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What is the sad hormone?

Serotonin. Serotonin is another hormone that affects mood, appetite and sleep. It is also a neurotransmitter, which means that it transmits messages between nerve cells. Fewer hours of sunlight means that less serotonin is produced. If you have SAD, your serotonin levels may be lower than average during the winter.

nhsinform.scot - Seasonal affective disorder (SAD) - NHS inform

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Depending on the nature and severity of your symptoms, your GP will recommend the most suitable treatment option for you. This may involve using a combination of treatments to get the best results.

NICE recommendations

This includes using talking treatments, such as cognitive behavioural therapy (CBT) or medication, such as antidepressants (see below). Light therapy is also a popular treatment for SAD. There is no strong evidence to support the long-term benefits of using light therapy to treat SAD, although research does suggest that it may have a positive short-term effect. See the NICE guidance about the treatment and managment of depression in adults.

Psychosocial treatments

Psychosocial treatments focus on both psychological aspects (how your brain functions) and social aspects (how you interact with others). Some possible psychosocial treatments are described below.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) starts with the idea that your problems are often created by you. It is not the situation itself that is making you unhappy, but how you think about it and how you react to it. Changing how you think about certain situations will help you change your behaviour so that the situation no longer makes you feel unhappy. CBT involves having a number of sessions with a specially trained therapist, usually over several weeks or months. Your programme could be:

an individual programme of self-help

a programme designed for you and your partner (if your depression is affecting your relationship) a group programme that you complete with other people who are in a similar situation a computer-based CBT programme that is tailored to your needs and supported by a trained therapist

Counselling and psychodynamic psychotherapy

Counselling is another type of talking therapy that involves talking to a trained counsellor about your worries and problems. During psychodynamic psychotherapy, you discuss how you feel about yourself and others and you talk about experiences in your past. The aim of the sessions is to find out whether anything in your past is affecting how you feel today.

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Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) are the preferred type of antidepressants for treating SAD. They increase the level of the hormone serotonin in your brain which helps to lift your mood.

If you are prescribed antidepressants, be aware that:

It can take between four-to-six weeks for the medication to take full effect. It is important to take the medication as prescribed and to continue taking it even if you start to feel better. Some antidepressants have side effects and may interact with other types of medication that you are taking. An upset stomach is the most common side effect of antidepressants. See the information leaflet that comes with your medication for a full list of possible side effects. The evidence that antidepressants are effective in treating SAD is limited. They are thought to be most effective if they are taken at the start of winter (before the symptoms appear) and continued until spring.

Light therapy

For some people with SAD, using light therapy can help improve their mood considerably. It involves sitting in front of, or beneath, a light box. Light boxes are special lamps that come in a variety of designs, including desk lamps and wall-mounted fixtures. They produce a very bright light. Light intensity is measured in lux – the higher lux, the brighter the light.

the light intensity you should be using

how long you need to sit in front of the light

When buying a light box, make sure that you choose one that has been produced by a fully certified manufacturer and is medically proven to treat SAD. The SAD Association (www.sada.org.uk) can provide a list of recommended manufacturers.

Very bright light may not be suitable if you:

have an eye problem or your eyes are particularly sensitive to light

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are taking certain types of medication, such as antidepressants

have epilepsy – a condition that causes seizures (fits)

Speak to your GP if you unsure about the suitability of a particular product.

How light therapy works

Light therapy is thought to work by simulating the sunlight that is missing during the darker winter months. The additional light encourages your brain to reduce the production of melatonin (the hormone that makes you sleepy) and increase the production of serotonin (the hormone that affects your mood). However, this is based on the assumption that the condition is caused by a lack of light and the effect that this has on the hormones that are released in your brain.

Research into light therapy

There is mixed evidence regarding the overall effectiveness of light therapy. It is difficult to compare the research that has been carried out in this area because a variety of light sources were used and clinical trials (medical tests) were often conducted over short periods of time. However, several studies have concluded that light therapy is effective, particularly if it is used first thing in the morning. It is thought that light therapy is best for producing short-term results. This may mean that it will help to relieve your symptoms but that you will still be affected by SAD next winter.

Side effects of light therapy

It is rare for people using light therapy to have side effects. However, in rare cases, you may experience:

mild agitation or irritability

headache

sleeping problems (avoid using light therapy during late evening)

Visit your GP if you experience any side effects while using light therapy.

nhsinform.scot - Seasonal affective disorder (SAD) - NHS inform

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