1 / 15

Treating Seasonal Affective Disorder

Treating Seasonal Affective Disorder. By: Melissa Green. Table of contents. What is SAD? Symptoms of SAD Physiology Treatment Options. Light Therapy Vitamin D Antidepressant Medication Group Therapy Cognitive Behavioral Therapy Mindfulness-based Cognitive Therapy Outdoor Therapy.

lou
Download Presentation

Treating Seasonal Affective Disorder

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Treating Seasonal Affective Disorder By: Melissa Green

  2. Table of contents • What is SAD? • Symptoms of SAD • Physiology • Treatment Options • Light Therapy • Vitamin D • Antidepressant Medication • Group Therapy • Cognitive Behavioral Therapy • Mindfulness-based Cognitive Therapy • Outdoor Therapy

  3. What is SAD? • Seasonal affective disorder (SAD), also known as winter depression, winter blues, summer depression, summer blues, or seasonal depression, is a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or summer, spring or autumn year after year.

  4. What is SaD? • The U.S. National Library of Medicine notes that "some people experience a serious mood change when the seasons change. They may sleep too much, have little energy, and may also feel depressed. Though symptoms can be severe, they usually clear up."

  5. symptoms • Symptoms of SAD may consist of difficulty waking up in the morning, morning sickness, tendency to oversleep and over eat, especially a craving for carbohydrates, which leads to weight gain. Other symptoms include a lack of energy, difficulty concentrating on or completing tasks, and withdrawal from friends, family, and social activities and decreased sex drive.

  6. Physiology • Seasonal mood variations are believed to be related to light. One possibility is that SAD is related to a lack of serotonin, and serotonin polymorphisms could play a role in SAD. Another theory is that the cause may be related to melatonin which is produced in dim light and darkness by the pineal gland, since there are direct connections, via the retinohypothalamic tract and the suprachiasmatic nucleus, between the retina and the pineal gland.

  7. Treatment options • Fortunately, there are many different treatments for classic (winter-based) seasonal affective disorder, including light therapy, medication, ionized-air administration, cognitive-behavioral therapy and carefully timed supplementation of the hormone melatonin.

  8. Light therapy • Light therapy uses a light box, which emits far more lumens than a customary incandescent lamp. Bright white "full spectrum" light at 10,000 lux, blue light at a wavelength of 480 nm at 2,500 lux or green (actually cyan or blue-green) light at a wavelength of 500 nm at 350 lux are used, with the first-mentioned historically preferred. Bright light therapy is effective with the patient sitting a prescribed distance, commonly 30–60 cm, in front of the box with her/his eyes open but not staring at the light source for 30–60 minutes.

  9. Vitamin d • Another explanation is that vitamin D levels are too low when people do not get enough Ultraviolet-B on their skin. An alternative to using bright lights is to take vitamin D supplements. A study of Canadians of wholly Icelandic descent also showed low levels of SAD. It has more recently been suggested that this may be attributed to the large amount of fish traditionally eaten by Icelandic people, rather than to genetic predisposition; a similar anomaly is noted in Japan, where annual fish consumption in recent years averages about 60 kg per capita. Fish are high in vitamin D. Fish also contain docosahexaenoic acid (DHA), which has been shown to help with a variety of neurological dysfunctions.

  10. Antidepressant medications • Antidepressant medication (ADM) has been shown to be effective in treating various forms of depression. Bupropion, a norepinephrine-dopamine reuptake inhibitor, was approved by the U.S. Food and Drug Administration for the prevention of seasonal affective disorder.ADMs are considered to be largely compensatory in nature. In other words, ADMs may suppress depressive symptoms while they are being used, but lasting changes are not guaranteed once treatment is discontinued.

  11. Group therapy • OTs in mental health settings often lead groups for inpatients and outpatients with mood disorders.Some group therapy topics that target occupational performance issues related to SAD could include: • Stress management • Social skills and networking • Weight control and nutrition • Smoking cessation • Substance abuse • Time management • Wintertime activities • Sleep education • Self-esteem • Sexual health

  12. Cognitive Behavioral Therapy (CBT) • CBT aims to help clients identify the expectations and interpretations that can lead them towards depression and anxiety; adjust to reality; and break through their avoidances and inhibitions.Occupational therapists can help clients with SAD engage in pleasurable activities in the winter months: • Developing a repertoire of wintertime leisure interests • Using diaries to record automatic negative thoughts • Creating a balanced activity level • Improving time management skills • Problem solving about situations that initiate negative thinking • Setting goals and plans for maintaining gains and preventing relapse

  13. Mindfulness-based cognitive therapy (MBCT) • Unlike CBT, MBCT does not emphasize changing thought contents or core beliefs related to depression. It instead focuses on meta-cognitive awareness techniques, which are said to change the relationship between one’s thoughts and feelings. Once awareness of negative feelings and thoughts are cultivated, MBCT emphasizes accepting and letting them go.

