In addition, the condition has been linked to bipolar disorder and other psychiatric conditions. “Often when you talk about seasonal affective disorder, you talk about the pure [condition]” Rosenthal says. “However, in practice, this winter deepening of depression often coexists with other conditions. For example, chronic depression gets worse in winter, and bipolar disorder can be accompanied by winter depression.”

Treatment of Seasonal Affective Disorder


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Exposure to bright white light is the main treatment for SAD and has the best supporting evidence.4

“Bright light therapy is unquestionably the first-line intervention for SAD,” says Michael Terman, MD, of Columbia University Medical Center in New York City. “When timed correctly, based on an estimate of the individual’s circadian rhythm phase while depressed, symptom reduction is strikingly rapid – often within days. Full remissions are frequent, and residual symptoms are minimized compared with drug antidepressants.

“Unfortunately, administration of light therapy by clinicians has been sloppy in many cases, without knowledge of or care in applying dosing and timing principles parallel to pharmacotherapy,” he continues. “Furthermore, because light therapy apparatus is commercially available without prescription, many SAD sufferers opt to self-treat rather than seek clinical guidance. The result, of course, is lower efficacy than is readily attained with informed administration.”

However, Docherty suggests that “care should be exercised to determine if a patient is bipolar because you could possibly switch that person into manic episode. As a practice, it would be prudent to make sure the person is taking a mood stabilizer before starting light therapy in bipolar patient.”

Other options that have been effective in addressing SAD include a specialized elaboration of cognitive behavioral therapy and a broad array of antidepressant medications.5

“Many people will use other therapies for SAD. Mindfulness-based [cognitive-behavioral therapy] has been reported fairly recently. If the depressive symptoms are very severe and light is not working, patients may need to be treated with antidepressants,” says Kryger.

Beth Gilbert is a freelance writer based in West Palm Beach, Florida. This article has been medically reviewed by Pat F. Bass III, MD, MS, MPH.

References

  1. Cleveland Clinic. Seasonal Depression. Accessed: December 30, 2014.
  2. Kryger MH. A SAD Tale: New research sheds light on winter depression. Psychology Today. January 29, 2013.
  3. Tartakovsky M. Are you SAD this Winter? Coping with Seasonal Affective Disorder. PsychCentral. 2011. Accessed: December 30, 2014.
  4. DeAngelis T. Promising new treatments for SAD. Monitor on Psychology. 2006; 37 (2): 18.
  5. Rohan KJ, Roecklein KA, et al. Winter depression recurrence one year after cognitive-behavioral therapy, light therapy, or combination treatment. Behavior Therapy. 2009; 40 (3): 225-238.