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Treatments available for seasonal affective disorder

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Manitoba has a reputation for being one of the sunniest provinces in Canada.

But when November rolls around all that seems to change. As the days get shorter and colder, it can feel like the darkness is closing in.

Not surprisingly, this sudden change in our environment can lead to mood changes. For most people, these changes are mild and might result in a few days of irritability or sleep disruption. But for others, the changes can be significant and might result in disruptions of daily life over the winter months, sometimes referred to as the "winter blues."

For a small percentage of people, seasonal mood changes can become a type of clinical depression known as seasonal affective disorder or SAD. Seasonal mood changes are thought to be linked to a reduction in sunlight which, in turn, disrupts the body's internal clock and the production of serotonin and melatonin, hormones that have several important functions including the regulation of sleep and mood.

According to the Canadian Mental Health Association, SAD affects up to three per cent of the population, while a milder form of "winter blues" may affect as much as 15 per cent of the population. Those who experience winter blues might notice changes in their eating and sleeping routines. Other common symptoms include irritability, anxiety, lack of energy, fatigue, lack of interest in activities, a craving for sweets and starchy foods, or changes in weight.

Mild symptoms can be managed with small changes to your lifestyle. But when these changes severely disrupt your ability to function at work and home, it is important to seek medical advice. Your doctor will be able to assess your symptoms and also rule out any underlying causes such as thyroid dysfunction, anemia or other conditions.

Seasonal depression most often occurs in the fall and abates in the spring, so people are only affected by symptoms during the winter months. For a diagnosis of SAD, there must be a seasonal pattern which has occurred over at least two years. SAD tends to occur more frequently in adults, is identified more often in women than men, and is also thought to run in families. People suffering from SAD might also have pronounced feelings of sadness, guilt and hopelessness. They can also feel irritable and tense and tend to isolate themselves, withdrawing from relationships and their usual social activities. Difficulty concentrating and making decisions can also affect a person's ability to go about their daily tasks at home or at work.

There are a number of common treatments for SAD. Up to 80 per cent of people with SAD have found light therapy to be helpful in reducing symptoms of seasonal depression. According to the Mayo Clinic, sitting approximately 14 inches away from a light box that produces 10,000 lux (a measurement of light intensity) for a minimum of 30 minutes each morning might be helpful.

Light boxes can be rented or purchased and the cost might be covered by some health-care plans with a medical prescription. It is important to consult a health-care professional about light therapy since it might be inadvisable for some people.

As with other types of depression, counselling can also be helpful. Cognitive behavioural therapy (CBT) is a form of therapy available through qualified therapists and psychologists. Medications might also be helpful in treating moderate to severe depression. The type of medication, dose and length of treatment will vary with each individual and should be recommended and monitored by a doctor.

There are a number of other things a person can do for themselves to help fight off the "winter blues" or ease the symptoms of SAD. And, yes, the things that are most helpful might be very difficult to do when you are feeling grumpy and exhausted, but they are proven strategies that will lessen symptoms, help you feel better and let you get on with your life. Understanding what you are dealing with and having a good support system is also important.

The first step is to take control of the things you have control over and develop a plan of action. The key strategies include increasing daily exposure to bright outdoor light, staying active during the winter months, eating well and maintaining social contacts.

Winter in Manitoba really isn't that long. Before you know it, we'll be basking in the warm sun again and grabbing the mosquito repellant.

Laurie McPherson is a mental health promotion co-ordinator with the Winnipeg Regional Health Authority.

Republished from the Winnipeg Free Press print edition November 15, 2013 A21

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