  14. Outdoor therapy • Outdoor therapy is yet another psychotherapeutic intervention that OTs can recommend. Outdoor work has been used effectively as a therapy to treat those with mood difficulties during the winter season in Denmark. Similarly, outdoor walking can provide a “therapeutic effect” to individuals with SAD that is on par with light therapy. Occupational therapists should incorporate outdoor occupations into their interventions with clients diagnosed with SAD.

  15. references • ^ Seasonal Depression can Accompany Summer Sun. Ivry, Sara. The New York Times. Retrieved September 6, 2008 • ^ Lurie, Stephen J.; et al. (November 2006). "Seasonal Afective Disorder". American Family Physician74 (9): 1521–4. PMID 17111890. • ^ Friedman, Richard A. [1] “Brought on by Darkness, Disorder Needs Light”. New York Times’’, 2007-12-18. • ^MedlinePlus Overview seasonalaffectivedisorder • ^ abc Seasonal Affective Disorder by Mayo Clinic • ^ ab Rosenthal NE, Sack DA, Gillin JC, Lewy AJ, Goodwin FK, Davenport Y, Mueller PS, Newsome DA, Wehr TA. et al. (1984). "Seasonal Affective Disorder: A Description of the Syndrome and Preliminary Findings with Light Therapy". Archives of General Psychiatry41 (1): 72–80. doi:10.1001/archpsyc.1984.01790120076010. PMID 6581756. • ^ abc Marshall, Fiona. Cheevers, Peter (2003). "Positive options for Seasonal Affective Disorder", p.77. Hunter House, Alameda, Calif. ISBN 0-89793-413-X. • ^ abTerman, M.; Terman, J.S. (2006). "Controlled Trial of Naturalistic Dawn Simulation and Negative Air Ionization for Seasonal Affective Disorder". American Journal of Psychiatry163 (12): 2126–2133. doi:10.1176/appi.ajp.163.12.2126. PMID 17151164. 17151164. • ^ "Properly Timed Light, Melatonin Lift Winter Depression by Syncing Rhythms" (Science Update). National Institute of Mental Health. 2006-05-01. Retrieved 2009-08-30. • ^Gabbard, Glen O. Treatment of Psychiatric Disorders. 2 (3rd ed.). Washington, DC: American Psychiatric Publishing. p. 1296. • ^ Rose, Phil Fox (2 November 2010). "SAD That DST is Ending--Dealing with the shortening days and the end of daylight-saving time". Busted Halo. Retrieved 3 November 2010. • ^ abcdef Lam, RW; Levitt AJ, Levitan RD, Enns MW, Morehouse R, Michalak EE, Tam EM (2006). "The Can-SAD Study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder". American Journal of Psychiatry163 (5): 805–812. doi:10.1176/appi.ajp.163.5.805. PMID 16648320. • ^ abcde Avery, D H; Eder DN, Bolte MA, Hellekson CJ, Dunner DL, Vitiello MV, Prinz PN (2001). "Dawn simulation and bright light in the treatment of SAD: a controlled study". Biological Psychiatry50 (3): 205–216. doi:10.1016/S0006-3223(01)01200-8. PMID 11513820. • ^ abc Modell, Jack; Rosenthal NE, Harriett AE, Krishen A, Asgharian A, Foster VJ, Metz A, Rockett CB, Wightman DS (2005). "Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL Biological Psychiatry". Biological Psychiatry58 (8): 658–667. doi:10.1016/j.biopsych.2005.07.021. PMID 16271314. • ^ Johansson, C; Smedh C, Partonen T, Pekkarinen P, Paunio T, Ekholm J, PeltonenL,Lichtermann D, Palmgren J, Adolfsson R, Schalling M (2001). "Seasonal affective disorder and serotonin-related polymorphisms". Neurobiology of Disease8 (2): 351–357. doi:10.1006/nbdi.2000.0373. PMID 11300730. • ^ Johansson, C; Willeit M, Levitan R, Partonen T, Smedh C, Del Favero J, BelKacem S, Praschak-RiederN,Neumeister A, Masellis