How Can I Best Take Care Of Myself If I Have Seasonal Affective Disorder
Talk to your healthcare provider. By planning ahead, you can manage your symptoms and feel your best.
- Stick to your treatment plan: If you have medications or a lamp for SAD, use them as directed. Follow up with your healthcare provider if you dont see an improvement in your symptoms.
- Care for yourself: Eat a well-balanced diet. Get enough sleep. Exercise regularly. Try to manage stress, perhaps by talking to a counselor or therapist.
- Plan ahead: Make a plan for what youll do if your symptoms get worse. If you notice signs of depression, take action. It might help to plan a lot of activities during these months. Having a busy schedule keeps you from hunkering down at home.
- Start treatment early: Talk to your healthcare provider about preventive treatment. If you know your symptoms start in October, consider starting treatment in September.
Dont:
- Isolate yourself: Being alone can make your symptoms worse. Even though you may not feel like going out or being social, try to reach out to friends and loved ones.
- Use alcohol or drugs: They might make symptoms worse. And they can interact negatively with antidepressants.
What Should I Ask My Healthcare Provider
If you have SAD, ask your provider:
- What treatment is best for me?
- How can I prevent depressive episodes?
- Will light therapy work?
- Should I take an antidepressant?
- When should I start treatment?
- How long should my treatment continue?
- What can I eat to improve my symptoms?
- What else can I do to feel better?
A note from Cleveland Clinic
Seasonal affective disorder is a type of depression that happens every year during a specific season, usually winter. Symptoms can include a lack of energy and feelings of hopelessness. Fortunately, theres treatment for seasonal depression. Talk to your healthcare provider. The provider may recommend a special lamp for SAD. The lamp emits bright light to improve symptoms. Antidepressants and talk therapy can also provide relief. If youve had seasonal depression in the past, talk to your provider about starting treatment before symptoms begin.
Last reviewed by a Cleveland Clinic medical professional on 12/07/2020.
References
Is Light Therapy Safe
Light therapy is typically safe and well-tolerated. But you may need to avoid light therapy if you:
- Have diabetes or retinopathies: If you have diabetes or a retina condition, theres a potential risk of damaging the retina, the back of your eye.
- Take some medications: Certain antibiotics and anti-inflammatories can make you more sensitive to sunlight. Light therapy can then cause harm.
- Have bipolar disorder: Bright light therapy can trigger hypomania or mania, uncontrolled boosts in mood and energy level. People with bipolar disorder need medical supervision to use light therapy.
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Sleep Deprivation: What Happens When We Dont Get Enough Sleep
First of all, sleep is a big deal, and were not getting enough. An estimated 50 to 70 million Americans 1 are affected by poor sleep and its having an impact on both our mental and physical health. When there is misalignment between our internal biological clock and the rise and set of the sun, we can find ourselves totally out of sync with the rest of the world and feel completely disconnected.2
When people dont get enough sleep, there are many things that happen in the body and we are constantly learning more about what this does, says Michael A. Grandner, PhD, an associate professor of psychiatry at the University of Arizona College of Medicine and director of both the Sleep and Health Research Program and of the Behavioral Sleep Medicine Clinic at the COM in Tucson, Arizona. For example, it can lead to systemic inflammation and it makes your brain less able to remove toxins like beta-amyloid, which can lead to dementia. Other hormones get thrown off as well, like leptin and ghrelinwhich control hunger and appetitetestosterone, estrogen, insulin, and cortisol, causing many effects in the brain and body.
How To Treat Seasonal Affective Disorder
Light therapy is a highly effective treatment for SAD for most people. It basically involves sitting next to a special type of light box that emits a broad spectrum of light for 30 minutes or so. Here are some guidelines for picking out a good one.
When scientists thought that SAD was simply caused by insufficient light exposure, they recommended doing this twice a day, extending the day in the morning and in the evening. But now, itâs generally thought that a morning dose of light right when you wake up is best for synchronizing your circadian rhythms with the time you actually spend awake.
For the minority of SAD sufferers that are misaligned in the opposite direction that is, their internal clocks think itâs nighttime before they actually go to sleep light exposure therapy in the evening, rather than the morning, is best.
In either event, you should talk to your doctor if you think you have SAD. Melatonin tests can confirm a diagnosis and indicate which way you need to shift.
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Sad Differs From Depression
Major depressionis a disease in which your brains pleasure responses are broken. You mayhave a loss of appetite, fatigue, trouble sleeping and feelings ofhopelessness. Depressed people often have a harder time managing theirsymptoms in the winter. But when depressive symptoms are only affecting youin the winter, its considered seasonal affective disorder .
Should You Take Melatonin For Anxiety
Melatonin has been a popular sleep aid for decades, but research hasnt yet determined if it works for all forms of anxiety. Consider talking with your doctor to determine if using melatonin for anxiety is the right choice for you. If the root cause of your anxiety is due to poor sleep quality, melatonin could be the key to falling asleep with ease and waking up feeling well-rested and ready to conquer the day.
