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Seasonal Affective and Bipolar Disorder

© Colleen Sullivan

With the shortening of the days and the falling of the autumn leaves…with the scurrying of the squirrels gathering their Winter food supply so they might withdraw to the safety of their nest, so too does the mood of individuals with Bipolar Disorder who are also affected by Seasonal Affective Disorder (SAD), fall.

According to the NIMH (National Institute of Mental Health) approximately 10 percent of Americans have SAD. The incidence is higher in Northern Latitudes and lower in Southern Latitudes. (For example 10 percent in Seattle, WA compared to 1 percent in Los Angeles, CA.). Individuals already diagnosed with Bipolar Disorder, especially Bipolar II and other depressive illnesses are more at risk for SAD. SAD also seems to affect women much more often than it does men, often beginning in their twenties.

According to the DSMV-IV the essential feature of SAD is its characteristic pattern of onset and remission. In most cases, episodes begin in September to December, with October and November being the most common months for onset. Less commonly there may be recurrent summer episodes. These episodes typically remit in March or April.

Diagnosis of seasonality can be made if there has been onset or worsening of mood within the same sixty-day period in two successive years

And

Recovery has occurred within the same sixty-day period in the spring (no later than June) in two consecutive years. (Spring/Summer hypomania or mania may or may not appear)

Symptoms of SAD

· Feeling sad or depressed

· Lethargy

· Difficulty concentrating

· Carbohydrate or sugar cravings (often accompanied by weight gain)

· Difficulty waking in the morning

· Sleep disturbance (usually hypersomnia – sleeping too much 2 or 3 hours a day more than usual)

· Social withdrawal · Reduced productivity

· Feeling worthless, hopeless or guilty

· Reverse diurnal variation of mood (afternoon or evening “slump” as opposed to more severe morning symptoms)

What Causes Seasonal Affective Disorder?

Change in light exposure is the key. The amount of daylight exposure one receives and the changes in sunrise/sunset reducing the daylight hours in the fall affects people with SAD. It is commonly believed that even though the body has natural daily rhythms, they are not precise and depend on the intensity of sunlight for adjustment. The cues for these adjustments originate in the retina at the back of the eye and create signals which pass through the optic nerve to the hypothalmus and set in motion a number of chemical changes including increasing the neurotransmitter serotonin which is necessary for a sense of well being, and regulating and suppressing melatonin, a factor in normal sleep patterns. For a look at what the hypothalamus and “biological clock” in humans looks like Go Here>

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