M, Basile V, Zill P, Bondy B, Paunio T, Kasper S, Van Broeckhoven C, Nilsson LG,Lam R, Schalling M, Adolfsson R. (2003). "The serotonin transporter promoter repeat length polymorphism, seasonal affective disorder and seasonality". Psychological Medicine33 (5): 785–792. doi:10.1017/S0033291703007372. PMID 12877393. • ^Uz, T; Manev, H (2001). "Prolonged swim-test immobility of serotonin N-acetyltransferase (AANAT)-mutant mice". Journal of Pineal Research30 (3): 166–170. doi:10.1034/j.1600-079X.2001.300305.x. PMID 11316327. • ^ ab Avery, D. H.; Kizer D, Bolte MA, Hellekson C (2001). "Bright light therapy of subsyndromal seasonal affective disorder in the workplace: morning vs. afternoon exposure". ActaPsychiatricaScandinavica103 (4): 267–274. doi:10.1034/j.1600-0447.2001.00078.x. PMID 11328240. • ^Leppämäki, Sami; Haukka J, Lonnqvist J, Partonen T (2004). "Drop-out and mood improvement: a randomised controlled trial with light exposure and physical exercise ISRCTN36478292". BMC Psychiatry4: 22. doi:10.1186/1471-244X-4-22. PMC 514552. PMID 15306031. • ^Naish, John (2008-11-08). "Breakthroughs tips and trends: November 7th - Times Online". London: www.timesonline.co.uk. Retrieved 2008-11-10. • ^ Rosenthal, Norman E.. (2006) Winter Blues, Revised edition, The Guilford Press, New York. ISBN 1-57230-395-6 • ^ More, Lee Kremis. Gannett News Service. “It's Wintertime: When Winter Falls, Many Find Themselves In Need Of Light”, Milwaukee Sentinel, 1994-12-26. • ^ abNesse, Randolphe M; Williams, George C (1996). Why We Get Sick (First ed.). New York: Vintage Books. pp. 290. • ^ abBhattacharjee, Y (2007). "Psychiatric research. Is internal timing key to mental health?". Science317 (5844): 1488–90. doi:10.1126/science.317.5844.1488. PMID 17872420. • ^ Howland, RH (2009). "Somatic therapies for seasonal affective disorder". J PsychosocNursMent Health Serv47 (1): 17–20. doi:10.3928/02793695-20090101-07. PMID 19227105. • ^ |title=The Visible Light Spectrum |author=Zimmerman, Andrew |url=http://physics.about.com/od/lightoptics/a/vislightspec.htm |date=2012-02-15 • ^ abSaeeduddin Ahmed, Neil L Cutter, Alfred J. Lewy, Vance K. Bauer, Robert L Sack and Mary S. Cardoza (1995). "Phase Response Curve of Low-Intensity Green Light in Winter Depressives". Sleep Research24: 508. ""The magnitude of the phase shifts [using low-level green light therapy] are comparable to those obtained using high-intensity white light in winter-depressives."" • ^ Strong, RE; Marchant, BK; Reimherr, FW; Williams, E; Soni, P; Mestas, R (2009). "Narrow-band blue-light treatment of seasonal affective disorder in adults and the influence of additional nonseasonal symptoms". Depression and Anxiety26 (3): 273–8. doi:10.1002/da.20538. PMID 19016463. • ^ J. J. Gooley, S. M. W. Rajaratnam, G. C. Brainard, R. E. Kronauer, C. A. Czeisler, S. W. Lockley (May 2010). "Spectral Responses of the Human Circadian System Depend on the Irradiance and Duration of Exposure to Light". Science Translational Medicine2 (31): 31–33. doi:10.1126/scitranslmed.3000741. PMID 20463367. • ^ Beck, Melinda. (December 1, 2009) "Bright Ideas for Treating the Winter Blues". (Section title: "Exercise outdoors") The Wall Street Journal. http://online.wsj.com/article/SB10001424052748703300504574567881192085174.html?mod=rss_Today%27s_Most_Popular • ^ "Applications: Health". Practical Solar. Retrieved 2009-06-09.

More Related