Seasonal affective disorder

The winter depression or seasonal - affective disorder ( SAD also from Seasonal Affective Disorder, Seasonal Affective Disorder ) is a depressive disorder that occurs in the fall and winter months. As a special form of affective disorders is associated with recurrent depressive disorders in ICD-10.

In addition to depressive symptoms, depressed mood, reduce energy levels and anxiety atypical symptoms will be added as an extension of the duration of sleep, increased appetite for sweets ( Kohlehydratheißhunger ) and weight gain. In the independent seasonal depression rather loss of appetite, weight loss and sleep shortening occur.

Causes

As a cause disturbances of the biological circadian rhythms are accepted. There are different hypotheses regarding the etiology. One states that the symptoms of SAD patients is related to the melatonin metabolism and thus influence melatonin may have an antidepressant effect. The occurrence of depressive symptoms in the winter can be, according to this theory with the increased production of melatonin in the dark winter months and the resulting lower serotonin levels explain ( Melatonin is a breakdown product of serotonin). Low serotonin levels, in turn, be made in particular responsible for the depressive symptoms and the otherwise atypical symptoms of SAD.

Treatment

As with all diseases applies primarily to correct the cause.

Causal treatment

In the human brain, many serotonin -producing cells, the serotonin on the internal clock are controlled depending on the time ( in the waking reinforced) leave the blood. This internal clock is synchronized over the over the eyes incident light and presumably the light color ( blue / red).

Is the serotonin -releasing cells this rhythm is disturbed, for example, by missing or incorrect external timer, it can lead to depression ( and sleep ) come. By substituting for this timer or the restoration of winter depression may well be counteracted. It makes sense, especially a lot of light in the early morning; in the evening or at night, however, is to steer clear of too much light. Be successfully used in addition to light therapy and early morning exercise and supplements with vitamin D, which can be formed only under light irradiation in the skin.

Symptom overlap

If the causal treatment is not possible, the symptoms may be masked temporarily. However, they provide a lot of side effects that - except in severe cases without causal treatment option - would be disproportionate to the benefits (such as a risk of drug dependence).

Therapeutically, modern antidepressants could be used, such as serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors, serotonin -norepinephrine reuptake inhibitors or atypical antidepressants such as the selective norepinephrine dopamine reuptake inhibitor bupropion, which in the U.S. is the only antidepressant for an authorization for the has treatment of seasonal Affective Disorder (seasonal affective disorder). Bupropion has besides the sentiment drive a slightly increasing effect.

Likewise, Rhodiola is used to relieve the symptoms. According to preliminary data, it could be due to its weak MAO inhibitory properties anxiolytic, act drive -enhancing and anti-depressive, with Roseroot unlike synthetic antidepressants should be free of side effects.

History

Winter depression have been described in antiquity by Hippocrates and Aretaeus.