Abstract
Seasonal Affective Disorder is a type of depression that is recurrent that affects individuals based on seasonal changes. Most people with SAD have been found to experience depressive symptoms at the beginning of fall or winter and remit as the season ends. SAD ‘saps the energy of an individual,’ and the affected individual feels moody and loses their happiness. The risk factors of SAD include female sex, family history of depression, bipolar disorder or SAD, and those living far away from the equator (Melrose, 2015). A study done by Pjrek et al. (2016) on the socioeconomic impact of seasonal affective disorder and epidemiology in Austria concluded that there is no gender difference in terms of prevalence and that the higher rates of clinical SAD in females are contributed by more females seeking help comparatively to males. The diagnostic technique mostly used in identifying individuals is Seasonal Pattern Assessment Questionnaire (SPAQ). Treatment of SAD involves using antidepressants, light or photo-therapy, psychotherapy, and Vitamin D.
Etiology and Pathophysiology
According to Kurlansik and Ibay, A.D (2017), Seasonal Affective Disorder can be attributed to several biologic mechanisms, including circadian phase delay; this appears to be the underlying etiology in the literature. Other contributing factors include neurotransmitter dysfunction, retinal photo-sensitivity, and psychological factors such as stress and serotonin levels. Some studies suggest that SAD may be associated with alcoholism and hyper-reactive disorders (Lurie et al., 2018). Researchers suggest that the disorder is best viewed as a result of a combination of several mechanisms and factors.
Symptoms
Meesters &Gordijin (2016) describe SAD as a syndrome that affects individuals in the winter and autumn and often resolves during the summer or spring. Symptoms often experienced include feeling listless or sad throughout the day, losing interest in usually pleasurable activities, difficulty concentrating, feeling sluggish, and oversleeping. Lurie et al. (2018) note that some patients experience carbohydrate cravings, overeating, and weight gain.
Diagnosis
Physicians fail to diagnose approximately 50% of individuals presenting with the disorder and other psychiatric disorders and syndromes . There are several techniques for diagnosing depression in primary care, which range in specificity and sensitivity. A clinical examination involves using a structured questionnaire still remains the gold standard for diagnosing mental health disorders and measuring its severity. The most widely used tool is Seasonal Pattern Assessment Questionnaire (SPAQ), which has a high specificity (96 %) and low sensitivity (40%). The Seasonal Health Questionnaire (SHQ) is postulated to have high sensitivity and specificity comparatively.
Prevalence
Epidemiological Studies shows that SAD occurs in 0.5 to 3 percent of the general population and increases towards the pole. It affects approximately 25% of individuals with bipolar disorder and 10 to 20 percent of individuals with depressive disorders. According to a study, it was estimated that the prevalence is more than 10 percent in the northern latitude (Kurlansik and Ibay, 2017).
Treatment
Clinical and empirical employed in trials have shown cognitive behavior therapy (CBT), light therapy, and pharmacotherapy as the main beneficial treatments for the syndrome.Reduced amount and intensity of light received during winter or fall may convey SAD through phase shifts in circadian rhythms, causing anomalies in serotonin metabolism. Light therapy remains the most studied treatment option .literature review of studies shows that an average dosage of 2500 lux used daily for a week shows a better prognosis in depression reduction than the placebo.
Cognitive Behavioral Therapy (CBT) is derived from the analogy that our thoughts and perceptions towards seasonal changes affect our feelings and behavior. It is an empirically suitable management for non-seasonal type. Clinical trials have found that second-generation antidepressants are effective in decreasing depression scores and occurrence rates. selective reuptake inhibitors are the most effective.Prevention options aimed at avoiding remits include exposure to light, medication, and cognitive behavioral therapy.
References
Galima, S. V., Vogel, S. R., & Kowalski, A. W. (2020). Seasonal Affective Disorder: Common Questions and Answers. American family physician, 102(11), 668–672. https://doi.org/10.3810/psm.2002.11.529
Kurlansik, S. L., & Ibay, A. D. (2012). Seasonal affective disorder. American family physician, 86(11), 1037–1041. https://doi.org/10.1176/ajp.143.8.1035
Lurie, S. J., Gawinski, B., Pierce, D., & Rousseau, S. J. (2006). Seasonal affective disorder. American family physician, 74(9), 1521–1524. https://doi.org/10.1176/ajp.143.8.1035
Meesters Y, Gordijn MC. Seasonal affective disorder, winter type: current insights and treatment options. Psychol Res Behav Manag. 2016 Nov 30;9:317-327. doi: 10.2147/PRBM.S114906. PMID: 27942239; PMCID: PMC5138072. https://doi.org/10.2147/prbm.s114906
Psychology
Melrose, S. (2015). Seasonal affective disorder: an overview of assessment and treatment approaches. Depression research and treatment, 2015. https://doi.org/10.1155/2015/178564
Pjrek, E., Baldinger-Melich, P., Spies, M., Papageorgiou, K., Kasper, S., & Winkler, D. (2016). Epidemiology and socioeconomic impact of seasonal affective disorder in Austria. European Psychiatry, 32, 28-33. doi:10.1016/j.eurpsy.2015.11.001 https://doi.org/10.1016/j.eurpsy.2015.11.001
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