The Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision (2000) (DSM-IV-TR) does not distinguish SAD as a unique mood disorder but as a specifier of mood disorders such as Major Depressive Disorder; however the two terms will be used interchangeably in this article . The American Psychiatric Association (2000) reports that prevalence of SAD increases with higher latitudes and that younger individuals are more likely to experience seasonal pattern depressive episodes. Additionally, of the individuals people diagnosed with SAD, 60% to 90% are women. To be diagnosed with the seasonal pattern specifier, one needs to experience a regular mood episode at a particular time of the year, such as fall or winter. Additionally, the individual recovers fully during another characteristic part of the year such as spring. When this seasonal pattern occurs for two years and the seasonal episodes do not greatly outnumber the nonseasonal episodes, the individual can be diagnosed with the seasonal patter specifier (American Psychiatric Association, 2000).
Symptoms of SAD usually present themselves during the winter months when daylight is sparse. The exact cause of SAD is unknown, but increased levels of melatonin have been associated with sleep and depression. Melatonin production increases in the dark; thus more melatonin is produced in the winter months and this has been thought to contribute to SAD. Severity of symptoms differs among those with SAD.
Several treatments can be used to combat SAD. Light therapy has gotten significant press for use with SAD. Three elements are particularly important to the efficacy of this treatment: intensity, duration, and timing. Light boxes come in a variety of intensities. These usually range from 2,500 to 10,000 lux. The length of the daily light session depends on the intensity of your box and can range from 30 minutes to 2 hours. The use of such devices if fairly common in northern climates where this disorder is frequent and sales of the devices have been increasing in recent years as the public has become aware of their therapeutic potentials. Currently, Welbutrin XL is the only antidepressant FDA approved for the indication of SAD, but other antidepressants are also prescribed for depressive symptoms.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision. Washington, DC: American Psychiatric Press.
Additional information about Seasonal Affective Disorder:
· National Institute of Mental Health www.nimh.nih.gov
· National Mental Health Association www.nmha.org
· Mayo Clinic www.mayoclinic.com
· Society for Light Treatment and Biological Rhythms www.sltbr.org