Wednesday, February 9, 2022

If you were to find yourself sinking with each passing day as the available sunlight slid backward you might suspect you had Seasonal Affective Disorder (SAD). And if you were to take yourself to your primary care and that primary care was nurse practitioner Alicia Allen, she would ask whether your depression symptoms were year-round or specific to a season.
If your symptoms came in the winter when light is limited and improved as more and more light returned, then Alicia would also consider the possibility that you might be suffering from SAD. And if your symptoms included depression, fatigue, loss of pleasure or interest in things you previously enjoyed, sleep disturbances, increased appetite and carbohydrate craving, weight gain, agitation, confusion or cognitive changes/decline and/or thoughts of harming yourself, then a diagnosis of SAD would start looking even more likely and the conversation might move to treatment possibilities.
At this point Alicia, with Northern Light Health Family Care in Clinton, would think about the following treatment options when considering what might be most helpful for you:
  1. Light Therapy
  • Light therapy is helpful for milder SAD. 
  • These lights can be purchased OTC and range from table-top boxes to wearable light headsets. Use your Health Care FSA to pay for this.  
  • Lights work by resetting the circadian clock. 
  • For optimal results, you should sit facing this light with eyes open for approximately 30min each morning with lights that emit 10,000 lux. 
  • More face time may be required if the light has a lower intensity.   
  1. Antidepressants
  • Appropriate for more severe symptoms or in those who suffer with underlying depression. May be used from months of October to April, tapering off as the days are longer
  1. Cognitive Behavioral Therapy
  • Can be used in conjunction with light therapy and medications
  1. Self-care strategies
  • Exercise – daytime activity is encouraged, 4-6 hours prior to bedtime,
    • avoid rigorous activity within 2 hours of bedtime
  • Spend time outside when the sun is out
  1. Good sleep hygiene:
    • Regular bedtime and wake time
    • Avoid napping
    • Limit caffeine after lunch
    • Limit alcohol near bedtime
    • Avoid nicotine
    • Keep bedroom quiet and dark
    • Avoid checking clock at night
    • keep cell phone out of your bedroom
    • Avoid eating a large meal near bedtime
  2. Supplements
    1. avoid them since there is no evidence supporting the use of supplements such as St. John’s wort, vitamin D, or melatonin in the treatment of SAD

And finally, if you were to:
  • Get out in nature every day to breathe fresh air and feel the chill on your skin it would make coming inside a cozy house feel good.
  • Require yourself to go do something social or stimulating every week it would give each week a rhythm that would help move the winter along.
  • Take advantage of activities that are only available in the winter or go best in the winter like making soup, building fires, or other snow-related activities that would help to re-frame winter as a season with good things.
  • Watch or read only funny or uplifting things then you would bring some light into your life.
  • Remind yourself that you won’t always feel this way and there are many things you can do each day that will improve your mood and elevate your experience then aren’t owned by SAD.
Always consult your primary care provider before making any changes in your treatment plan. Their guidance is a key component of your success and wellbeing. And know that SAD can be managed; whatever you are feeling, you can feel better than that.  
More light is on the way. As the Native American saying goes, “Hope is on the horizon.”