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Managing Seasonal Affective Disorder

October is National Depression and Mental Health Screening Month. Seasonal Affective Disorder (SAD) is a type of depression linked to seasonal changes, typically beginning when fall starts and intensifying during late fall or early winter.

What’s the difference between SAD and the “winter blues”?

Many people feel a little down during colder months because they are stuck inside, and it gets dark early. These feelings, often called the “winter blues,” are temporary. SAD is a clinical form of depression that affects your daily life, including how you feel and think. SAD can last up to five months of the year.

What causes SAD?

About 5% of adults in the U.S. experience SAD. It tends to start in young adulthood. SAD may be caused by reduced serotonin and vitamin D levels, altered melatonin levels, decreased sunlight and shorter days.

What are the symptoms of SAD?

If you have SAD, you may experience mood changes and symptoms of depression, including:

  • Persistent sadness
  • Increased anxiety
  • Food cravings and weight gain
  • Extreme fatigue and low energy
  • Feelings of hopelessness
  • Social withdrawal
  • Sleep disturbances

What are treatment options for SAD?

Treatment should be tailored to you and supervised by a healthcare professional. Options include:

  • Spending time outdoors—Getting more sunlight can help improve your symptoms.
  • Light therapy—Using a light therapy box daily helps regulate circadian rhythms and boost mood.
  • Cognitive behavioral therapy—This treatment helps identify and change negative thought patterns.
  • Vitamin D—A supplement may help if a deficiency is present.
  • Medication—Antidepressants may be prescribed for severe cases.

For more on Seasonal Affective Disorder, visit our website for National Depression and Mental Health Screening Month, MagellanHealthcare.com/Mental-Health, and be sure to check out the suicide prevention tip sheets and awareness campaign toolkit.

Sources




Do I need a Depression Screening?

This article was co-written by David Michael 

Imagine yourself arriving at an airport, getting your ticket, checking your bags, and then heading to security. What if you arrived at the security checkpoint and there was no one there? No screening, no questions or checking your tickets… On the one hand, you might be relieved, and on the other hand, you might be more concerned about your flight! Safety screening has become a regular part of our lives. The screening is brief, systematic, and designed to maintain safety for airline passengers. But what if it was optional?

The Importance of Depression Screenings

There are many optional health screenings that we know to be beneficial and yet we still try to avoid them … everything from annual exams to the blood pressure cuff machine in the pharmacy. Screenings seem to have gotten a “bad rap.” A health screen is designed to be a preliminary tool for providing information at pivotal points when interventions may be crucial.

Learning that depression is more unpredictable and widespread than once thought can produce mixed emotions that reflect on how one conceptualizes depression and its many levels and possible stigma. Depression affects everyone differently; it might surface in the life of someone who has been diagnosed or it may emerge in someone who looks like they have it all together. It is known that most people will face depressed feelings at some point in their life. Life circumstance is bound to “throw a curve ball” and offer the personal support system an opportunity to employ coping skills and reflexive responses to tough situations.

Why get screened for depression?

Here are some ‘Depression Flags’ or Indicators that combined, provide a “road map” recommendation towards further care: (2) (3)

  • You have been through a series of tough events or situations and cannot seem to get back to feeling normal again.
  • You cannot remember the last time that you felt happy.
  • You are irritable and feel down a lot.
  • Intrusive negative thinking.
  • Change in appetite.
  • Change in sleep patterns.
  • Change in energy level or motivation.
  • Lowered ability to concentrate.
  • Change in daily behavior or moods.
  • Increased irritability, feelings of helplessness or hopelessness.
  • Lowered self-esteem.
  • Thoughts about suicide or a desire to have life over with.
  • Social withdrawal or isolation.
  • Refusals by a child for normal activities such as social gatherings, foods, school attendance.
  • For Children: A regression in skills already gained and increased need for reassurances.
  • For Teens getting into trouble, concerning behavior changes, or self-harm.
  • For Men: irritability, tiredness, anger
  • For Women: sadness, worthlessness, guilt.

