As someone who suffers from Seasonal Affective Disorder, or SAD, I thought I'd help shed some light on the subject (pun intended, sorry).

Seasonal Affective Disorder, despite the godawful cutesy acronym (GCA), really is sad. It is classified as a mood disorder that is biochemical in nature. SAD is thought to be caused by the the body's reaction to decreased sunlight, specifically in a decrease in serotonin production, although no reproducible clinical evidence has been able to satisfactorily pinpoint the cause of the disorder. Symptoms include hypersomnia (sleeping a lot), hyperphagia (eating a lot), and weight gain; given the similar symptoms, it is easy to see why the disorder can be misdiagnosed as depression.

Treatment typically involves daily application of full-spectrum light. This comes in the form of light boxes (overhead lights that are installed on a wall), desk lamps (well, really big desk lamps), or visors that are worn just above the eyes. The exact treatment varies from patient to patient, but generally involves twenty-minute applications of about 10,000 Lux of light (Lux is used as a measurement of intensity; indoor lighting ranges from about 200 to about 700 Lux, a sunny spring day is about 10,000 Lux, a cloudless summer day is about 50,000 Lux), although treatments of only 60 Lux have been effective when used in visors. Ultra-violet light has been shown to have no effect on the SAD patient, and most full-spectrum light sources include a UV filter of some sort.

That's all the clinical stuff. Here's the bit about what it's like.

Imagine your energy draining away, day by day, so slowly that you can't even tell it's disappearing. Every now and again, you begin to feel that something is wrong, that you're in trouble for something, that there is a terrible doom of some sort that is about to happen. You start to have unreasonable, irrational, paranoid thoughts that your friends are excluding you, or that your co-workers don't respect you. Eventually, you stop caring about things, you don't want to do anything but stay in bed and kill time.

This is the worst case, of course. It begins subtly a week or so after the autumnal equinox. It gets worse and worse, and hits bottom about three or four weeks after the winter solstice. It's a devious thing, and most SAD sufferers don't even realize what's happening. The depression gnaws away at the personality, reducing a person to an obnoxious, disturbed, and unpleasant individual.

I didn't know what was going on until I was 22 (or 23, I'm not certain; ironically, my birthday is about three or four weeks after the winter solstice), when I consciously noticed my mood problems and decided to go for help. As a child, my parents had sent me to therapy, but usually in the late Spring, when I was getting better anyway, so it looked like the therapy worked and I didn't need to be there any more. The therapist I went to listened to my story, and suggested that SAD may be at the root of my problem. I agreed, but then she said that a diagnosis couldn't be made unless there was four consecutive years of evidence. I was terrified that I was stuck for four years, but before total desperation settled in I remembered that my grades throughout my primary education tended to form an upside-down bell curve when taken as a function of time over the course of the school year; this saved my proverbial emotional butt.

I was loaned a light box. It was an obnoxious size, too big for one person but too small for two to carry comfortably. A roommate helped me get it home and I plopped down in front of it for twenty minutes. I didn't notice any effect, but my excitement about getting treatment was enough to carry me for the day. A few days later, I did notice an effect: I was starting to be me again. No angst, no depression, energy up, no disgust with myself or the world. It was my electric teddy bear, my happy light.

Nowadays, I have a desk-lamp version, which pokes up over my computer and keeps me company during the morning email. Now that I know what to look for, I can notice when my mood starts shifting, and start the therapy then. During the longest nights of the year, I usually have to do another twenty-minute session in the evening, just to keep me from going to bed around six in the evening. On advice from a doctor, I've also tried St. John's wort, and found it to be a mildly effective stop-gap for when I'm away from my light, although not a good alternative.

SAD is a weird thing, although I'm sure that the cause and cure will someday be figured out by people that know a lot more about this thing than me. It's kinda spooky to know that something in your body can subvert your mind and personality, your soul, if you prefer. But at least I get a bright morning every day, well, for twenty minutes, at least.

Pike's writeup above is a vivid account of what I, and other SAD sufferers, go through every winter. Here is a list of ways to cope.

  1. Get a light box for SAD treatment and use it every day.
    Pike's information above is good, except that studies have shown that it is the intensity if the light (10,000 lux) that matters, rather than its spectrum. Ordinary fluorescent light boxes are equally effective, and not as expensive, as full spectrum light boxes. The same goes for desk lamps and visors. Every little bit of light helps, too. Even a normal desk lamp can improve your work environment and keep your performance from slumping in the winter.
    Light boxes are pricey, but you can sometimes get them on health insurance in the US. In the UK, light boxes for medical purposes are exempt from VAT.
    Although many SAD sufferers find that 20 minutes a day of light therapy is sufficient, people in more northern areas may find that longer periods are needed in the darkest days of the year. In midwinter, I use my light box for 2 hours a day. (But then, I live at 55° 53' N latitude, where midwinter days are 7 hours long.)

  2. If you have trouble getting up in the morning, consider a dawn simulator
    These gadgets incorporate an alarm clock and a light on an automatic dimmer. They fool your body into thinking it's sunrise, so you wake up naturally.
    In winter, my dawn simulator makes the difference between waking up properly and spending the first half of the day half asleep.

  3. Take St. John's Wort
    St. John's Wort is a natural antidepressant, and has become very popular with SAD sufferers.
    Research it first - SJW does have side effects, notably photosensitivity. This is another reason not to use full-spectrum lights, since fluorescents don't seem to trigger it.

  4. Get outside
    Even a light box isn't as bright as the midday sun. If it's a bright day, take a walk at lunchtime, looking up frequently to get the most of the light. This doesn't mean staring at the sun.

  5. Monitor yourself
    There are a number of signs that SAD is creeping up on you. True depression is one, but many other things show up first:
    • carbohydrate cravings, especially in the evenings. If you can't get enough bread at night, you're probably under-treating.
    • tiredness and lethargy during the day, particularly the afternoon
    • trouble sleeping. This can be bitterly ironic, considering how tired you can get.
    • unwillingness to try anything to solve the creeping depression, usually because of a combination of denial and pessimism that anything will help

  6. Accept that you're not at your best in the winter
    Deepest winter may not be the time to make life-changing decisions, begin new projects, or change jobs. If it is all you can do, endure the darkness and trust that things will be better come spring.

  7. Get in touch with other SAD sufferers.
    Usenet, discussion groups and support groups can all help. Your fellow saddies may spot creeping symptoms before anyone else does, and will have experience with the different treatments

  8. Live healthily
    Exercise, even though you may not feel like it at the time. Cut down on caffeine and alcohol, both of which will disrupt your sleep. Eat a balanced diet.

  9. Take a holiday in the sun
    You'll only feel better while you're actually in a lighter place, but the anticipation and memories can improve your mood. Its also a vivid reminder that the darkness will pass.

  10. If you really, really can't stand it, move south.

By the way, watch out for spring. Some SAD sufferers go hypomanic when it gets lighter.

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