In most cases, SAD appears during late fall or early winter and goes away during the sunnier days of spring and summer (often called winter depression). Fall and winter SAD-symptoms may include: Irritability Tiredness/low energy Problems getting along with other people Hypersensitivity to rejection Heavy feeling in the body Changes in sleep pattern (increased sleeping-hours) Changes in appetite Weight gain When to see a doctor or a psychologist?: It‘s normal to have some days when you are feeling down. But if you feel down for days at a time and can‘t get motivated to do the activities you normally enjoy, then see a general practitioner (GP), psychiatrist or a psychologist. This is especially important if your sleep patterns and appetite have changed or if you feel hopeless or have frequent thoughts of death or suicide. *Recommendation It is highly recommended to take vitamin D, lýsi (cod liver oil) and Omega-3 during the winter months in Iceland. Research shows that Omega-3 can have a positive effect on depression and SAD. Outdoor activities during the day-time and regular exercise are recommended as well. Possible factors The specific cause of SAD remains unknown. Some factors that are likely to play a role include: Your biological clock (circadian rhythm): The reduced level of sunlight in fall and winter may cause winter-onset SAD => the decrease in sunlight may disrupt your body‘s internal clock and lead to the feeling of being depressed. Serotonin levels: Reduced sunlight may cause a drop in serotonin that might trigger depression. Melatonin levels: The change in season can disrupt the balance of the body‘s level of melatonin, which plays a role in sleep patterns and mood. Treatments Treatment for SAD may include light therapy, medications and psychotherapy. First of all to rule out other possibilities, such as lack of B-12 vitamin, iron and vitamin D, see your GP and have your blood tested. Light-therapy: It‘s one of the first line treatments for fall-onset SAD. Research shows it is effective for most people in relieving SAD. It‘s a specific light-therapy lamp/box, it mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood. It is to be used daily, the duration depending on the distance of the box. It generally starts working after a few days to two weeks. You can either buy a light-therapy lamp or go to the Vesturbæjarlaug (swimming pool in the west part of Reykjavik) that has these boxes, access inclusive in the entrance fee. Medication: Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe. Keep in mind that it takes 2-4 weeks to notice full benefits from an antidepressant. Your GP may recommend starting treatment before your symptoms typically start. Psychotherapy: In Iceland, Cognitive Behavioural Therapy is the most commonly offered psychotherapy. Psychotherapy can help you identify and work on negative thoughts and behaviours that are maintaining a vicious cycle or making you feel worse. It can also help you find healthy ways to cope and how to manage stress. References Mayo Clinic Foundation for Medical Education and Research (1998-2015). Diseases and Condition. Seasonal Affective Disorder (SAD), retrieved in August 2015 from http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorde.... A.C.Logan (2003) Neurobehavioral aspects of omega-3 fatty acids: Possible mechanisms and therapeutic value in major depression. Alternative Medicine Review, 8, 410-425. Seasonal affective disorder (SAD) facebooklinkedintwitter
