Hong Kong has a pleasant winter, compared to many countries. With cool, dry and cloudy weather for a few months, and the occasional cold front, winter isn’t very threatening here. However, winter is still the season when the greatest number of cases of seasonal affective disorder (SAD) occur. In fact, some people actually call this type of depression “winter depression.”
What Is Seasonal Affective Disorder?
SAD, also known as seasonal adjustment disorder, is a seasonally-tied form of depression. It is common in countries further from the equator. Most (but not all) people who experience SAD experience it during the winter months. It is rarer but not unknown for people to experience SAD in the summer, or in the rainy season.
Seasonal affective disorder is frequently undiagnosed, and many doctors seem to have a lack of awareness of the condition, even though estimates indicate that more than 10% of the population is affected. It often takes two to three years of suffering with SAD before the syndrome is diagnosed, and the line between SAD and the “winter blues” is still fuzzy. Basically, if a doctor diagnoses you, you have SAD.
Seasonal affective disorder was first described in literature in 1845, but did not have a clinical name until the early eighties, and many doctors have had little education on it, seeing it mentioned as a footnote to depression. Few realize how common it is.
Females tend to be more prone to SAD, although males tend to have stronger symptoms and tend to self-medicate with alchol and drugs more oftent. It is more common for someone with relatives who have the disorder to develop it.
Symptoms of Seasonal Affective Disorder
- difficulty getting up in the morning
- feelings of apathy and lethargy
- feelings of guilt/worry/anxiety
- reduced energy for even minor tasks
- weakened immune system
- reduced focus/concentration
- overeating / weight gain
- sleep problems
- alcohol or drug abuse
- reduced libido
- social/relationship problems
Causes of S.A.D.
It’s not clear what causes seasonal affective disorder. Speculation that reduced light, neurotransmitter changes (serotonin levels), changes in sleep hormones (melatonin), or disruption to the body clock (circadian rythyms) are causes have not been proven by research. It could be one of those, or several in combination. Most professionals believe that SAD is tied to light, rather than to cold temperatures. The symptoms seem to build up gradually as the days start getting shorter, and gradually reduce in spring as the amount of daily sunlight rises.
There is recent evidence that vitamin D deficiency is a factor in seasonal affective disorder.
Treating Seasonal Affective Disorder With Light Therapy
It does seem that exposure to more natural light helps, and many SAD sufferers have been helped by light therapies. Usually these involve bright light boxes or specially calibrated lights that generate high intensity artifical daylight. These lights are usually 10 times as bright as normal indoor lighting. Typically, a user would expose themselves to the light box for thirty minutes or more each morning. This is known as phototherapy.
Common SAD Therapies
Other therapies for seasonal affective disorder typically involve antidepressant medication or psychological counseling (psychotherapy). Cognitive Behavioral Therapy (CBT), a brief, structured therapy focused on changing negative thought patterns and behaviors, has had good results. Using light therapy and CBT together is common. Taking at least 2000 IU of vitamin D daily is advisable during the winter months, if you don’t live near the equator.
If you’re feeling the winter blues in Hong Kong and need some help getting back to feeling yourself, call us at (+852) 2523 8044 for an appointment. Because we offer an integrative medical practice, we can help you find the right treatment for your situation. We offer counselling, psychotherapy, acupuncture and kinesiology, all of which can treat seasonal affective disorder or depression without drugs. If antidepressants are required, our physician can dispense those as well.