"SAD isn't just in your head. It is a very real condition, and there is growing evidence that it does seem to be spreading somewhat as we become more and more of an indoor society," says Jan Smith, a psychotherapist with Plains Area Mental Health Center, which serves Storm Lake.
SAD produces real symptoms that can range from mild in most cases to severe for a smaller percentage of individuals who may need to seek help.
Anyone can get SAD, but it is more common in:
* Women (one recent study found that females on average spend only 20 minutes a day in sunlight, less than a third of the time for the average male.)
* People in northern climates where winter days are short and there is a marked change in the amount of daylight by season.
* People age 15-55 (The risk of experiencing SAD for the first time goes down after age 30.)
* Those with a close relative who suffers from SAD.
* Those who work long hours indoors with little access to sunlight can actually experience SAD at any time of year. Some who are very sensitive to the amount of light even notice mood changes during extended stretches of cloudy weather.
While it is natural for everyone to feel sad or depressed at times, what differentiates SAD is its cyclical nature of feeling bad in the dark months and better in the lighter ones. "If you have SAD, you have probably had that pattern for a while. On the other hand, if you are experiencing sadness at more random times, it is more likely to be something going on in your life that is triggering the feelings," says Smith.
Experts are still not certain what causes SAD symptoms in some people and not others, but it is theorized that a reduction in light may upset the sleep-wake cycle, and cause issues with a brain chemical called serotonin that impacts mood, or melatonin, a sleep-related hormone linked to depression, which seems to be produced faster in dark hours. Others theorize that fluctuation in temperature and barometric pressure may play a role.
Some feel Abraham Lincoln suffered from extreme SAD conditions - the two most severe bouts of depression that he suffered in his life coincided with the two most dramatic periods of barometric pressure changes during that historical period.
"There is a lot yet to be learned about all of the chemical balances that go on in our body, but it seems clear that people do better if they get a little sunshine," Smith says. "Unfortunately that is often not a part of our society. Even in summer people aren't getting outside."
The local professional says there is already evidence that SAD is spreading geographically because people aren't getting sun, and she wonders if it will spread more to other seasons and younger people as well.
What are the symptoms?
* Feeling sad, grumpy or anxious more than usual.
* Social withdrawal.
* Feelings of guilt, worthlessness or hopelessness (SAD patients sometimes describe an "empty" feeling.)
* Loss of interest in a person's usual activities.
* Eating more, weight gain and craving carbohydrates, such as bread and pasta.
* Oversleeping and feeling drowsy during the day.
* Difficulty concentrating. remembering and making decisions.
* Having these conditions come and go at the same time each year - starting in September or October for most people, and ending in April or May.
* Not everyone experiences all of the symptoms.
To treat SAD, your doctor or mental health professional will likely ask about the experiences with the symptoms above, whether there is a family history with such depression periods, and whether the symptoms have come and gone in a pattern over at least two years.
For many people, just identifying their condition as real is helpful. For more severe cases, light therapy may be prescribed using special florescent bulbs, and in some patients eases symptoms within a week - but must be used regularly throughout the season. In some cases, counseling, antidepressant medication and even cognitive behavioral therapy has been useful.
Local doctors are also coming to recognize the importance of exercise in fighting SAD. Being active, especially first thing in the morning, may help many feel less depressed and more energetic throughout the day. Moderate to intense exercises such as fast walking, rising an exercise bike or swimming is a good way to get started, but if you have not been active, it may be a good idea to get a checkup at one of the Storm Lake medical clinics and ask for your doctor's advice to begin a workout regimen.
Smith, who has a personal interest in studying the phenomenon, adds that getting outdoors in the light shortly after waking up each day seems to be an effective therapy.
SAD can be a manageable condition. For some people, simply rearranging to put their favorite chair or their desk at a window helps, as does a short walk outdoors each day. But for those experiencing deep depression or thoughts of suicide, a doctor should be consulted immediately. In severe cases, a physician will want to rule out other illnesses that can have similar symptoms - such as hypothyroidism, hypoglycemia, infectious mononucleosis, other viral infections, or bipolar disorder. Those with bipolar issues in their family should see a professional before beginning any SAD treatment - some of the home light treatments on the market could trigger a manic episode for those with such illnesses, local experts warn.
"It's not so much a matter of diagnosing as it is just finding what is needed to get people back on their feet," the Plains Area professional says. "The big question - when do I quit white-knuckling it? When you are no longer taking pleasure in the things you used to enjoy, when you are isolating yourself and not even feeling like you want to talk to people, when you are just feeling tired of the whole deal, it's probably time to go get a little bit of help.
"A lot of people feel like they would have to be crazy to go talk to someone about their issues, but that just isn't the case," says Smith. "The sooner you deal with your troubles, the less is going to be needed to deal with it. Never wait for a crisis when you can avoid one."