Seasonal Affective Disorder (SAD)

Treatment for seasonal affective disorder (SAD) doesn't cure the seasonal depression, but it can help relieve your symptoms. Your symptoms may improve if you get more natural sunlight during the daytime. Light therapy is the main treatment for SAD, and research is continuing to determine the most effective way to use it. Medicines and counseling may also be used to treat SAD.

Light therapy

There are two types of light therapy. One type is bright light treatment, in which you sit in front of a "light box" for a certain amount of time (usually in the morning). The other type is dawn simulation, which is done while you sleep. For dawn simulation, a low-intensity light is timed to go on at a certain time in the morning before you wake up, and it gradually gets brighter.

Light boxes use fluorescent lights that are brighter than indoor lights but not as bright as sunlight. Reference Ultraviolet light Opens New Window, full-spectrum light, tanning lamps, and heat lamps should not be used. You place the light box at a specified distance from you on a desk or in front of a chair and use it while you read, eat breakfast, or work at a computer. Light therapy is usually prescribed for 30 minutes to 2 hours, depending on the intensity of the light used and on whether you are starting out or are using it to maintain a response.

It may take as little as 3 to 5 days or up to 2 weeks before you respond to light therapy. Stopping light therapy might cause you to relapse back into depression.

Light therapy may work by resetting your "biological clock" (Reference circadian rhythms Opens New Window), which controls sleeping and waking.

If you have eye problems or you take medicines that make you light-sensitive, ask your doctor about whether light therapy is safe for you. Before you start treatment, tell your doctor about any other conditions you have and about the medicines you are taking.

Reference Reference Seasonal Affective Disorder: Using Light Therapy

Antidepressants

Antidepressants effectively treat episodes of depression in people who have seasonal affective disorder. You may start to feel better within 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor. Antidepressants can be used along with light therapy or alone. The most common antidepressants used to treat people with seasonal affective disorder include:

• Reference Selective serotonin reuptake inhibitors (SSRIs). Examples include citalopram (Celexa), fluoxetine (such as Prozac), paroxetine (Paxil), or sertraline (Zoloft).
• Reference Other antidepressants. Examples include bupropion (Wellbutrin or Zyban), desipramine (Norpramin), tranylcypromine (Parnate), or venlafaxine (Effexor).

SSRIs are usually the first type of antidepressants given to treat SAD. SSRIs often have less serious side effects than other antidepressants. All antidepressant medicines are started at low doses and increased gradually. When stopped, they should be decreased gradually to avoid side effects.

General side effects of antidepressant medicines can include:

• Nausea, loss of appetite, or diarrhea.
• Anxiety or nervousness.
• Difficulty sleeping or drowsiness.
• Loss of sexual desire or ability.
• Headaches.

Bupropion can cause dry mouth. Bupropion should not be taken if you have seizures, severe problems with eating, or an Reference eating disorder Opens New Window, because it can cause seizures.

Reference Reference Depression: Dealing With Medicine Side Effects

Reference Reference Depression: Taking Antidepressants Safely

Counseling

Counseling, such as Reference interpersonal therapy Opens New Window and Reference cognitive-behavioral therapy Opens New Window, may help with your treatment for SAD. You may choose individual counseling, participate in group counseling, or seek Reference family therapy Opens New Window. During Reference counseling Opens New Window, you will learn about SAD, ways to handle the symptoms, and how to help prevent future depressive episodes. If you have had SAD for a long time, your family members may also benefit from counseling.

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