Seasonal Affective Disorder - Anatomy of Psych

What is seasonal affective disorder?

Seasonal affective disorder (SAD) is a subtype of major depressive disorder whereby mood changes correlate with seasonal changes. It is also referred to as major depressive disorder with seasonal pattern. Younger individuals are more prone to winter depressive episodes.

What does SAD look like?

Signs & Symptoms

Feeling listless, sad or down most of the day, nearly every day
Losing interest in activities you once enjoyed
Having low energy and feeling sluggish
Having problems with sleeping too much
Experiencing carbohydrate cravings, overeating and weight gain
Having difficulty concentrating
Feeling hopeless, worthless or guilty
Increased irritability, agitation, or anxiety
Having thoughts of not wanting to live

DSM-5 Criteria

Criterion A. There has been a regular temporal relationship between the onset of major depressive episodes in major depressive disorder and a particular time of the year (e.g. in the fall or winter).

Note: Do not include cases in which there is an obvious effect of seasonally related psychosocial stressors (e.g., regularly being unemployed every winter).

Criterion B. Full remissions (or a change from major depression to mania or hypomania) also occur at a characteristic time of the year (e.g., depression disappears in the spring).

Criterion C. In the last 2 years, two major depressive episodes have occurred that demonstrate the temporal seasonal relationships defined above and no nonseasonal major depressive episodes have occurred during that same period.

Criterion D. Seasonal major depressive episodes (as described above) substantially outnumber the nonseasonal major depressive episodes that may have occurred over the individual’s lifetime.

How is SAD treated?

Bupropion (Wellbutrin) XL can be initiated prior to winter months to prevent SAD.

Nursing Management

See nursing nursing management for major depressive disorder.

References

[1] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.

[2] Boyd, M. A. (2019). Psychiatric & mental health nursing for Canadian practice. Wolters Kluwer.

[3] Modell, J. G., Rosenthal, N. E., Harriett, A. E., Krishen, A., Asgharian, A., Foster, V. J., Metz, A., Rockett, C. B., & Wightman, D. S. (2005). Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL. Biological psychiatry, 58(8), 658–667.

[4] Townsend, M. C. (2015). Psychiatric mental health nursing. F.A. Davis.