November 25, 2013
By Donna Peck
|Matthew Macaluso, D.O.|
As the days get shorter and the weather turns colder, many people develop the "winter blues." While most just feel nostalgic for long warm summer days, there are others who are more severely affected by the darkness and could be suffering from a type of depression called Seasonal Affective Disorder (SAD). Matthew Macaluso, D.O. is an assistant professor and director of clinical trials research in psychiatry and behavioral sciences at the University of Kansas School of Medicine-Wichita. We talked to Dr. Macaluso recently about seasonal affective disorder, its symptoms and treatment.
Q: How does seasonal affective disorder differ from the run-of-the-mill winter blues that many people suffer from?
Matthew Macaluso: Seasonal affective disorder, or SAD as it's often called, is a variation of clinical depression. One of the hallmarks of the disorder is its onset during the fall months when the days get short and then its departure when the spring arrives. Clinical or major depression is different from "having a bad day" because its symptoms persist and it interferes with an individual's ability to function in life.
Q: What are the symptoms?
MM: People who have SAD will often notice things like feeling sluggish and sad, a decrease in appetite, poor concentration and a lack of interest in daily activities.
Q: Is there any population or group that is more susceptible to seasonal affective disorder?
MM: Well, people who live in countries with longer winters with less sunlight are more susceptible, whereas those living closer to the equator where days are longer are less likely to be affected. Women are twice as likely as men to develop the disorder, and it can affect people of all ages.
Q: Is there a genetic predisposition to SAD?
MM: People who develop SAD are not that different from people who develop major depression without a seasonal pattern in that half of them will have a first degree relative that has a mood disorder like depression or bipolar disorder.
Q: Is there any research that explains why the shorter days and less light can lead to this kind of depression?
MM: There's nothing definitive, but there are certainly a number of theories. Some researchers believe that the decrease in the amount of sunlight can affect the metabolic activity that occurs in the brain. Sunlight - or the lack thereof - may alter the level of certain brain chemicals such as serotonin and hormones, which can affect your mood. With less sunlight during the winter months, changes in the balance of these chemicals and hormones may trigger depression. We even see differences in blood flow in different areas of the brain in patients who suffer from SAD.
Q: What kinds of treatments are available to help reduce the symptoms associated with SAD?
MM: I encourage patients to get as much natural sunlight as possible during the fall and winter, especially at midday and on bright days. Many people also find that bright light therapy helps to improve their symptoms. This involves sitting in front of a special light box for about 30 to 45 minutes every day. The idea is that the light box can help to replace the bright sunlight which you normally see in the summer. Some patients also take antidepressants to help deal with the symptoms.
Q: Are there any new treatments on the horizon that may help those with SAD?
MM: There is research going on now to determine whether an imbalance in the ratio of omega-3 fatty acids may increase the risk for SAD - and whether increasing your intake of omega-3 rich foods, such as fish, nuts, and canola oil, will reduce the severity of the disorder or even prevent it altogether.