At this time of year, the night sky makes an early entrance. It also ushers in frigid temperatures and regular precipitation in many parts of the country.
The waning daylight keeps many people snuggled under covers or wrapped around a warm mug.
For some, the time to crawl out from beneath the blankets doesn't come. They are the sufferers of seasonal affective disorder, more commonly known as SAD, a condition tied to both clinical depression and the winter weather.
How SAD Changes People
Allison Buttram saw the effects of SAD significantly change her roommate, who was diagnosed in 1999.
"We had been best friends since we were younger," she said. "It took a toll on me, her, her boyfriend and all of our friends. She used to lock herself inside her room and never come out. Our apartment basically became split down the middle and she was a zombie the majority of the time."
Sufferers of SAD tend to feel the same lethargy and fatigue that many people experience during the winter months, but on a larger scale, says the Suicide and Mental Health Association International. Other common symptoms include depression, hopelessness, anxiety, social withdrawal, oversleeping, loss of interest in activities, an increased craving for sweets or starchy foods, and difficulty concentrating or processing information.
According to the Mayo Clinic, some rare cases of SAD can manifest themselves on the opposite side of the spectrum. Instead of depression, sufferers experience symptoms of mania. This can mean having a persistently elevated mood, increased social activity, hyperactivity or overexcitedness.
SAD can also appear for some during the summer months with similar symptoms.
What Causes SAD?
In 1984, psychiatrist Norman Rosenthal first began to study what was later to be called seasonal affective disorder. He published "Winter Blues: Seasonal Affective Disorder: What It Is and How to Overcome It," and in his research hypothesized that SAD was brought about by "a combination of factors including shortened daylight, stress and genetic vulnerability."
One of the most agreed upon causes revolves around a person's circadian rhythm. The circadian rhythm is what regulates the body's internal clock. The lack of sunlight in winter, combined with lower temperatures, is thought to disrupt this natural clock and trigger the body to rest.
Melatonin is another factor. The hormone that regulates sleep has commonly been tied to depression and production in the body kicks into higher gear in the winter months. Serotonin, the chemical in the brain that affects mood, also is considered a contributor. Lower levels of serotonin often lead to depression.
Do You Really Have SAD?
The American Academy of Family Physicians estimates that 4 to 6 percent of the population suffers from SAD and that it is four times more common in women than in men. Although the symptoms can be debilitating, many people don't recognize SAD as a disorder.
Psychiatric professionals actually consider it a subtype of bipolar disorder or depression. They may give patients a psychological evaluation and, according to the Mayo Clinic, look at three important components:
If you've experienced depression and other symptoms for at least two consecutive years, during the same season. If the periods of depression have been followed by periods without depression. If there are no other explanations for the changes in your mood or behavior. Many times, other types of depression can mimic SAD, so it can be tricky to diagnose. But similar to depression, SAD can also have complications with sufferers experiencing suicidal thoughts or substance abuse.
Buttram said her friend turned to drinking to cope with her problems and struggled to manage stress. Treatment is key to managing the disorder. She wasn't sure if her roommate ever ended up getting the help that she needed.
What's The Treatment?
Light therapy is perhaps the most widespread treatment plan for people with SAD, although it has yet to be approved by the Food and Drug Administration. Specially designed visors or boxes produce bright light of a particular spectrum, similar to that of an outdoor environment. Some patients sit for between 30 minutes and an hour, usually in the morning according to SMHAI.
With relatively few side effects and a success rate of about 65 percent, light therapy is a popular procedure to elevate mood.
Some people also may benefit from antidepressants or other medications. The FDA has approved the use of Wellbutrin for those with a history of SAD, and Paxil, Zoloft, Prozac and Effexor may also be used to treat symptoms.
Some psychotherapists work with SAD patients, even though it is thought to be more of a biochemical problem.
But whether it is a genetic, chemical or behavioral onslaught, health professionals say the key to coping with SAD is staying aware of the symptoms and seeking treatment.
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