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Seasonal affective disorder (SAD), known as seasonal depression, is a type of depression that occurs seasonally. Usually, episodes of depression appear at the same time every year during the season of lack of solar activity. If you feel completely healthy during the spring and summer, if you start to feel uncomfortable towards the end of the fall and have symptoms of depression during the winter, you may have seasonal affective disorder. In most cases, symptoms begin in the fall, as daylight hours begin to shorten. The maximum manifestations of seasonal depression are observed in December, January and February. Women with seasonal affective disorder react negatively to decreasing amounts of sunlight and lower temperatures during the fall and winter.

In the spring, women with seasonal affective disorder are “reborn”, the intensity of the symptoms begins to decrease, and then the manifestations of the depressive state completely disappear. Seasonal affective disorder was not recognized as a specific disorder until the early 1980s, when Dr. Norman E. Rosenthal and his colleagues formally reported the condition and gave it a name. According to Dr. Rosenthal, he himself experienced symptoms of depression every winter and spent a lot of time trying to determine the causes of his own condition, such as childbirth and understanding seasonal affective disorder. Dr. Rosenthal suggested that less light during winter may be a major cause of seasonal affective disorder.

It should be noted that some women may suffer from an atypical form of seasonal affective disorder, sometimes clinical symptoms of seasonal depression may appear during the summer (instead of winter or in addition to winter).

Seasonal affective disorder is about four times more common in women than men. An increase in the incidence of seasonal affective disorder has been noted in countries far from the equator. In general, women of all ages can be susceptible to seasonal depression, but the highest incidence of seasonal depression is found in women 22-25 years old.

Seasonal depression - causes and risk groups

Most scientists suggest that the underlying cause of seasonal affective disorder is decreased exposure to sunlight over more than short days of the year. A lack of sunlight can cause malfunctions in the body, disrupting the sleep-wake cycle and circadian rhythms (inc. morning hours organism). Violation of cycles provokes a decrease in the level of serotonin, which is responsible for mood.

Another theory suggests that light stimulates the part of the brain (mainly the hypothalamus) that controls mood, appetite and sleep. So a lack of light can alter mood (causes sadness), changes appetite (or anorexia) and causes sleep disorders.

Lack of light can affect the body's production of melatonin and serotonin, as well as disrupt the body's circadian rhythm. Women who live in northern latitudes are at greater risk of developing seasonal affective disorder. At the same time, it was found that low level Vitamin D levels in the blood are associated with a higher incidence of seasonal depression. Seasonal affective disorder may begin in adolescence(more often in girls) or in mature age(more often in women). Women with family history Those with depression are at higher risk of developing seasonal affective disorder.

Seasonal depression - symptoms

Seasonal affective disorder symptoms tend to start and end around the same time every year. Symptoms of seasonal affective disorder typically begin slowly in late fall and continue into the winter months. Most women notice symptoms in September-October and notice a decrease in them in April-May.
The two main symptoms of seasonal affective disorder are: low mood and lack of interest in life. But some women may have other symptoms, such as:

• Sadness, grumpiness, moodiness, or anxiety;
• Decreased activity and loss of interest in usual activities;
• Decreased energy and ability to concentrate;
• Sluggishness of movements;
• Hopelessness and irritability;
• Increased need for prolonged sleep;
• Overeating or cravings for food (mainly carbohydrates - baked goods, cakes, pasta);
• Weight gain;
• Closedness (isolation).

Seasonal depression - diagnosis

The main diagnostic criterion for seasonal affective disorder is the dependence of the manifestation of all symptoms of depression on the time of year. If you experience the symptoms of depression listed above for short periods of time winter days, you probably have seasonal affective disorder. The main diagnostic symptoms are symptoms of depression associated with seasonality.

Seasonal depression - treatment

Light therapy can be very effective for treating seasonal affective disorder. There are two types of light therapy:

• Bright light of the device for a limited period of time (30-120 minutes) in the morning.
• The light of a device that simulates dawn, when the dim light while you sleep gradually becomes brighter (similar to the natural sunrise/sunset).

Light therapy is an effective treatment for most women suffering from seasonal affective disorder. A positive effect can be observed after 1-2 weeks of treatment. Light therapy should be used over a long period, throughout the fall and winter season. Light therapy can be stopped in late spring.

Sometimes doctors may prescribe antidepressants for seasonal depression; these medications can improve the balance of brain chemicals that affect mood. Counseling can also be a helpful component of effective treatment for seasonal affective disorder.
It is recommended to be active during the entire treatment period, since during the daytime (especially in the mornings) physical activity can help you have more energy and feel less depressed.

Seasonal depression - forecast

Treatment for seasonal affective disorder is usually effective and the outcome is usually good. But some women may experience seasonal affective disorder throughout their lives.

