD, and to decide upon the treatment that seems most

appropriate.

In addition to light therapy, daily one-hour exposures outdoors, and (perhaps) anti-depressant medication, it’s a good idea to increase the amount of light in your home, using more lamps and brighter bulbs, along with opening shades so that as much outside light as possible can stream into your rooms. It’s also helpful to make sure that you get outdoors as much as possible, and to commit yourself to a schedule of exercise. Exercise can be done outdoors or indoors. In addition, finding effective ways to relax and to manage stress is an important aspect of treatment.

Counseling might be another component of your treatment plan. It may provide an opportunity to examine your assumptions and negative expectations, and can help you to alter certain life situations and modify possible interpersonal patterns that may contribute to your depressed mood. Counseling may also provide you with an opportunity to assess your stress patterns and find better ways to manage and reduce them.

If you think you might be among those who suffer from SAD, please don’t hesitate to give me a call at the MAP office. Together, we can decide how you might best cope with it!

Janet Becker, LCSW, Ph.D., is the new coordinator of 802’s Musicians’ Assistance Program. You can reach her at (212) 397-4802, or by e-mail at map@local802afm.org.