SAD was at first believed to be related to abnormal melatonin metabolism, but later findings did not support this hypothesis. Studies of brain serotonin function support the hypothesis of disturbed activity. The short-allele polymorphism for serotonin transporter is more common in patients with SAD than in healthy people. Atypical depressive symptoms commonly precede impaired functioning, and somatic symptoms are frequently the presenting complaint at visits to family physicians. The best treatment regimens include 2500 lx of artificial light exposure in the morning. When patients seem to have no response or to prefer another treatment, antidepressants should be considered.
Lurie, Gawinski, Pierce and Rousseau echoed the advice to use light therapy in the morning, but mentioned the importance of substance abuse as a contributor to depression. Once again they suggested that drug therapy was another option to consider.
Physicians should be aware of comorbid factors that could signal a need for further assessment. Specifically, some emerging evidence suggests that seasonal affective disorder may be associated with alcoholism and attention-deficit/hyperactivity disorder. Seasonal affective disorder often can be treated with light therapy, which appears to have a low risk of adverse effects. Light therapy is more effective if administered in the morning. It remains unclear whether light is equivalent to drug therapy, whether drug therapy can augment the effects of light therapy, or whether cognitive behavior therapy is a better treatment choice.
Suggestions for Natural SAD Therapy
Artificial light has been found to be beneficial, but what your body is really craving is natural sunshine on your skin. Of course keep in mind that the sun can be damaging, but try to get out and about through the winter months. Taking a walk or even sitting by a window can all contribute.
Resist the temptation to load up with comfort foods. No matter if your urges are telling you to prepare for a long hard winter, you are not actually going to hibernate! Stay fresh with lots of fresh fruits and vegetables to stop your system from becoming sluggish.
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