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Seasonal Affective Disorder troubles millions during winter months

If this is the season of joy, then why are so many of us sad? During the fall and winter months, millions of us feel our spirits sag as the days become shorter and darker. These people suffer from a form of depression called Seasonal Affective Disorder (SAD). Never has there been a more appropriate acronym.

Approximately 5 percent of Americans suffer from SAD, considered a major depressive disorder, but as many as 25 percent experience milder seasonal depression. There is even a “summer version” of SAD, but it is relatively rare, according to the American Psychiatric Association.

SAD has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and a lack of sunlight in winter. Not surprisingly, the incidence of SAD increases at higher latitudes. In Florida, just over 1 percent of the population suffers. In Alaska, the figure is closer to 10 percent.

SAD shares a number of symptoms with other depressive disorders. These include fatigue, weight gain, social withdrawal, carbohydrate craving and lack of interest in normal activities. Most SAD sufferers experience normal mental health throughout most of the year but are overcome by depressive symptoms in the winter or summer.

Practitioners distinguish SAD from the more typical “holiday blues.” SAD is a depressive disorder with a biological basis. Many of us suffer from a milder form of “blues” during the holidays – a result of too much to do, not enough exercise, family demands, past memories and more.

There are many different treatments for SAD, including light therapy, medication, ionized-air administration, cognitive-behavioral therapy and melatonin. Even getting outside during daylight can help.

The popular and seminal book on the subject is “Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder (Guilford Press, 2006). Author Norman E. Rosenthal, M.D., is a nationally recognized psychiatrist and expert on depression. In fact, it was Rosenthal who first described and named Seasonal Affective Disorder, while at the National Institutes of Mental Health in 1984.

“Winter Blues” is a must read for anyone who thinks he or she may be suffering from SAD. It is both scientifically rich in information as well as an enjoyable read. Rosenthal tells the story of SAD: what it is, who suffers from it, what causes it and how to treat it.

While those who experience seasonal depression should be evaluated by a medical professional, “Winter Blues” is a useful self-help book. There is a quiz to help readers understand their own conditions and decide on the intervention best for them. Rosenthal makes suggestions for diet and exercise that help people cope with winter. A long section on light therapy examines the evidence for the treatment and helps readers learn how to use it. The use of medication including antidepressants and melatonin is also discussed. A separate chapter for family and friends aims to increase understanding and support for SAD sufferers.

This revised edition of “Winter Blues” was published in 2006. While still relevant and full of valuable information, you may want to know more. To augment this read and learn about any new research findings and the most current treatment recommendations, call, visit or email Stanford Health Library. “Winter Blues” is available for borrowing, as are a number of other books and videos on depression and SAD. We provide evidence-based answers to your health-related questions and will search the medical literature to answer your specific questions, at no charge. We have access to information that cannot be found on the public Internet. To begin your search online, visit healthlibrary.stanford.edu/resources/bodysystems/mental_depression.html.

Stanford Health Library is free and open to the public in five locations:

• Stanford Shopping Center, near Bloomingdale’s.

• Stanford Hospital, 300 Pasteur Drive.

• Stanford’s Cancer Center, 875 Blake Wilbur Drive.

• The Taube Koret Center for Jewish Life, 3921 Fabian Way, Suite G106, Palo Alto.

• The Ravenswood Family Health Center, 1807 Bay Road, East Palo Alto.

Nancy Dickenson is head librarian at Stanford Health Library. For more information, call 725-8400, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit healthlibrary.stanford.edu.

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