How to Get a Depression Screening

  • Most medical providers or pediatricians will offer a basic depression screen when needed or requested during an office visit.
  • Local mental health professionals offer screenings with an office appointment or intake process and can follow up with therapeutic interventions as needed.
  • Online screens and helplines:
  • Anxiety & Depression Association of America: (1)
  • The Reach Institute (2)
  • Mental Health America (16)
  • Veteran’s Administration (17)
  • SAMHSA National Helpline: 1-800-662-4357
  • NAMI Helpline: 1-800-950-6264

Tips for Your Wellness Journey

Assemble a Care Team:

  • Bring the Guide: A medical professional can provide a depression screening and can also screen for another underlying medical condition exhibiting symptoms of depression, as well as a discussion of the possibility of vitamins and supplement use to balance any deficiencies. A wellness coach, naturopath, chiropractor, or other medical professional can also be consulted. A good first step for support would be to check with the Employee Assistance Program (EAP) provided through your employer for available mental health services.
  • Phone a Friend: Talk to a mental health provider, Chaplain, or someone you trust about your inner thoughts and feelings who will offer loving encouragement. Looking for ways to reduce isolation and increase connectedness can be an important step toward wellness.

Bounce Toward Wellness: (13)

  • Discover Yourself: Journal your thoughts and feelings to help you get to the bottom of what is bothering you. You may want to discuss this with a trusted professional as old losses or traumas can accumulate and catch up to the one who feels they are well within the rear-view mirror. This can feel overwhelming or like having a lingering ‘emotional cold’ draining your resources.
  • Eat Smart: Consuming quality protein and fruits and veggies improves the gut and brain’s ability to provide the neurochemicals needed for feelings of wellness. Junk food and low-nutrient foods increase feelings of depression or low mood in most people. While fast food seems easy, it is the rougher road in the long run. Hydration and taking deep breaths can help your brain have what it needs to perform and calm.
  • Pump the Breaks: A daily and weekly break from stress through recreation, creativity, reading, athletics, or other restorative activities can help the body regenerate. Too much stress can produce other physical maladies and drain your emotional and physical batteries. Limiting your schedule can help you regain balance during a stressful time.
  • Power Down and Reboot: To drain the body is to drain the mind. Sleep, exercise, and movement increases self-esteem and the immune system almost immediately; the lack of which can produce other urgent issues. While joining a gym might be ideal, even a minimal hour of ping-pong a week or a 10 minute walk a day can have a positive effect on mood and body. Depressed feelings often follow a weary body.
  • Screen the Screens: Limit use of devices and time on social media as these influences can contribute to isolation and low self-esteem through comparison, especially at night. Melatonin, which is needed to help one sleep, is depleted with blue light used in devices and the light used can trick the brain into thinking it is time to be awake. Limiting parental screentime and finding ways for family connection through games, conversation, or activities can help kids feel less isolated and more connected providing some protection from depressed moods for all.
  • Avoid the Mud: Negative thoughts get one stuck in a negative mind frame. Positive self-talk and optimistic thinking can go a long way to help reduce depressed feelings as evidence of the corresponding relationship between negative thinking and depression. Though it might feel difficult, finding something good in a situation can break up the mire to help one move in the right direction toward wellness. Follow the rule of thumb of thinking and speaking kind thoughts and words to oneself just like a good friend would do. Finding positive and meaningful ways to celebrate wins, whether big or little, can add fuel to the journey.
  • Embrace Your Natural State (15): Stimulants and depressants, and other mood-altering substances (even immoderate use of alcohol, sugar, and caffeine) can be addictive, impact the gut, and worsen feelings of unwellness. Alcohol can worsen depressed feelings and interfere with sleep as it turns to sugar in the bloodstream.
  • Pack the Jams: Positive or upbeat music and media can go a long way to lighten the mood and lighten thoughts; conversely sad or negative music or media should be used with caution.
  • Believe: Research points to many benefits of praying and the belief that there is a purpose to life, a Higher Power and that one is loved. A return to one’s faith and values can help that purpose and meaning to be rediscovered. (13)

Benefits of a Depression Screening

Ultimately, a depression screening is not mandatory like airport security. It is brief, systematized and can be a good measure of your current state so that you can make the best decision for your wellness. At a minimum, it is designed to give you a ‘snapshot’ of your current resources and your ability to find balance. It can offer some perspective for what might be needed to manage feelings and what kind of support would be best suited to help.

