DEPRESSION AND GRIEF MAPS: 1A | 1B | 2 | 3 | 4 | 5
depr1Aa
SECTIONS: 1 | 2 | 8 | 23
DEPRESSION AND GRIEF MAPS: 1A | 1B | 2 | 3 | 4 | 5
depr1B
SECTIONS: 3 | 4 | 8 | 9 | 10 | 11 | 12 | 13 | 14
DEPRESSION AND GRIEF MAPS: 1A | 1B | 2 | 3 | 4 | 5
depr2a
SECTIONS: 5 | 8 | 16 | 19 | 21 | 22 | 24 | 25 | 39 | 44 | 46 | 47 | 48
DEPRESSION AND GRIEF MAPS: 1A | 1B | 2 | 3 | 4 | 5
depr3
SECTIONS: 8 | 28 | 29 | 30 | 32 | 33 | 34 | 35 | 36 | 37 | 39
DEPRESSION AND GRIEF MAPS: 1A | 1B | 2 | 3 | 4 | 5
depr4
SECTIONS: 8 | 31 | 38 | 39 | 40 | 41 | 42 | 43 | 45 | 46 | 47 | 49
DEPRESSION AND GRIEF MAPS: 1A | 1B | 2 | 3 | 4 | 5
depr5
SECTIONS: 6 | 7 | 8 | 46 | 50
24. SEASONAL AFFECTIVE DISORDER

24a. Description

Seasonal Affective Disorder consists in a variability in mood (and biological rhythms) as a function of changes in daylight. Symptoms are discussed in Section 22.

24b. Formal Diagnoses

Three possible diagnoses are suggested by DSM IV:

  • 296.xx: Bipolar I Disorder with seasonal pattern
  • 296.89: Bipolar II Disorder with seasonal pattern
  • 296.3x: Major Depressive Disorder, recurrent, with seasonal pattern

24c. Treatment

ENVIRONMENTAL CHANGE:

Moving to a sunnier climate can reduce the severity or duration of symptoms.

LIGHT THERAPY

The normal seasonal decrease in natural light reaching the person’s eyes is compensated-for by an increase in high-intensity artificial lights. When it is effective, an improvement may be felt after as little as one to three treatments. A patient’s muscles may relax and his/her attention may become more focused.

There may be mild side effects: headache, slight nausea, eye irritation. Usually the patient feels a surge in energy, which may make him/her irritable or hyperactive temporarily and can be controlled by the amount of light received.

Treatment is usually begun as summer comes to a close and is increased as the winter progresses. By January and February, a person may need up to four hours a day.

A standard dose would consist of at least two hours using a 2500 lux fluorescent light box or 30 minutes using a 10,000 lux box. By way of comparison, summer sunshine is about 100,000 lux. A number of commercial products are available to treat this condition.

RELAXATION THERAPY can be helpful. See Anxiety Map, Section 31

CHANGE OF EATING HABITS to allow for weight gain, work toward regular, balanced meals and less reliance on carbohydrates.

EXERCISE in the daylight. Find other ways to make use of daylight

ANTIDEPRESSANTS may be used, especially if light therapy is ineffective. SSRI’s are generally preferable to tricyclics, because the latter typically have side effects of drowsiness and increased appetite.