Cameron Vigliotta
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Depression Symptoms And Signs
Promote suicide prevention by knowing the warning signs and symptoms of depression, major depressive disorder, postpartum depression, and anxiety. According to the National Institute of Mental Health the following are common signs and symptoms of depressive disorders.
Feeling sad, a previous history of depression, and anxiety often go hand in hand. Untreated depression and anxiety can result in aggravated medical issues like heart disease. Older adults need to take special care to get immediate treatment for depression to avoid aggravating heart disease related conditions.
The most obvious outward sign of depression is the loss of interest in daily activities that have previously been a normal part of your everyday life. For example, a person experiencing depression major depressive disorder or postpartum depression may have unexplained weight gain when they were previously focused on healthy living and weight consciousness.
***Important Note: If you are struggling with bouts of depression and have thoughts of death or suicidal thoughts – reach out to the National Suicide Prevention Lifeline at 1-800-273-8255 immediately to speak with a counselor 24-hours a day.
Counseling Helps Depression
One of the hardest things about getting help when you are depressed is believing you can get better. When you work with a counselor, they will show you that there is hope, and you can heal.
Online Therapy
Can You Use Melatonin For Anxiety Heres What The Experts Say
Melatonin supplements have been used for decades to promote sound, natural sleep. Whenever we have trouble getting shut-eye, this natural hormone thats also produced by our brains pineal gland can come to the rescue.
While melatonin may help combat sleep problems or even sleep disorders, recent clinical trials suggest this natural hormone can improve anxiety disorders too. Some believe this is because melatonin improves sleep, which reduces anxiety, while others suspect melatonin may directly impact anxiety symptoms to counteract this mental health disorder.
So, whats really happening beneath the surface? Read on to learn how melatonin may help your anxiety, how you can use it, what potential side effects it may have, and more.
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How Is Melatonin Production Regulated
The pineal gland is a circumventricular organ that monitors the level of pathogen-associated molecular patterns and damage-associated molecular patterns in the cerebrospinal fluid and peripheral circulation. In pinealocytes, the activation of the NFB pathway by toll-like receptors and TNFRs inhibits AANAT-gene transcription both in diurnal and nocturnal animals. Cortisol or corticosterone at concentrations compatible with arousal potentiate melatonin synthesis, while concentrations compatible with immune suppression blocks it. In immune-competent cells PAMPs and DAMPs promote the synthesis of melatonin by activating the transcription of the gene that codifies AANAT. This process is also dependent on the binding of NFkB dimers to the gene promoter, but it is not an immediate effect. Activation of PAMPs or DAMPs receptors promote the nuclear translocation of the NFkB dimer that leads to the synthesis of the subunit necessary for activating AANAT transcription. The induction of melatonin synthesis in rodents and human macrophages by the transcription factor is a hallmark in inflammatory responses and inflammation . The fact that stressful conditions increase extra-pineal melatonin synthesis independently of environmental light strongly suggests that the amplitude of daily melatonin rhythm, classically attributed to reduction of nocturnal melatonin synthesis, may also result from an increase of the output from extra-pineal sources .
Other Possible Melatonin Side Effects
- Melatonin and birth control effects melatonin supplements may not be safe for women trying to get pregnant. It seems that melatonin has similar effects as birth control, making it more difficult for women to reach ovulation and become pregnant. Some evidence shows that lower doses, up to 3mg are safe, but there is not enough research to prove that.
- Melatonin and bleeding disorders it is believed that regular melatonin intake can worsen the symptoms and effects of bleeding disorders. Studies show that melatonin may slow blood clotting or coagulation, which may lead to excessive bleeding and bruising.
- Melatonin and epilepsy studies and current data show that melatonin can trigger or worsen epilepsy and seizure frequency in some people. While some experts argue otherwise, some professionals do not recommend melatonin intake in people who are prone to having epileptic or other types of seizures not even small doses.
- Melatonin and transplant recipients because melatonin can increase the immune function, it might interfere with immunosuppressive therapy used by transplant recipients.
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Side Effects Of Melatonin Interactions
- Sleepiness and drowsiness with sedative medication the interaction between sedative medications or depressants and melatonin can lead to excessive daytime sleepiness and drowsiness. It is essential you avoid taking melatonin with medications like lorazepam, clonazepam, zolpidem, etc.
- Wakefulness with caffeine combining melatonin with caffeine may result in decreased melatonin effects. Caffeine will overpower melatonin, so instead of sleepy, one might feel more wakeful and alert.
- Increased blood sugar with diabetes medication because melatonin increases blood sugar levels, and the diabetic medication lowers it, it can completely overpower the effectiveness of diabetes medication. This can lead to some serious issues in diabetic patients, who should avoid taking melatonin with insulin, glimepiride, glipizide, rosiglitazone, etc.
- Bleeding risk with anticoagulants because melatonin slows down blood coagulation, it should be smart to avoid taking it together with medication that has the same effects. The combination of anticoagulants with melatonin may cause bleeding and bruising. Such medications include aspirin, ibuprofen, naproxen, enoxaparin, heparin, diclofenac, etc.
