Seasonal Affective Disorder: Symptoms, Causes, and Treatment

In people who have developed seasonal affective disorder, it is common for the change in time of year or season to lead to the onset of a mood disturbance. Normally, this psychological imbalance begins during the fall or winter and ends in the spring or summer. Since it is mainly associated with depression, the symptoms are typical of this disorder.

if you want to know the psychological effects of seasonal affective disorder, here you will find a summary about the characteristics of this alteration.

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What do we understand by seasonal affective disorder?

Currently in the fifth edition of the Diagnostic Manual of the American Psychiatric Association, the seasonal pattern is a specifier of mood disorders; Specifically, it can be related to any episode of mood affectation, that is, both with a depressive, manic, or hypomanic episode.

Thus, as its name indicates, seasonal affective disorder is characterized by following a pattern of presentation of emotional disturbance,

the onset and remission of the episodes occurring at a certain time of the year. It would also meet the criteria if, instead of ending the episode, a pole shift occurs, for example, from presenting a depressive episode to a manic one.

The most common pattern, linked to depressive episodes, is the one that begins in autumn or winter and subsides during the spring. This type of depression will be called winter. On the other hand, with regard to manic or hypomanic episodes, it is more common for them to start in summer and show the opposite pattern.

Despite the fact that the onset pattern presented above is the usual one, it does not have to be strictly so and can be shown to be the other way around, where the depressive episode begins in summer. In any case, the important factor to be able to use this specifier is that in the last two years there have been at least 2 episodes with a seasonal pattern and none without this pattern. In the same way, if we value the different episodes that the subject has shown throughout his life, they must be mostly seasonal in order to apply this specifier.

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Causes

In relation to the cause that causes the appearance of the seasonal disorder, it is believed that this is not only one, that is, that It is a multi-causal phenomenon, affecting both more biological factors and other more psychological ones.Although it is not yet known exactly what they are, what specific variables cause this disorder.

In different studies, comparing the levels obtained in subjects of the clinical population and those of the population In general, it has been observed that there are differences between neurotransmitters and hormones, presenting special relevance serotonin and melatonin.

The serotonin It is a neurotransmitter linked to affective disorders, especially with depressive episodes, where this neurotransmitter is decreased.

A fact that confirms this lower level of serotonin is that if we treat depressed patients with drugs inhibitors of serotonin reuptake, this means that it increases it, an improvement is observed in its symptoms. Thus, we deduce that serotonin is an important neurotransmitter for mood regulation.

Why does a decrease in serotonin occur? Sunlight has been observed to function as a regulator of serotonin, making it find and maintain its normal levels throughout the year, but in the case of subjects with affective disorder seasonal, this regulatory function does not work well, causing the levels of this neurotransmitter to be lower than the normal level during the winter. For this reason, this affectation is linked above all with onset in winter.

Regarding the hormone melatonin, this is related to the regulation of sleep-wake cycles, increasing its levels during the night, when it gets dark, so that the feeling of drowsiness in the subject increases. Thus, in patients with seasonal affective disorders an overproduction of melatonin is observed, which makes the individual feel more tired, not wanting to do anything and more sleepy.

It is known that melatonin is produced from serotonin, and the balance between the two needs to be balanced so that the sleep-wake cycle is regulated. As in the case of the subjects with seasonal alterations an imbalance is produced, it will show problems in maintaining regulated rhythms adapted to the different times of the year, to the different seasons, manifesting problems sleeping and changes in mood and behavior.

Another factor linked to the decrease in serotonin is the lower level of vitamin D, it has been observed that this type of vitamin influences the activity and function of serotonin. We can obtain vitamin D both from the diet and increase its production when we sunbathe or sunbathe, likewise, during the autumn and winter seasons, where there are fewer hours of sun or the rays arrive with less intensity, they will have an impact on the production of this vitamin and consequently on the function of the serotonin.

Likewise, more psychological variables have been studied that may also act as a cause of this disorder. It has been observed that the personality of each subject affects the presence of seasonal affective disorder. Specifically, it has been seen that the two most linked traits are extraversion (affected subjects show lower levels of this variable) and neuroticism (on the contrary, they will present a higher score in this trait). After the treatment, when the levels were checked, it was obtained that higher levels in extraversion and lower in neuroticism with respect to the scores shown before the therapy.

It has also been taken into account How negative thoughts, beliefs and feelings related to winter affect this alteration, which are typical to find in patients with seasonal mood disorders, although the results are not conclusive either, since by not treating of an experimental study, the researcher cannot modify the variable beliefs and thoughts, independent variable, as he wants, we cannot affirm that the relationship is causal and that the negative beliefs produce the disorder, since it could also be the other way around and that the thoughts occur as a consequence.

• Related article: "The 8 types of emotions (classification and description)"

Main symptoms and psychological effects of seasonal affective disorder

As we already mentioned, since it is a specifier for a mood disorder and especially a depressive disorder, the typical symptoms of this affectation will be those of the depressive episode:

• Anhedonia, or decreased ability to feel pleasure.
• Significant weight gain or decrease.
• Insomnia or hypersomnia.
• Agitation or psychomotor retardation.
• Loss of energy.
• Feeling of guilt or worthlessness.
• Decreased ability to concentrate.
• Repetitive thoughts of death or suicide.

To meet the criteria, it must also be taken into account if they present 5 or more of the symptoms mentioned for a minimum of 2 weeks. If the disturbance is related to a winter or summer onset, the type of symptoms displayed will also vary..

When this emotional alteration is linked to a winter pattern, it is more characteristic that an increase in sleepiness appears, that is, hypersomnia. There is also a tendency to social isolation, the subject stops relating so much with others and spends more of his free time eating (so there are increases in body mass).

Conversely, if the pattern appears in summer, we observe more difficulty sleeping, insomnia, weight loss and decreased appetite and increased agitation, anxiety and behavior violent.

Treatment for seasonal mood disturbance

Since the causes of seasonal affective disorder are diverse, there are also different treatments that are used currently to improve the symptoms of affective mood disorder, both linked to more biological measures or more psychological.

The most widely used form of therapy is phototherapy treatment., which consists of exposing the subject daily to a very bright light of about 10,000 lux (unit photometric) for a period of 30 to 45 minutes, preferably early in the morning, coinciding with the sunrise. This procedure will be carried out during the autumn, winter and spring seasons, to counteract the lack of sunlight and thus regulate the activity of serotonin.

The phototherapy, despite being safe, may be contraindicated for patients with eye conditions or with greater sensitivity to sunlight.

Cognitive behavioral therapy has also been used to improve and treat negative thoughts, beliefs and feelings associated with winter. In the same way, an attempt will be made to increase the subject's activity by doing activities that they like and that motivate them. Cognitive behavioral therapy has been proven effective and despite the fact that the results take a little longer to be observed than with phototherapy, in the long run the improvements can be more lasting.

As we have already seen, this seasonal specifier is normally associated with episodes of depression, and it is for this reason that reason that the type of psychotropic drug that is commonly used is the serotonin reuptake inhibitor (SSRIs). Another antidepressant, the bupropion, which works mainly by inhibiting the reuptake of norepinephrine and dopamine.

Finally, as it is typical for patients with seasonal emotional affectation to observe decreased levels of vitamin D, it has been tried to increase said amount through nutritional supplements, although the results obtained are not clear, detecting in some cases improvements similar to light therapy and in others not being observed effect.