Seasonal Affective Disorder: Symptoms, Causes And Treatment
In people who have developed seasonal affective disorder, it is common for the change in time of year or season to lead to the onset of a mood alteration. Normally, this psychological imbalance begins during the fall or winter and ends in spring or summer. Since it is mainly linked to depression, the symptoms are typical of this disorder.
If you want to know The Psychological Effects of Seasonal Affective Disorder here you will find a summary about the characteristics of this alteration.
What do we understand by seasonal affective disorder?
Currently, in the fifth edition of the Diagnostic Manual of the American Psychiatric Association, seasonal pattern is a specifier of mood disorders ; Specifically, it can be related to any episode of emotional distress, that is, to a depressive, manic or hypomanic episode.
Thus, as its name indicates, seasonal affective disorder is characterized by following a pattern of presentation of emotional disturbance, the onset and remission of the episodes occurring at a certain time of the year. It would also meet the criterion if instead of ending the episode a pole change occurs, for example, from presenting a depressive episode to showing a manic one.
The most common pattern, linked to depressive episodes, is the one that begins in autumn or winter and subsides during spring; this type of depression will be called winter depression. On the other hand, regarding manic or hypomanic episodes, it is more common for them to begin in summer and show the opposite pattern.
Although the onset pattern presented above is the usual one, it does not have to be strictly like this and can occur the other way around, where the depressive episode begins in summer. In any case, the important factor to be able to use this specifier is that in the last two years there have been at least 2 episodes with a seasonal pattern and none without this pattern. Likewise, if we evaluate the different episodes that the subject has shown throughout his life, they must be mostly seasonal in order to apply this specifier.
Causes
In relation to the cause that causes the appearance of seasonal disorder, it is believed that this is not just one, that is, that It is a multicausal phenomenon, affecting both more biological factors and also more psychological ones although it is not yet known exactly what they are, what specific variables cause this disorder.
In different studies, comparing the levels obtained in subjects from the clinical population and those from the general population, it has been observed that there are differences between neurotransmitters and hormones, presenting special relevance serotonin and melatonin.
Serotonin is a neurotransmitter linked to affective disorders, especially depressive episodes, where this neurotransmitter is decreased.
A fact that reaffirms this lower level of serotonin is that if we treat depressed patients with serotonin reuptake inhibitor drugs, this means that it increases, an improvement in their symptoms is observed. Thus, we deduce that serotonin is an important neurotransmitter for mood regulation.
Why does a decrease in serotonin occur? It has been observed that sunlight functions as a serotonin regulator, causing it to be found and maintain its normal levels throughout the year, but in the case of subjects who present seasonal affective disorder, this regulatory function does not act well, causing the levels of this neurotransmitter to be lower than the normal level during the winter. . For this reason, this affectation is mainly linked to onset in winter.
In reference to the hormone melatonin, this is related to the regulation of sleep-wake cycles, increasing its levels at night, when it gets dark, so that the subject’s feeling of drowsiness increases. Thus, Overproduction of melatonin is observed in patients with seasonal affective disorders which makes the individual feel more tired, without wanting to do anything and more sleepy.
It is known that melatonin is produced from serotonin, and it is necessary that the balance between the two be balanced so that the sleep-wake cycle is regulated. As in the case of subjects with seasonal alterations an imbalance occurs, they will show problems in maintaining regulated rhythms adapted to the different times of the year, to the different seasons, manifesting problems sleeping and alterations in mood and behavior.
Another factor linked to the decrease in serotonin is the lower level of vitamin D, it has been observed that this type of vitamin influences the activity and function of serotonin. We can obtain vitamin D both from the diet and increase its production when we drink or get the sun. Likewise, during the autumn and winter season, where there are fewer hours of sun or the rays arrive with less intensity, they will have an impact on production. of this vitamin and consequently in the function of serotonin.
Likewise, more psychological variables have been studied that may also act as a cause of this disorder. It has been observed that the personality of each subject affects the presence of seasonal affective disorder. Specifically, it has been seen that the two most closely linked traits are extraversion (affected subjects show lower levels of this variable) and neuroticism (On the contrary, they will have a higher score in this trait). After treatment, when the levels were checked, higher levels of extraversion and lower levels of neuroticism were obtained compared to the scores shown before therapy.
It has also been taken into account How negative thoughts, beliefs and feelings related to winter affect this alteration which are typical to be found in patients with seasonal mood disorders, although the results are not conclusive either since this is not an experimental study, the researcher cannot modify the variable beliefs and thoughts, an independent variable, as he wants, We cannot affirm that the relationship is causal and that negative beliefs cause the disorder, since it could also be the other way around and that the thoughts occur as a consequence.
Main symptoms and psychological effects of seasonal affective disorder
As we already mentioned, since it is a specifier of mood disorder and especially depressive disorder, The typical symptoms of this condition will be those of the depressive episode:
To meet the criteria, it must also be taken into account if they present 5 or more of the symptoms mentioned for at least 2 weeks. If the condition is related to a winter or summer onset, the type of symptoms shown will also vary.
When this emotional alteration is linked to a winter pattern, it is more characteristic that increased drowsiness appears, that is, hypersomnia. There is also a tendency towards social isolation, the subject stops interacting as much with others and dedicates more of their free time to eating (which is why there are increases in body mass).
On the contrary, if the pattern appears in summer, we observe more difficulty sleeping, insomnia, weight loss and decreased appetite and increased agitation, anxiety and violent behavior.
Treatment for seasonal mood disturbance
Since the causes of seasonal affective disorder are diverse, there are also different treatments that are currently used to improve the symptoms of affective mood disorder, both linked to more biological or more psychological measures.
The most commonly used form of therapy is phototherapy treatment, which consists of exposing the subject daily to a very bright light, of about 10,000 lux (photometric unit) for a period of 30 to 45 minutes, preferably early in the morning, coinciding with sunrise. This procedure will be carried out during the autumn, winter and spring seasons, to counteract the lack of sunlight and thus regulate the activity of serotonin.
Phototherapy, although safe, may be contraindicated for patients with eye conditions or greater sensitivity to sunlight.
Cognitive-behavioral therapy has also been used to improve and treat negative thoughts, beliefs and feelings linked to winter. In the same way, an attempt will be made to increase the subject’s activity by carrying out activities that they like and that motivate them. Cognitive behavioral therapy has been proven effective and although the results take a little longer to be observed than with phototherapy, in the long run the improvements can be more lasting.
As we have already seen, this seasonal specifier is normally linked to episodes of depression, and it is for this reason that the type of psychotropic drug commonly used is the serotonin reuptake inhibitor (SSRI). Another antidepressant, bupropion, which acts mainly by inhibiting the reuptake of norepinephrine and dopamine, has also been found useful.
Finally, as it is typical for patients with seasonal emotional impairment to observe decreased values ​​of vitamin D, it has been tried to increase this amount through nutritional supplements, although the results obtained are not clear, with improvements similar to therapy being detected in some cases. with light and in others no effect was observed.