How To Stop Taking Melatonin
Im not a doctor and I dont have a magic solution for you.
I almost never recommend going cold-turkey on anything .
It just so happened that in my situation, stopping melatonin suddenly and completely made sense since it wasnt helping at all anyway at that point.
If melatonin is still working for you, I recommend back off gradually.
There isnt a specific schedule for how to wean off of melatonin.
- Start slowly taking less than you are taking now.
- You could try cutting the pill in half, or even fourths if you wanted to.
- Take the new dose for a few days , then cut it down again until youre not taking any at all.
Use the sleep tips in this article to start working on ways that will help your quality of sleep in the long run while you are cutting down on your dose.
Its not necessarily going to be easy and there will most likely be some sleepless nights in the process, but its all working toward the goal of giving you a lifetime of better sleep.
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What Happens When You Stop Taking Melatonin
The good news is, your body can reset its natural sleep-wake cycles. The bad news is, it doesnt happen overnight .
I have slept 7-8 hours a night with melatonin for about a decade.
I stopped taking it altogether two weeks ago and was only sleeping 4-5 restless hours a night .
Then, something wonderful started to happen.
For the last three nights, I was actually able to fall asleep in under an hour and stay asleep all night long!
- I get tired at bedtime.
- Ive been waking up a few minutes before my alarm clock in the morning.
- And I actually feel rested, something I am not taking for granted!
I am absolutely convinced that taking melatonin for a few days every once and a while to help your body reset is a great thing, but taking it every single night, relying on a fabricated form on melatonin instead of your bodys natural sleep cycle is a terrible mistake.
Ethics Approval And Consent To Participate
The study will be performed in agreement with the Helsinki II Declaration and law 593 of 2011 pertaining to the Scientific Ethics Committee System. The study is approved by the Local Ethics Committee of Region Zealand , the Danish Health and Medicines Authority and the Danish Data Protection Agency .
The participants will be thoroughly informed about the study design, objectives and potential risks and/or benefits from participation. Both oral and written informed consent will need to be given, and the patients are informed of their option to withdraw their informed consent. In case of a patients withdrawal from the study, this will have no consequence for their future treatment and they will receive treatment as per the standard treatment of care. After the participants completion of the trial they will return to usual care and no further treatment will be given.
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What Are More Of The Drawbacks To Taking Melatonin
As previously mentioned, if you have a history of depression, anxiety, or low blood pressure, do not take it unless otherwise instructed to do so by your doctor or other medical professional. If you are in that category, then it is best that consult your doctor before taking this sleep med and then monitor your condition if he/she gives you clearance to try it.
Generally, the recommended dosage on a commercially available melatonin supplement can be almost triple the recommended dosage for you if you are suffering one of these conditions.
So please be aware that because of this, there is a possibility that low dosage combined with your condition may make melatonin supplements ineffective and in some cases do more harm than good. Another important thing is that you should check with your doctor and/or your pharmacist to see if it will interact with any of your current medications.
Because of the possibility of this disrupting up your sleeping patterns when taken incorrectly, it is not always recommended for children under 18 years of age, even though it is generally considered safe so be careful and diligent.
Finally, melatonin, as you can see, can sometimes be considered somewhat controversial. Some people will swear by it and will use it regularly for nothing else other than to help them get a restful nights sleep.
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What Type Of Antidepressants Can Help With Seasonal Affective Disorder
Medications called selective serotonin reuptake inhibitors can treat SAD. They improve mood by regulating serotonin levels in your body.
Another approved antidepressant called bupropion comes as an extended-release tablet. It can prevent seasonal depression episodes when people take it daily from fall to early spring.
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Melatonin May Be Key To Summer Depression
Melatonin may hold the key, or one key, to treatment of summer seasonal depression.
The hormone, produced naturally by the human body, is frequently taken as a supplement to help travelers adjust to new night and day cycles and to help insomniacs get to sleep. Very early research suggests that this ability to affect the bodys circadian rhythms could make the hormone a potential treatment for depression triggered by seasonal changes as well.
Melatonin is a hormone that sets the seasonal rhythms in animals, such as the timing of breeding seasons and coat growth. And in humans, melatonin helps regulate day and night cycles, called circadian rhythms. Melatonin is produced during nighttime darkness in all animals, including humans. So during long winter nights, more melatonin is produced than in summer, when nights are shorter.
In a 2006 study in the Proceedings of the National Academy of Sciences, Dr. Alfred Lewy, a professor of psychiatry at Oregon Health and Science University, and his colleagues showed that by treating patients who have winter depression with melatonin in either the morning or afternoon/evening, they could reset the patients circadian clocks.
Melatonin worked as well as or better than antidepressants currently in use for depression, says Lewy, who has studied seasonal disorders for 30 years.
Depression pathways
Other researchers say that the studies are promising but that it is still early to draw sweeping conclusions.
Medication cycles