Seasonal Affective Disorder (SAD) is a type of depression that appears to be related to the amount of light people are exposed to. It is an extreme form of "winter blues" because most people tend to get worse in the fall or winter. However, some people experience symptoms in late spring or early summer.
It is estimated that every year, as days get shorter and temperatures drop, 2 to 3 per cent of the population is affected by SAR. About 15 in 100 people experience lighter symptoms called "winter blues".
This disorder affects women more than men and usually starts in their twenties. Older people are less at risk than others. Children may also have SAD, though less frequently.
causes
The cause of the CAS is unknown, but it is believed that it may come from less exposure to sunlight. The TAS could be related to the body's biological clock that regulates temperature and hormonal secretion.
TAS could also be related to the concentration of melatonin in the body, a hormone secreted by the pineal gland. The nerve centers of the brain that control daily rhythms and moods are stimulated by the amount of light entering the eyes. During the night, the melatonin produced by the pineal gland puts us to sleep. In the morning, bright sunlight stops the production of melatonin. During the dark winter days, there is not enough light to cause this waking process and some people may have a very hard time getting up in the morning.
In addition, on dark winter days, the eyes absorb less light during the day, and some people may feel "depressed".
Geography also seems to play a role. SAR is more common among people living in northern climates and those who left the sunny south for the north. We can all be affected by the CAS, even if we are not predisposed to depression. If a person has a history of depression and lives in a northern climate, they may be more susceptible to this condition.
Complications
CAS occurs during the last months of the fall and during the winter, usually between October and April. Symptoms associated with this condition include:
lethargy and fatigue (a low level of energy);
taking a distance with friends and family;
an inability to concentrate;
sadness, anxiety and despair;
changes in appetite with cravings for sweets and starchy foods;
weight gain
headaches;
irritability;
an extension of the duration of sleep.
In children, symptoms include irritability, school problems and difficulty getting out of bed.
Some people, especially those who experience SAD in the summer, may experience a range of adverse symptoms such as loss of appetite and weight, as well as insomnia.
Diagnostic
CAS can affect someone who is not predisposed to depression. The diagnosis of TAS is made when the clinical presentation meets certain criteria.
Your doctor will ask you about your symptoms and you will undergo a physical exam. He may also request blood tests to rule out the presence of other medical conditions (eg, hypothyroidism) with symptomatology similar to that of the CAS.
Treatment and Prevention
Doctors have many ways to treat SAR. They usually use light therapy, exercise, good nutrition, and antidepressants in the most severe and severe cases.
Daily phototherapy (supervised by a professional) with exposure to a certain kind of light (the white light with continuous spectrum) can sometimes make the TAS disappear very quickly. Phototherapy is administered through a "bright screen" device that can be rented by the month or purchased from a private provider or a medical equipment store. During the few hours of the day when light therapy lasts, one can read but not sleep.
Symptoms should subside in a few days, but they may reappear when treatment is stopped. Phototherapy should always be followed by a doctor since it is contraindicated for some people.
Exercise is very beneficial, especially if it is aerobic and associated with light, such as walking outdoors on a beautiful winter day or exercising on a treadmill in front of a bright screen.
As many people with SAD gain weight, it is important to follow a healthy, low-fat diet to limit weight gain.
Psychotherapy can also be incorporated into the treatment plan for the CAS.
As part of this multifactorial conceptualization, Alan Stewart of the University of Georgia College of Education and colleagues (1) analyzed more than 100 articles on the possible contributions of vitamin D3 to these sub-mechanisms.
There are several reasons to hypothesize that vitamin D plays a regulatory role, they say:
The levels of vitamin D in the body fluctuate seasonally, with a shift, in direct relation to available sunlight. "For example, studies show that there is a lag of about eight weeks between the peak of the body. intensity of ultraviolet radiation and the onset of seasonal depression, which is correlated with the time required for the UV radiation to be converted into vitamin D by the body.
Lower levels of vitamin D were observed in depressed people (as well as in people with other psychiatric disorders) compared to comparison groups.
Vitamin D levels in the central nervous system affect the production of the neurotransmitters serotonin and dopamine that are involved in depression.
Vitamin D and the elements that respond to it are found in all regions of the midbrain and are particularly concentrated in the hypothalamus, a region that encompasses circadian rhythm systems and much of these neural circuits.
For most people, a few minutes a day of exposure to sunlight should be enough to maintain adequate vitamin D status, the researchers say.
Seasonal depression would affect up to 10% of the population, depending on the geographic location, according to some estimates.
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