STUART L. KURLANSIK, PhD, and ANNAMARIE D. IBAY, MD,
found at Am Fam Physician. 2012 Dec 1;86(11):1037-1041.
This article on SAD was a good review, and all the research pretty much confirmed what we already know. SAD is basically depression that occurs in the fall and winter months and resolves in the spring and summer. This doesn't mean that every patient who walks into your office with depression around the holidays has SAD. It needs to occur for two seasons in a row. The amount of depression episodes in the fall/winter must outnumber the number of episodes in the spring summer. It is more common in women during childbearing years. One interesting factor is that patients have a tendency to have carbohydrate cravings and hyperphagia. This will cause the patients to gain weight. I could see how these patients could be under treated if a young lady comes into your office upset because she gained some extra weight over the holidays. There are some depression tools to help determine if the patient is depressed Beck Depression Inventory and Hamilton Rating Scale for Depression)
Treatment has not changed much recently. The three types of therapy are light therapy, antidepressants, and CBT. Light therapy is done for 30 minutes a day with a specific lux and spectrum.It takes bout 1-2 weeks to kick in. The medications used are typically second generation antidepressants (SSRI's and SNRI's) most commonly Prozac. CBT is not typically done by everyone and more often referred out, do to the expertise needed and time restraints. Combinations of these therapies have been shown to be more effective than any one therapy alone.
Prevention has been shown to be effective as well. Patients can begin light therapy or take Wellbutryn prophylactically n the early autumn. CBT can be done prophylactically as well. Exercise and relaxation techniques can also help.
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