About Seasonal Affective Disorder

This is the time of year when daylight hours are at their shortest.

During this time of the year, we often hear people say, “I can’t get up in the morning,” or “No matter how much I sleep, I still feel sleepy during the day. I can’t wake up in the morning,” “I feel sleepy during the day no matter how much I sleep, and I have no motivation,” “I want to eat sweets,” and “I can’t help craving carbohydrates.” The list is long!

Seasonal Affective Disorder (also known as SAD) causes recurring depressed moods, hypersomnia, and increased cravings for carbohydrates in the winter.

Shorter daylight hours are thought to be the cause.

Seasonal Affective Disorder is more common in women, and one-third of those who experience SAD also experience manic symptoms with mood elevation in early spring and summer.

In other words, some people experience only depressive symptoms, while others experience bipolar mood swings.

Treatment methods include light therapy, antidepressant medication, and psychotherapy. However, none of these methods are supported by solid medical evidence.

Light therapy is considered effective if done in the morning using a lightbox or similar (using a light source of about 2500 lux.)

Because light therapy only involves exposure to light, it has few side effects. You can find a variety of lightboxes on the market in the range of ¥3,000 to ¥30,000 by entering the keyword “light therapy” when shopping online. Additionally, exercising outdoors where you are exposed to light is also said to be effective.

When considering pharmaceutical therapy, antidepressants – normally SSRIs which do not cause side effects such as drowsiness and fatigue during the day – are often prescribed.

Some SSRIs are not yet available in Japan (such as bupropion), but sertraline and other medications are gaining support. Treatment is started in the autumn when daylight hours are shorter and then discontinued in the spring.

There is no definitive scientific answer to talk therapy or cognitive behavioral therapy. However, it is worth considering to help avoid falling into a deleterious psychological cycle, as daylight hours increase after the winter solstice.

However, it has not yet been scientifically confirmed whether light therapy is as effective as medication, whether it can increase the effects of medication, or whether psychotherapy (cognitive behavioral therapy) is a more appropriate treatment.

At our clinic, the treatment is considered after consultation with the patient and after understanding their preferences.

The ability to consult with your physician and give appropriate feedback is essential when choosing a doctor.