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How Do I Know If I Have Seasonal Affective Disorder?

Because no laboratory test exists for SAD, diagnosis is made on the basis of the patient's history and should be made by a psychiatrist experienced with the disorder. Illnesses with similar symptoms that must be ruled out are underactive thyroid function, chronic viral infections and chronic fatigue syndrome. In children, abuse and separation anxiety should also be considered, and in adolescents, substance abuse and anxiety disorder. Physicians can diagnose SAD based on standards developed by the American Psychiatric Association.

What Are the Treatments?

The most effective treatment for SAD is light therapy, sometimes combined with antidepressant drugs, psychotherapy (talk therapy), or both.

Light therapy, sometimes called phototherapy, can be used in different ways and may employ different types of light boxes, light visors, and lamps. All are designed to bring in extra light to the eyes. Check to be sure a light box filters out harmful ultraviolet light.

In the most common form of light therapy, you sit before a light box of strong fluorescent light covered with a plastic screen to block ultraviolet light (10,000 lux - about 10 to 20 times brighter than ordinary indoor light) for periods varying from 15 minutes to 1 1/2 hours a day. You place the box on a table or desk where you can do paperwork, read, or make phone calls. You do not need to look directly into the light.

Other light sources include larger boxes that stand on the floor, visors with lights attached, and dawn simulators - lights programmed to turn on by your bed on winter mornings before dawn.

Light boxes can be bought for several hundred dollars at special stores. Experts warn against constructing your own light box because of possible damage from ultraviolet light.

Light therapy is safe and generally well tolerated. Minor side effects of light therapy include eye strain, headache, irritability, fatigue and insomnia.

Since SAD is a form of depression, many different types of antidepressants have been used. Selective serotonin reuptake inhibitors (SSRIs, such as Paxil and Prozac) are often used as the first line of treatment, but other antidepressants, such as Wellbutrin, have also been used successfully alone or in conjunction with light therapy.

In a few of the most severe cases, especially when the patient is suicidal, electroconvulsive therapy may be used. In this treatment method, finely controlled electrical charges are used to induce seizure-like activity in the brain.

At-Home Remedies

• Take a walk at lunchtime when the sun is high. Be outdoors as often as you can.
• Exercise as much as you are able.
• Take winter vacations in places with long days.
• Increase the natural light in your home by trimming low-lying branches near the house and hedges around windows.
• Paint your walls with lighter colors.
• Keep warm and enjoy the fun aspects of winter — such as wood fires, books, music.
• If all else fails and you can manage it, move to a sunnier climate.