The weather outside is changing, and with it our mood is changing. Moreover, it is important to understand that this is completely normal: the amount of sunlight directly affects the production of endorphins (hormones of joy), which, in turn, helps us perceive certain events in a positive way. But what to do if the situation no longer resembles a banal bad mood, and shows quite obvious signs of depression? Let's figure it out.

What is seasonal depression

Seasonal affective disorder (SAD) is a form of depression that occurs during the fall (less common) and winter months. Its symptoms are no different from classic depression, with the only difference being that they tend to develop when daylight hours begin to decline (in September) and reach their peak in January-February. The severity of symptoms then begins to decrease as the hours of daylight increase.

Symptoms of seasonal depression

Permanently depressed mood

Melancholy

Irritability

Sleep problems (difficulty falling asleep, insomnia or excessive sleeping)

Low energy level

Changes in appetite (it may be decreased or increased, there is a craving for carbohydrates)

Loss of interest in things that used to bring you pleasure

Social isolation

Difficulty concentrating

Decreased libido

Why does seasonal depression occur?

The exact cause is still unclear, but the most widely accepted theory suggests that seasonal depression is caused by decreased levels of sunlight during the fall and winter, which has a direct effect on the brain.

Thus, reduced levels of sunlight affect the part of the brain called the hypothalamus. The hypothalamus, in turn, has many important functions: one of these functions includes helping with the functioning of the nervous and endocrine systems.

Plus, in the case of seasonal depression, the brain produces increased amounts of melatonin, a hormone that controls sleep and wake cycles. This leads to sleep problems, unexplained fatigue and apathy. At the same time, decreased levels of sunlight cause a decrease in serotonin production in the brain. Serotonin is a hormone that affects our mood, appetite and sleep.

The hypothalamus also controls our body's internal clock, known as circadian rhythm. The body needs sunlight to regulate the timing of the metabolic functions that occur in the body over a 24-hour period. In some cases, decreased levels of sunlight during the winter months can disrupt the body's natural rhythm and, as a result, cause symptoms of seasonal depression.

How to cope with seasonal depression

The first thing the doctor will recommend in case of depression - it doesn’t matter so much whether it’s seasonal or not - is a course of mild antidepressants (and a number of selective serotonin uptake inhibitors). However, it is not necessary to contact a specialist if we are not talking about serious psychological problems.

Try to cope with mood changes on your own, and, quite possibly, you will achieve what you want. And the main thing you should do is modify your lifestyle.

1) Try to get as much sunlight as possible during the day. Incorporate a short walk into your commute, and make sure you leave the office at lunchtime.

2) Working out helps produce endorphins - and this is perhaps The best way increase their number in the body naturally.

3) Try to sit near windows or, if this is not possible, in well-lit areas. Especially if we're talking about about work during the day.

Other lifestyle tips are quite general: eat healthy and balanced foods, relieve stress with any accessible ways(dancing on your bed, boxing, or 15 minutes of meditation), take a soothing bath at least once a week and be attentive to your body's needs.

Faculty of Psychology, Moscow State University

Collective, conscious

Is there a seasonal depression?

In 2016, researchers from Auburn University (USA) published the results of a study refuting the existence of so-called “seasonal depression.” According to scientists, a wide survey of the population did not reveal any patterns between depression and the time of year. However, other psychiatrists and biologists think differently - although the neurophysiological mechanism of seasonal depression has not yet been revealed, it is known that some people are able to react painfully to the arrival of not only winter, but also summer.

What psychiatrists say

The first professional psychiatrist to draw attention to the fact that mentally healthy people may suffer from severe emotional disturbances associated with the changing seasons, became Norman Rosenthal. Personal experience “helped” him in this. In the early 1980s, Rosenthal and his wife moved from South Africa to New York, and the couple soon discovered that during the dark winter months, both became lethargic and apathetic for no reason, and suffered from depressed mood. However, as soon as the snow melted and the number of hours of sunshine per day increased, these symptoms inexplicably disappeared. Rosenthal shared his observations with a group of researchers at the National Institutes of Health, and in 1984 they described “seasonal affective disorder” (SAD).

Today, ATS is not identified as a separate mental illness, and is considered a specification of major depressive disorder. A diagnosis of major depressive disorder is made when five or more of the following nine symptoms are present, each of which must have been present for at least two weeks and must include at least one of the two core symptoms of depressed mood and/or loss interests or pleasures:

The diagnosis of seasonal affective disorder is made according to the following criteria, if they have been present for at least two years:

Although most people are familiar with the so-called “winter depression,” there is also a summer affective disorder, which, however, is much less common. Summer and winter affective disorders differ quite greatly in their manifestations. If winter is characterized by a reluctance to get up in the morning, depression, lethargy, increased appetite, cravings for foods high in carbohydrates and sugar and, as a result, weight gain due to overeating, as well as difficulty concentrating, irritability, alienation from friends and family , lack of sexual desire, then for the summer, in addition to irritability, a decrease in appetite, weight loss, insomnia, general arousal, restlessness, anxiety and episodes of aggressive behavior are characteristic.

