Alazne Díez: "That the days are shorter affects some people a lot"

Mood disorders, a group of different psychopathologies that have in common the fact of producing emotional imbalances, have their most famous and popularly known representative in what we usually call "depression".

However, beyond clinical depression (also known as major depression) there are other disorders capable of making us feel sad and down, such as seasonal affective disorder.

In this interview with the psychologist Alazne Díez we will learn about the characteristics of this emotional disturbance from an expert on the subject.

• Related article: "The 6 types of mood disorders"

Interview with Alazne Díez: what is seasonal affective disorder and how does it arise?

Alazne Díez Abad is a psychologist and Director of the Loratu Psychology Center, located in Bilbao. This professional has been caring for adults with emotional problems for many years, and one of the most curious is what occurs through the so-called seasonal affective disorder. In this interview we asked him about this psychological alteration.

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What is seasonal affective disorder and how is it different, for example, from the simple sadness of leaving behind a season that we liked?

Seasonal affective disorder (SAD) is characterized by the appearance of depressive episodes at a certain time of the year, remitting said episodes when the season ends. It usually occurs at the end of autumn and disappears in the spring and, although less frequently, there are people affected in the summer months.

The prevalence is between 1 and 10% of the population, especially in women with family members with a history of depression, including SAD. In addition, people whose origin coincides with northern latitudes are at greater risk of having this disorder, as daylight hours are reduced (as in Finland, for example).

The difference with the sadness of leaving behind a pleasant season lies in the gravity of the symptomatology and in which the episode systematically recurs every year on the same dates for at least least two years. Also, it is not a nostalgic or sad day, but rather a continuum of months with something more complex to manage than sadness.

And what is it that differentiates it from major depression? Is its severity considered to be comparable to that of this disorder?

In the major depression symptoms must be present for at least two weeks. The main difference is that in the SAD the symptoms subside when the season ends, while in the major depressive disorder remission is not frequent without being under a psychological, pharmacological or combined.

SAD can be considered as a specifier within depressive disorders and not so much as a separate or specific mood disorder; Although we usually call it that. It is, therefore, a major depressive disorder with a seasonal pattern, where major depressive episodes do not occur outside of that period.

It is difficult to talk about seriousness, since in both cases the person has significant clinical discomfort that makes it difficult and has repercussions on a personal, social and/or work level. It could be said that the diagnosis may be more difficult to identify in the SAD or for the person to resort to psychological help after having remission.

Likewise, treatment should include elements such as vitamin D, melatonin and adaptation to the new light cycles, as well as psychological issues. Likewise, SAD can be associated with other disorders, such as bipolar disorder, so it is important to pay attention to the pattern to prevent some hypomanic episodes, for example.

How can this psychological alteration influence the personal relationships of the person who develops it? For example, in family life, in relationships with friends, etc.

People who have this type of mood pattern often experience interference with family, social, and/or work life. In addition, since it begins in a certain season, we could say abruptly, the environment usually also identifies the changes.

Each person can have different alterations but, in general, apathy or irritability may appear, greater sensitivity even with a tendency to cry, less interest in social relationships or doing things activities. As in other mood problems, both the person and the person's environment perceive a significant change in personality and functioning compared to previous moments. In addition to this, the environment could also notice a sadder aspect, such as having a duller look.

And how does it usually influence the workplace?

At the work level, concentration and/or memory problems could appear. The depressive state in which he is found can affect work performance or we can identify, for example, failures or forgetfulness that are not usual in that person. In addition, it may be more difficult to start tasks or finish them, a feeling of guilt or uselessness when realizing failures or not performing properly or feeling tired.

What are some of the most recurring complaints or thoughts that characterize the state mental disorder of people with seasonal affective disorder, when this alteration is expressing its symptoms?

Considering rather a subtype within affective disorders, the predominant symptomatology or complaint will depend mainly on the underlying depressive disorder. The symptoms are similar to those that a person with major depressive disorder might have: sadness for much of the day (may appear crying), lack of energy or vigor and tiredness, changes in weight, appetite and/or sleep, loss of interest and enjoyment in previously satisfying activities, anxiety or restlessness, feelings of hopelessness, worthlessness, emptiness, etc

Since seasonal affective disorder is linked to the passing of the seasons and these are characterized by changes in daylight hours and temperature, are these two variables considered to be related to the causes of this psychopathology?

Yes, the fact that the days are shorter and we have fewer moments of light affects some people in a very noticeable way on a physical and psychological level.

One of the explanations, in addition to genetic vulnerabilities, has to do with the adaptive capacity of circadian cycles to those new shorter light periods. This influences the duration and onset of sleep.

In addition, the efforts of our organism and our psychic apparatus to adapt also pass on a physiological level, altering the functioning of serotonin (related to mood) and melatonin (related to dream). What for some can last a couple of weeks until the mind-body adapts, for others it constitutes the start of the SAD with duration for the rest of the season.

What can be done in psychotherapy to help people who are suffering because they have developed seasonal affective disorder?

The first thing is to become aware of it. If we know that at the beginning of the winter months we begin to feel worse, we also have the opportunity to have adequate medical and psychological assistance during that period.

It is possible that in addition to the biological issues mentioned, where work on sleep routines and habits, for example, can produce changes, there are other factors as well. psychological factors that can influence and work on (such as memories or longing for loved ones during Christmas, more accentuated distorted thoughts, pessimism, etc.).