Seasonal affective disorder: Nov '13

Seasonal Affective Disorder is thought to affect 2 million people in the UK. Dr Mark Winwood was at hand to answer your questions.

AXA PPP healthcare asked: Good afternoon and welcome to toady's live chat. We are joined by Dr Mark Winwood, who will be answering your questions about Seasonal Affective Disorder.

Sean asked: Hi Mark, I often feel down on dark/dreary days... I've heard a lightbox could help? Is this true? Also why does it cause me to feel low when the weather is worse?

Dr Mark Winwood answered: Hello Sean. Thanks for your question. Light boxes have been shown to be effective in up to 85% of diagnosed cases of SAD. Most modern light boxes emit an intensity of 10,000 lux and treatment will take 30 mins - 1 hour a day. The intensity of a bright summer day can be 100,000 lux.  Light treatment should be used daily in winter (and dull periods in summer). Start in early autumn when (or before) the first symptoms appear. Follow the manufacturer's instructions, allowing the light to shine directly through the eyes. Treatment usually starts to work with 3 to 4 days.
There are lots of reasons why me might feel low in the winter but  it seems to be a simple lack of daylight in winter. We now live much more of our lives indoors and so see less sunlight. It is thought that a lack of such light affects how serotonin (an important neuro-chemical) works in the brain and that this can make us more likely to become depressed.
I hope this answers your questions!

Sean commented: Thanks Mark, very useful. I have seen numerous places on the Internet where I can purchase a LB, but would you recommend one over another?

Dr Mark Winwood answered: Hi Sean, unfortunately light boxes are not available on the NHS but are available VAT free when used for medical purposes.  I can't recommend a particular retailer but I would go to one that offers you the opportunity to try it before you buy (many retailers will now allow this).  Your local pharmacist might be a good place to start.
All the best


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Lisa asked: Just looking at your answer to Sean's original question. Other than the sun what are good sources of Seretonin?

Dr Mark Winwood answered: Hi Lisa. Other good ways of helping your body to stimulate serotonin production are exercise and good diet.   This means, pushing away the leftover cake and eating sensible carbs to stimulate serotonin. Sweets and simple carbs, like white rice and white bread, quickly raise blood sugar, flood you with insulin, and then you tend to feel low. Eating wisely also means watching the caffeine, which suppresses serotonin.
The foods to have on hand if you tend to feel low in winter are : Popcorn
- Oatmeal (original)
- Nuts
- Egg whites for omelets
- Peanut butter
- Prewashed veggies
- Fruit
- Whole grain crackers and bread
- Lean Turkey/chicken
- Cottage cheese
I hope this is helpful

Lisa commented: Yes very, luckily I like most of those foods. Thanks.

Tamzin asked: The majority of people seem to be affected by the cold/winter... Can SAD be triggered by the heat/summer. I tend to get hot and bothered a lot, and I'm never too happy to see the sun arrive.

Dr Mark Winwood answered: Hello Tazmin. Interesting question - SAD typically causes depression as the days get shorter and colder. But about 10% of people with SAD get it in the reverse -- the onset of summer triggers their depression symptoms. This usually happens for individuals who live closer to the equator. Specific symptoms of summer depression often include loss of appetite, trouble sleeping, weight loss, and anxiety.
There are a number of reasons this may occur including schedule changes (having a routine is a good way of managing your mood - in the summer months this can be ambushed by kids holidays etc...), body-image issues (summer close are more revealing), financial concerns (the expense of holidays etc..) or just because you find the heat and oppressive.
So to answer your question 'yes' SAD can happen in the winter and summer!

AXA PPP healthcare asked: We've had a question come through from Simon on Facebook;
"What are the symptoms of s.a.d and how do they differ from depression?"

Dr Mark Winwood answered: Hello Simon. SAD is a type of depression with a particular pattern - it starts in the autumn or winter and stops in the spring and summer, regularly each year.  It is sometimes know as - recurrent winter depression and is classified as a diagnosable depressive disorder in its more severe forms.
 Most of the symptoms of SAD are the same as those of  'ordinary' (non-seasonal) depression  These symptoms include:
 - low mood (often worse in the mornings)
 - lack of energy
 - less “get up and go”
 - less interest in life
 - being unable to enjoy things
 - irritability
 - seeing other people less
 - less interest in sex.
But the symptoms of SAD are slightly different. In non-seasonal depression, people commonly sleep less and eat less. In SAD, they usually sleep more and eat more.
If you have  SAD, you may find it very difficult to wake up on a winter's morning and can often feel sleepy during the day. You may crave chocolate and high carbohydrate foods, such as white bread or sugary foods. If you have SAD, you probably won't be doing as much physically, so it's easy to put on weight during the winter. Unlike non-season depression SAD-type depression recovers in the spring. Thanks for your question.


If you missed our live chat and have any further questions relating to seasonal affective disorder, then why not ask our panel of experts a question?

Anonymous215 asked: Are there any known links between comfort eating and S.A.D - are people more likely to eat more if they're spending more time indoors / feeling depressed?

Dr Mark Winwood answered: Hello 125. One of the most common symptoms of SAD is eating more and usually foods that are high in processed carbohydrates.  People who experience SAD usually gain weight during the winter months.  I think you are right one of the contributing factors for the weight gains that people tend to stay inside more when it is dark and the weather is bad and are therefore less active and do less exercise.
I would certainly recommend (I covered this more in Tazmins question earlier) increasing outdoor exercise particularly during day-light hours and also eating plenty of fresh vegetables and high protein foods to help boost your resistance to low mood during the winter months.
All the best

Anonymous215 commented: Thanks Mark, that's great advice

AXA PPP healthcare: Thats it from today's live chat, thanks for your questions and thank you to Dr Mark Winwood for his answers. We hope they have helped.


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