When a teen patient recently told Dr. Michael Ward that he was feeling
but couldn't say why, the doctor suspected the cause might be December's especially gloomy weather. After all, the 17-year-old hadn't just broken up with a girlfriend, left for college and missed his friends or experienced family troubles, Ward said.
Ward, a family practitioner at Advocate South Suburban Hospital in Hazel Crest, Illinois, already was seeing the boy's mother for seasonal affective disorder, a mood disorder that occurs in late fall and early winter and lasts until spring or summer, making the boy's diagnosis all the more likely.
Though SAD is considered a major depression that sometimes requires a trip to a
, family practitioners like Ward are often the first doctors to encounter and treat patients with this disease. Ward said he has come to recognize the symptoms at this time of year, which include feelings of hopelessness, anxiety, loss of energy, social withdrawal, oversleeping and weight gain.
For the teen with suspected SAD, Ward prescribed an antidepressant/antianxiety medication, exposure to sunlight by getting out more during the day, and enjoyable activities or recreation. He also recommended healthy eating with lots of vegetables, fruits and complex carbohydrates that provide a burst of energy and getting enough sleep. He plans to see the young man in about six weeks to find out if the treatment helps.
Experts believe SAD could be caused by a lack of sunlight brought on by the shorter days in fall and winter and a disruption of the biological clock, or circadian rhythm, which tells us when we should be asleep or awake. Other factors could include an imbalance of the hormone melatonin, which regulates sleep patterns and mood, and a drop in serotonin, a brain chemical that affects mood.
"I kind of encourage patients to seek recreation, as well as vent some of the things that are making them feel down, whether hitting tennis balls or lifting weights, because that releases endorphins (proteins released by the body that can create a sense of well-being)," said Ward.
The holidays and post-holiday weeks can exacerbate the problem, according to Ward and the Rev. Larry Jackson, vice president of mission and spiritual care at South Suburban. Jackson makes it a point to stop in to talk with any new patient in the hospital and often counsels patients' relatives who are having trouble dealing with loved ones' illnesses over the winter holidays.
"Sometimes people just really need others to listen to them and ask why they are sad," said Jackson.
But some experts believe that because SAD is a major depressive illness, a mental health specialist with experience in the disease is needed, especially if the problem worsens.
Dr. Mark Sinibaldi, chairman of the department of psychiatry at Palos Community Hospital in Palos Heights, said patients who feel horrible for weeks, experiencing negative thoughts, decreased sleep and appetite and weight loss, should "do more than just get tips from your family doctor." They should seek help from a specialist, and those who begin thinking of suicide should contact a specialist immediately.
"SAD is basically a major depression, and major depression can really be a life-threatening disorder," Sinibaldi said.