SAD

What is it?

Seasonal affective disorder or SAD is a kind of depression that tends to come on at the same time of year every year.

What causes it?

It seems to be due to the length of daylight - usually the shorter the days the worse it is. No one is quite sure how this lack of daylight affects your body - it might be connected with the levels of the body chemical melatonin which controls your body clock.

Who gets it?

Anyone who suffers from depression can get SAD. You may be more at risk if you have a lot of stresses in your life such as money or relationship problems.

What are the symptoms?

You will usually start to feel depressed, miserable or even suicidal at a particular time of year between September and November. You will often feel particularly tired and sleep more than usual. You may want to eat a lot, especially sweet or stodgy foods, and you could put on weight. You may also find you avoid going out or seeing people, that you feel anxious and guilty and that your moods swing very quickly. You will usually feel better without any treatment in the spring. To be officially diagnosed as having SAD you have to have these symptoms every year for at least three years.

When should I go to my GP?

You should make a routine appointment to discuss your symptoms with your GP if they are bad enough to interfere with your life - especially if they go on for more than a few days or start to worsen. If you ever feel so miserable that you wonder whether life is worth living you should arrange an appointment with your GP straight away. It is really important to talk to your GP about your feelings and not keep them to yourself until they get out of hand. Don't feel embarrassed about telling the doctor about them and don't feel you are wasting his or her time - you aren't.

What tests will my Doctor want to do?

Your GP will want to hear about your symptoms and may ask a lot of questions about your mood, your past medical problems, and so on.

What is the short-term treatment?

This depends on whether or not your depression is caused by SAD. Your GP might want you to have some counselling or to take antidepressant tablets. These tablets are not addictive - they are very safe as long as you follow your doctor's instructions and they really work. If your doctor thinks you have SAD you may be referred to a hospital for light treatment as an outpatient. Light treatment involves sitting for a while in bright artificial daylight when it is dark outside. You should find that if you do this every day you start to improve in less than a week.

Will I need long-term treatment?

The light treatment only really works while you are having it so you may have to keep going back in future winters.

How can I stop them getting worse?

Like all depressions it is important to treat SAD before it gets too bad - that means not putting off going to your GP about it if you are feeling really unwell. It helps to have someone you can confide in and to call them up if you feel low.

Will I need regular check-ups?

You will need to go back regularly while you are having light treatment or while you are taking tablets. Your GP may want you to go back regularly at the same time every year.

Will I need to go to hospital?

You may need to be referred to hospital as an outpatient to get your light treatment. Otherwise you will only need to be referred if your symptoms are very bad.

A DOCTOR information leaflet for patients