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As the days get shorter, many people find themselves feeling tired and blue. This condition, known as Seasonal Affective Disorder or S.A.D. is said to affect about 10 percent of the U.S. population, but the numbers could be much higher.  

Also called Winter Depression, S.A.D. is a mood disorder characterized by depressive symptoms such as difficulty sleeping, weight gain or loss, fatigue, anxiety, irritability, decreased energy and other symptoms typical of depression. The difference between depression and S.A.D., however, is that individuals experiencing S.A.D. will feel normal during the summer months.  

According to Norman Rosenthal, a pioneer S.A.D. researcher, cases of S.A.D. vary widely by geography; with 1.5 percent of the Florida population suffering compared to about 9 percent of the population in northern latitudes.  

Although it is obvious that the lack of daylight is the trigger for the disorder, what is not so clear is WHY. One possibility is that it is related to a lack of Seratonin (our bodies’ natural feel-good chemical). Another theory is that it is related to levels of Melatonin which are produced in the pineal gland since there is a direct connection between that gland and the retina.

There are several treatments for S.A.D. Bright light treatments work for about 20 percent of people. Patients spend 30 to 60 minutes sitting by specially designed lights to mimic the effect of sunlight on the body. 

Dawn simulation has also proven effective in some patients. In this therapy, special room lights come on gradually in the morning, mimicking sunrise.   

Medication such as SSRIs (Selective Serotonin Reuptake Inhibitors) and some antidepressants have been found to be effective therapy for some S.A.D. sufferers. Depending on the patient, a combination of the above treatments may be used.  

For most people however, a common sense approach, employing fresh air, exercise, healthy eating, cutting back on caffeine and alcohol and getting plenty of sleep is enough to take care of the problem or at least lessen the effects of S.A.D. 

However, for those for whom that approach does not work, it is wise to see a doctor. 

FOR MANY PEOPLE STRUGGLING WITH DEPRESSION, ANTIDEPRESSANTS OFFER THE HOPE OF A MORE NORMAL LIFE.

Often used along with talk therapy, antidepressants work by correcting the brain chemical imbalances which are most often at the root of clinical depression.  Studies by the National Institute of Mental health show that talk therapy alone resolves depression in about 50 percent of patients.  Antidepressant use alone also resolves the disorder in about 50 percent of those using them.  However, combining talk therapy such as CBT (Cognitive Behavioral Therapy) with antidepressant medications has a success rate of 60 – 70 percent.  Counseling can resolve the underlying issues causing the depression while antidepressants handle the symptoms.

There are several kinds of antidepressants including SSRIs (selective seratonin reuptake inhibitors) Tricyclics and MAOIs (mono amino oxidase inhibitors) among others.

For most people, antidepressants cause no serious side effects.  However, everyone’s brain chemistry is unique and meds can affect different people in different ways. 

For approximately 25 percent of people who take antidepressants, significant weight gain can be a problem with both long and short term use.

Recent research has shown that people who gain weight within about the first week or two of starting antidepressant treatment are more likely to have significant weight gain from the medication over an extended period of time.  However, the exact connection is not clear.*

UNDETERMINED CAUSATION

It is not yet known why antidepressants sometimes cause weight gain.  Appetite and metabolism may both be affected.

One theory is that antidepressants help people rediscover the pleasures in life…one of which is food.  The person who suddenly finds joy in eating again may be over-indulging without realizing it.

Some of the most interesting research has come from the Triad Weight Management Center at McClean Hospital in Belmont, Mass.  Researchers there believe that carbohydrate control is the key component for weight control in those using psychotropic medications.

According to their research, some people experience an uncontrollable urge to eat sweet and starchy foods while on antidepressants.  These simple carbs hit the blood stream quickly, increasing certain brain chemicals which cause a temporary “high.”

Researchers say the answer may be to consume carb rich food throughout the day to help curb cravings.  However, rather than indulging in sugary, simple carbs, patients are encouraged to eat complex carbohydrates which are metabolized more slowly.  Eating high carb, low fat foods throughout the day may help keep brain chemical levels even, thus eliminating the highs and lows experienced with simple carbs and reducing the urge to indulge in junk food.

WHAT NOT TO DO

First and most important, never stop taking an antidepressant without first checking with your doctor.  In many cases, you must be “weaned” from the medication to prevent the onset of withdrawal-type symptoms such as upset stomach, headaches and anxiety.

Also, never take any kind of over-the-counter weight loss medication or supplement without first checking with your doctor.  Interactions between your antidepressant and an over-the-counter med may render your antidepressant ineffective or cause problems such as rapid heart beat, changes in blood pressure and so on.  Always check with your doctor or pharmacist before adding ANY sort of medication or supplement to your daily regimen if you are taking an antidepressant.

Don’t severely restrict your calorie intake.  Severe calorie restriction can in itself cause stress and make depression symptoms worse.

WHAT TO DO

If your weight gain is significant enough to cause health problems or if you are feeing increased anxiety because of it, talk to your doctor about trying a different medication.  Although research has not shown that antidepressants can help with weight loss, it has been found that some antidepressants are weight neutral.  Changing to a weight neutral formulation may be all you need to get your weight back to normal.

Increase your calorie burning by exercising.  Not only will this help you stabilize your weight, research has shown that regular exercise is one of the most important tools for reducing symptoms of depression and anxiety.  In fact, regular exercise may help you reduce your medication (under your doctor’s guidance) thus helping you with weight loss.

Keep a food journal for a couple of weeks.  You may not realize that you are reaching for junk foods to get that temporary “high” or just eating more because you are enjoying it more.  Keeping a journal will help prevent you from eating mindlessly.

Finally, be realistic.  Your most important goal should be getting your depression under control.  Seeking help and taking the necessary mediation is a big step toward wellness.  Once you get your depression under control and you are feeling better, you can work on your weight loss goals.

* Daniel K. Hall-Flavin, M.D., Mayo Clinic

 Resources:

 WEB MD

about.com

Do you find this information helpful?  If so, you may want to check www.shelbycounselingassociates.org for more Timeless Wisdom.

 

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