It's important to note that SAD can vary greatly in severity. Some people may experience a milder form of seasonal depression known as the "winter blues." Others, however, may become completely incapacitated: in some cases, SAD symptoms are as severe as inpatients with non-seasonal depression.

What biologists say

Scientists have been studying the conditions and mechanisms of the occurrence of SAD for more than 30 years, but still cannot find its specific causes. However, they were able to identify a number of biological factors that are presumably associated with the occurrence of this mental disorder:

1) Serotonin levels. Reducing the amount of sunlight can lead to a decrease in the amount of serotonin, a brain chemical that is responsible for our good mood and emotional stability.

2) Melatonin levels. Melatonin is a hormone that is produced at nightfall, causing our body to fall asleep. As there is less light on winter days, the body may overproduce this hormone, causing you to feel lethargic and drowsy.

3) The biological clock. The combination of decreased serotonin levels and increased melatonin levels cannot but affect a person's biological clock. Several studies have found that in people with seasonal affective disorder, the circadian rhythms change with the seasons and are inconsistent with the seasonal changes in daylight hours, making it difficult to regulate the body's functioning.

4) VitaminD. Because our skin receives much less sunlight in winter than during warmer months, people with seasonal affective disorder may produce less vitamin D, which is thought to be related to serotonin activity. Therefore, vitamin D deficiency and depression may be linked.

Who is at risk? SAD is four times more common in women than in men and occurs more often among relatively young people, between the ages of 18 and 30. People living far from the equator are also at risk. For example, scientists estimate that among Florida residents, only 1 percent suffers from SAD, while in Alaska, this diagnosis is already recorded in 9 percent of the population. In general, the prevalence of SAD is thought to be between 1 and 3 percent in the general population. However, these data can hardly be called accurate, since many cases of the disorder remain unregistered because people do not always seek help. It is often difficult for a doctor or psychiatrist to diagnose SAD because other types of depression, alcoholism, eating disorders, and other mental disorders can cause very similar symptoms.

What does the new work say?

After analyzing data from a survey in which more than 30 thousand Americans took part, scientists from Auburn University came to the conclusion that the number of people suffering from depression does not change significantly depending on the time of year. Among those surveyed in winter there were no more cases of depression compared to people surveyed at other times of the year. Additionally, the symptoms of those study participants whose responses indicated they were currently depressed were not worse or more numerous during the winter. The authors believe that “the idea of ​​seasonal depression may be deeply rooted in everyday psychology, but it is not supported by objective evidence,” and that “just because someone suffers from depression in the winter does not mean that they suffer from it because of the winter.” " The researchers hypothesized that since depression is a mental disorder that often recurs after apparent recovery, it may occur randomly over two consecutive winters. Depression that recurs over three or more winter seasons may be due to personal or social factors unrelated to the underlying cause. short period daylight hours.

However, not everything is so simple here. Firstly, in the opinion poll conducted, which included full list main symptoms of depression, participants recalled how many days during the previous two weeks they had experienced these symptoms. However, as already mentioned, the diagnosis of SAD is made on the basis of a longer history of the patient, because such a disorder involves the recurrence of symptoms over several years (at least two) at the same time of year. The authors of the study undoubtedly knew this, but since their diagnostic method was based on a single survey, they decided not to turn to the subjects’ distant memories for fear that they would remember not a real, but an imaginary experience, involuntarily adjusted to the idea of ​​“winter depression.”

Second, the Auburn University study did not take into account that people suffering from SAD may be undergoing treatment at the time of the survey, nor the fact that patients with a long history of the disorder may have developed their own appropriate strategies to cope with symptoms. In the study, conducted in the form of a survey, all of them should have fallen into the category of healthy rather than suffering from depression. In addition, patients with SAD interviewed in non-winter months simply could not be identified in such a study, since symptoms of the disorder appear only 3-4 months a year, and the rest of the time there are no signs of depression at all. This means that potentially, with such a study design, only 1/4 to 1/3 of patients with SAD who were not undergoing treatment could be identified, which should have significantly distorted the results and, accordingly, led scientists to false conclusions.

