Seasonal Affective Disorder (SAD) affects many individuals, particularly during winter months, leading to symptoms such as lethargy and mood changes, as illustrated by the story of Revati, a 59-year-old woman from Minnesota.
Revati* is a 59-year-old mother of Raghav, a first-generation Indian immigrant residing in the Twin Cities of Minnesota. A widow and retired teacher from India, she has been living with her son and his family in the United States for the past three years.
Each year, from November until April or May, Revati experiences a decline in her mood. She feels sad, avoids social interactions, becomes lethargic, and tends to oversleep and overeat, leading to weight gain. Concerned about this recurring pattern, she sought advice regarding her mental health.
Dr. Sharma, a mental health professional, explained that Revati’s symptoms are indicative of Seasonal Affective Disorder (SAD). This condition is recognized for its negative impact on mental health, particularly during the winter months when daylight is scarce. SAD was first identified in 1984 and is now classified as a distinct disorder in the Diagnostic and Statistical Manual of Mental Disorders. Individuals affected by SAD often experience depressive episodes in the fall or winter and typically feel better with the arrival of spring or summer. Symptoms may include excessive sleeping, overeating, cravings for carbohydrates and sugars, and significant fatigue.
When Revati inquired about the causes of her condition, Dr. Sharma noted that the exact origins of SAD remain unclear. However, it is believed to be linked to disruptions in the circadian rhythm, which affects brain neurotransmitters such as dopamine, norepinephrine, melatonin, and glutamate. Research has suggested that the ZBTB20 gene may be a risk factor for developing SAD, and studies indicate that women are more susceptible to this disorder than men. SAD typically manifests in young adulthood, particularly among those aged 18 to 30.
To alleviate her symptoms, Dr. Sharma recommended that Revati consult her primary healthcare provider. There are various screening tests available for SAD, including the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Seasonal Health Questionnaire (SHQ). A healthcare provider can administer these tests and, based on Revati’s medical history, physical examination, and other evaluations, confirm a diagnosis while ruling out alternative causes. They can also suggest appropriate therapies.
Dr. Sharma also provided Revati with strategies to prevent and mitigate the effects of SAD. Exposure to light is crucial for regulating the biological clock that governs sleep and wakefulness. Maximizing natural sunlight exposure during the day is essential, especially in the long Minnesota winters. In addition, phototherapy—using a bright light therapy lamp of 10,000 lux for 20 to 30 minutes each morning—can be beneficial. It is recommended to maintain a distance of 60 to 80 centimeters from the light source. Establishing a consistent sleep schedule by going to bed and waking up at the same times each day is also important.
Engaging in regular physical activity, such as walking or aerobic exercises, maintaining social connections, and eating healthily are further strategies to help prevent SAD. Dr. Sharma cautioned against alcohol consumption, as it can exacerbate symptoms of depression.
If Revati’s depression persists, Dr. Sharma advised that psychotherapy, particularly cognitive behavioral therapy (CBT), may be recommended. Antidepressant medications and Vitamin D supplements could also be considered by her healthcare provider.
When asked about the role of yoga and meditation in managing SAD, Dr. Sharma affirmed their effectiveness. Practices such as Surya Namaskar, or sun salutation, which consists of a series of 12 yoga poses, can be particularly beneficial. Other yoga asanas, along with meditation (dhyana), can also enhance coping mechanisms for those suffering from SAD.
For those seeking additional resources, Dr. Sharma suggested several informative websites, including the Cleveland Clinic and Mayo Clinic, which provide valuable insights into seasonal affective disorder. Additionally, there are yoga sessions available on platforms like YouTube that focus on alleviating symptoms of SAD.
If you have further questions, you can reach out to Dr. Manoj Sharma at editor@indiacurrents.com.
*Names have been changed upon request.
According to India Currents, understanding and addressing SAD is crucial for those affected, especially during the challenging winter months.