The late Jimmy Buffet’s last song, “Bubbles Up” (12) written during a time of great challenge, reminds the one who is under water to follow the air bubbles as they float to the surface to help re-orient oneself and find the exit where life, air, and light reside. It is a metaphor for life when facing a challenge as negative thoughts are intimately tied to negative feelings and increase feelings of overwhelm. Focusing on the positive can be a necessary lifeline for one who feels life is dark and confusing.

A valley of depressed feelings is not the destination. Regardless of which road brought you or a loved one to it, life does not have to be lived there. With some help and support, one may find themselves on a journey to self-discovery, healing, and hope.


References and Resources:

Depression Screens:

  1. https://adaa.org/understanding-anxiety/depression?gclid=EAIaIQobChMIzoWE2f3PgQMVEYvCCB2aEACeEAAYASAAEgJUKfD_BwE
  2. https://thereachinstitute.org/reach-and-adaa-anxiety-in-children-and-teens/?gclid=EAIaIQobChMIzoWE2f3PgQMVEYvCCB2aEACeEAAYAiAAEgJwYfD_BwE
  3. https://www.mhanational.org/national-depression-screening-day
  4. https://adaa.org/living-with-anxiety/ask-and-learn/screenings/screening-depression
  5. https://www.myhealth.va.gov/mhv-portal-web/depression-screening

Other References and Resources

  1. https://adaa.org/
  2. https://thereachinstitute.org/
  3. https://mhanational.org/
  4. https://mentalhealth.va.gov
  5. https://www.samhsa.gov
  6. https://www.nami.org
  7. https://youtu.be/6j3jDTOG7yI?si=eJQ4Qa5YHlLBcVI_
  8. https://www.amenclinics.com/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713100/
  10. “The Godfather | Plot, Cast, Oscars, & Facts | Britannica”. www.britannica.com. Retrieved December 31, 2021.
  11. Mental Health America. https://mhanational.org/
  12. Veteran’s Administration https://www.mentalhealth.va.gov/



Depression Screening

The U.S. Preventive Services Task Force recommends that all people, starting at age 12, be screened for depression. Screening for depression helps find depression early. And early treatment may help you get better faster.

Depression is a disease. It’s not caused by personal weakness and is not a character flaw. When you have depression, chemicals in your brain called neurotransmitters are out of balance.

Depression causes adults and children to feel sad or hopeless much of the time. It’s different from normal feelings of sadness, grief, or low energy. Always tell your doctor if you feel sad or have other symptoms of depression. Many times, people are embarrassed by these feelings and say nothing. Depression can be treated, and the sooner you get treatment, the better your chance for a quick and full recovery. Untreated depression can get worse, cause other health problems, and may last for years or even a lifetime. It can have a serious impact on both you and the people you care about.

Adults

To find out if you are depressed, your doctor may do a physical exam and ask you questions about your health and your feelings. Some questions may not seem related to your mood. But your honest answers can help give the doctor clues about how depression may be affecting you. Your doctor may ask you about feelings of sadness, changes in hunger or weight, energy level, concentration, guilt, thoughts of death and suicide, sleep, general interest in everyday activities, and more.

Some diseases can cause symptoms that look like depression. So your doctor may do blood tests to help rule out physical problems, such as a low thyroid level or anemia.

Children and teens

Symptoms of depression in children and teens can be different from adult symptoms.

To find out if your child is depressed, the doctor may do a physical exam and ask your child about his or her health and about how he or she thinks, acts, and feels. The doctor may ask your child about grouchiness, temper tantrums, headaches, stomachaches, social withdrawal, and more. It is common for children with depression to have other problems, such as anxiety, attention deficit hyperactivity disorder (ADHD), or an eating disorder. The doctor may ask questions about these problems too.

The doctor may also ask you or a teacher to fill out a form about your child’s symptoms.

Some diseases can cause symptoms that look like depression. So the doctor may do blood tests to help rule out physical problems, such as a low thyroid level or anemia.

For information about Magellan events during National Depression and Mental Health Awareness and Screening Month, downloadable materials and more free resources, visit our website here.

Adapted with permission from copyrighted materials here from Healthwise, Incorporated.  Healthwise, Incorporated disclaims any warranty and all liability for your use of this information.