Summarize. In addition to a single study that does not confirm the connection between daylight hours and the occurrence of seasonal depression, there are dozens of other studies performed in different research centers that document the existence of thousands of patients who meet the criteria for SAD. In addition, many other studies show a connection between people's mood and the time of year. More than one study confirms the fact that a lack of light negatively affects mood, while light therapy improves it. Therefore, there is no need to close the issue of “winter depression”.

Bibliography

Traffanstedt M.K., Mehta S., LoBello S.G. Major Depression With Seasonal Variation: Is It a Valid Construct? //Clinical Psychological Science, 1–10, 2016.

Melrose, Sherri. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches //Hindawi Publishing Corporation, Depression Research and Treatment, 2015.

Winkler D., Pjrek E., Spies M., Willeit M., Dorffner G., Lanzenberger R., Kasper S. Has the existence of seasonal affective disorder been disproven? // Journal of Affective Disorders, 2016.

Young, Michael A., et al. Which Environmental Variables Are Related to the Onset of Seasonal Affective Disorder? //Journal of Abnormal Psychology, 1997, Vol. 106, No. 4. P. 554-562

Seasonal, it begins to clearly manifest itself at the end of autumn in the form of a decrease in vitality and changes in mood. Most people simply do not pay attention to the manifestation of this disease, attributing the blues to bad weather, fatigue from worries or ordinary laziness.

According to statistics, every seventh inhabitant of the planet falls under the influence of autumn mood swings. In most cases, these are people with a fine mental organization, suffering from obsessive headaches, nervous disorders, showing constant dissatisfaction and having slight deviations in physical and psychologically. Seasonal symptoms manifest themselves differently in each person, varying from simple irritation to a protracted form of decline in mood and strength.

Types of seasonal mental disorder

Which appear during the off-season, always appear at the same time. If there is deterioration over several years emotional state person, then one can already suspect the appearance of seasonal depression. Psychiatrists distinguish two types of affective seasonal disorder: summer and winter.

Depression in summer is a rare phenomenon that appears in June or in the second half of July and lasts until late autumn. Among the entire population, only 10% of people suffer from symptoms of summer depression. Often this condition goes away without outside help with the onset of the first autumn days.

- This is a more common variant of the disease, which affects 90% of patients with minor mental disorders. Typically, this form of depression occurs in the first months of autumn and lasts until the beginning of May. With the onset of the first cold weather, many people experience increased appetite and constant drowsiness, and these are the first signs of seasonal depression.

Most patients suffering from seasonal disorder fall in the age group of 25 to 40 years. Seasonal mood changes go away with age and are much less of a concern.

Symptoms of depression

Since winter depression is more common, its symptoms are worth considering in more detail. In most patients, the disease is mild and manifests itself in the form of constant irritability, fussiness and bad mood, so you can deal with this yourself. For a more serious form of seasonal depression (symptoms of which include sudden mood swings, nervousness, loss of interest in what is happening around you, feelings of unreasonable anxiety, a desire to sleep during the day), you should consult a psychologist or therapist. Specialists such as cardiologist and psychiatrist should not be avoided either, as they know exactly how to deal with winter depression.

Ways to combat seasonal depression

According to the observation of doctors, with the arrival of autumn there are many more patients. Most of chronic diseases tends to worsen during the off-season. This is due to a significant reduction in daylight hours, since the lack of the required amount of sunlight affects the production of serotonin (a hormone responsible for the balance of the nervous system). A lack of serotonin leads to the appearance, increases appetite and fatigue. If, with the end of autumn, you begin to notice that you are overcome by seasonal depression, you can begin treatment on your own, trying to restore peace of mind through a change of environment, place of residence or new acquaintances.

Reducing daylight hours often leads to anxiety and anxiety. The fight against it must begin with the elimination of this factor. Effective method To combat this problem is to increase daylight hours, and for this you need to make full use of the morning hours. It is advisable to spend as much time as possible outside in the sun, especially in the first half of the day.

It is important to eliminate vitamin deficiency. An insufficient amount of vitamins in the body leads not only to loss of performance, but also to deterioration general condition. The body must be prepared for the off-season, and for this it is necessary to intensively consume fruits and vegetables, which contain vitamins and minerals. If it is not possible to eat fruits and vegetables in large quantities, you can replace them with a vitamin complex purchased at the pharmacy.

The benefits of tonic drinks

Tea and coffee, consumed in moderation, help overcome seasonal depression. Morning coffee or a cup of green tea can temporarily restore alertness and composure. The condition can also be achieved with the help of drugs designed to combat emotional depression (antidepressants). Their dosage and therapeutic course should be prescribed by a doctor, since self-medication can lead to prolonged depression. If you feel an attack of seasonal blues, try to spend more time in the fresh air, go out in public as often as possible, meet with friends, i.e. lead an active lifestyle.