There are many aspects of someone’s history that we gently examine in psychotherapy as we build the most complete understanding we can to see what it means to be that person, how they got to be who they are today in terms of their personality, and in particular the way they look and interact with their world.  One thing many of us look for are repeated patterns of behaviour, where often some particular facet of this might seem in some way to reoccur at a particular time of the year. Many of us will understand this in terms of experiencing sadness at anniversaries of particular events, such as the passing of a parent or partner, but in some cases the cause of this can be quite deeply repressed, well hidden in the brain and the body and not at all apparent, especially when this is related to trauma in earlier life. When such anniversaries occur, they can bring illness or depression in milder or more severe forms, or make people more prone to accident, or cause atypical changes in behaviour where maybe someone goes off the rails in some way at about the same time each year.

There are other reasons why mood can change related to a particular time of the year and here, with the darker mornings and nights with us, and the amazing, non-sunny, blue skies of Spain weather we have had on the Costa Blanca in the last month, it was suggested to me that I might write about Seasonal Affective Disorder or SAD.

In the psychiatric world many people like to label, examples being clinically depressed, bi-polar or schizophrenic. One thing we can miss if we only see things in terms of a specific condition or illness is that we are often looking at a continuum of symptomolgy, where many of us experience some aspects of that condition at various times in our lives, which we find more or less disabling, the intensity often depending on the interaction of many genetic, sociological and environmental factors, but principally, what else is happening in our lives at the time. SAD is a phenomenon or condition that fits this description, where many of us experience a mild, depressive effect when there is less sunshine and blue sky available each day, while others will find the time between September and April each year a very difficult time, with all sorts of behavioural change.

This can range from symptoms such as problems with sleeping and eating, and maybe tiredness and lethargy, but no actual depression. This is medically termed sub-syndromal SAD and is thought to affect around 10% of the U.K population.  At the other end of the spectrum, the full-blown condition is a major disabling illness, preventing a person suffering from it from functioning normally without medical and/or psychological treatment.  Medical diagnosis normally requires the pattern to have occurred on at least 2 consecutive years, with the depression lifting of its own accord in spring each year. The symptoms of SAD include a low, depressive mood for most of the day accompanied by lethargy and the need for more sleep than “normal.”  There can also be weight gain arising from a desire to eat more than usual, especially carbohydrate-rich “comfort foods”. A person with SAD may also be irritable and display mood swings and the whole experience can be very distressing for them and their family and friends. 

So how many people are affected by the disorder and why does it arise? We know that in the U.K. that about 2% of the population is likely to be disabled by SAD, with women more than men more likely to suffer.  It can arise at any age, but is most likely to appear between the ages of 18 and 30, but may of course not be recognized as SAD.

SAD is directly related to the amount of sunshine available, but that this is probably, as with so many psychological conditions, not the only factor at play – for example your chances of experiencing the condition are increased if a close family member also suffers. It occurs across the world but becomes rare in populations living closer to the equator, who experience consistently long and extremely bright days.  Similarly SAD is less prevalent in snow-covered countries where the intensity of light is much enhanced by the reflective effect of snow.

Next time we’ll look in more details at the causes of the condition and ways of managing it. If you are affected I would be very interested to hear from you – sharing knowledge is the way forward. Thanks for reading.