Understanding Seasonal Depression
December 7, 2023

Feeling down in winter, could it be depression?

As the full swing of winter arrives, Christmas carols echo through the streets. Yet, my mood strangely feels downcast and listless. Why is this?
The truth is, this isn't just my story. More people than you might think are going through a similar experience. There's a form of depression that appears in conjunction with seasonal changes, known as 'Seasonal Affective Disorder', or in simpler terms, 'Seasonal Depression'.

What is seasonal depression?

Seasonal depression usually appears during specific times of the year and tends to disappear once those periods are over. It's often seen in the fall and winter, but rarely, it can also show up in the spring and summer. Simply put, it's a type of depression that strikes during the fall and winter. The symptoms are the same as for ordinary depression, but the condition develops in connection with the changing seasons.

Causes of seasonal depression

Why does seasonal depression occur? While the precise cause isn't fully understood, it appears to be closely associated with biological factors. Issues related to our biological clock as a result of light exposure commonly emerge as a primary cause, which may lead to problems in the secretion systems of melatonin and serotonin. Although the evidence may be weaker, frequently mentioned risk factors for seasonal depression include:

  • Family history: The likelihood of developing seasonal depression is higher if there is a family history of the disorder.
  • Gender: Seasonal depression more commonly appears in women than in men.
  • Residence: It's more commonly seen in people living in the northern hemisphere.
  • Young adults: It's most commonly detected between the ages of 18 and 30.

Diagnosis of seasonal depression

To diagnose seasonal depression, there needs to be a temporal relationship between the onset of the depressive episode and changes in seasons. In other words, people with seasonal depression typically experience depression during a certain time of the year, and the depression disappears once that season is over. If this pattern emerges for two consecutive years, it can be diagnosed as seasonal depression. While there might be experiences of depression outside of these specific seasons, seasonal depression is diagnosed when the instances of depression related to seasonal changes greatly outnumber those unrelated to the seasons.

Treatment of seasonal depression

  • Light therapy: Light therapy involves a patient entering a space known as a "Light Box" to receive exposure to a certain intensity of light. It appears to resolve hormone imbalances related to seasonal changes by rectifying the biological clock. It may seem like an overly simple solution, but light therapy is backed by ample evidence and is known to be as effective as antidepressant treatment.
  • Antidepressants: Among antidepressants, those in the category of SSRIs are effective.
  • Cognitive-behavioral therapy: Cognitive-behavioral therapy has demonstrated a level of effectiveness on par with light therapy. However, it has a lower rate of recurrence and a higher rate of full recovery. Thus, statistically, cognitive-behavioral therapy is shown to have superior efficacy in the treatment of acute and recurrent seasonal depression.
  • Sleep hygiene and exercise: Both sleep hygiene and exercise, which both influence the biological clock, have been suggested to be effective. However, the efficacy of these treatments hasn't been proven through well-structured clinical trials.

Prevention of seasonal depression

Since seasonal depression recurs every winter season, prevention is very important. Unfortunately, only the antidepressant bupropion (Wellbutrin) is known to be effective in prevention. Other types of antidepressants or psychological therapy techniques like mindfulness-based cognitive therapy aren't greatly helpful in preventing seasonal depression.

Many supplement companies advertise that vitamin D helps since sunlight is related to seasonal depression. As disheartening as the facts may be, almost no research indicates that vitamin D is beneficial to seasonal depression, and even minor-scale studies that have been conducted did not report any positive effects.

In conclusion

Seasonal depression is not merely about being affected by the seasons. Therefore, if you're experiencing recurring, severe bouts of depression every winter, consider seeking professional help. You see, those moments you brushed off merely as 'feeling down due to the season' might be slowly draining your spirit.

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