They may increase their sleep by several hours, gain many pounds, feel sluggish and asocial. Women with SAD often suffer a worsening of premenstrual symptoms. However, all these troubles are relieved with the coming of longer days, and more light - some even experience a hypomanic or manic summer state.

For treatment, Dr. Michael Terman of the Winter Depression Program at the New York Psychiatric Institute told us that "current evidence strongly favors exposure to bright light in the morning." This is known as Light Therapy - exposure to intense levels of light under controlled conditions.

Dr. Terman cautions that it is difficult to quantify success rates across studies that have used different intensities and durations of light, but, estimates that "about 80% of people with simple winter depression show significant benefit from Light Therapy... almost 50% [of sufferers] experience complete remission."

The most common form of treatment is via a light fixture that gives off bright, diffused light. The individual sits in front of this light box, which contains broad-spectrum flourescent lamps behind a diffusing screen, for a session of 15 minutes to one hour, once or twice a day. One need not look directly at the light, but read, write, eat, or carry on other activities while facing the light fixture.

This treatment has few, if any, side effects, and those often abate on their own. Most common complaints are of mild nausea, headaches, eyestrain, irritability or overactivity. These are usually mitigated by adjusting the duration, intensity, and/or time of day of treatment. Light therapy has been in use since the mid-80s and there are no known side-effects to long term use.
 
There are several manufacturers who produce light boxes in various models. The price runs $375-$500. This may be reimbursed by insurance, with the proper diagnosis and prescription from a physician, although coverage is unpredictable. (Please note that tanning lights or "grow lights" should not be used as their ultraviolet levels can be harmful. Home-made light fixtures are also often dangerous.)

Other strategies for managing SAD include use of antidepressants. (Dr. Terman, however, considers that the benefit over placebo from the use of SSRI's is slight.) For those severely afflicted, it may be necessary to relocate  closer to the equator.

Dr. Terman is currently overseeing two NIH 5 year trials of possible new treatments. One is a dawn simulator, which differs from those currently commercially available. The other is the use of High-Density Negative Air Ionization. Part of the appeal of this treatment is that it is administered as the patient sleeps, and, may perhaps be effective for those who find Light Therapy is not helpful.

According to the Center for Environmental Therapeutics, Inc., there are measures you can start before winter, to help prevent these doldrums: Get outdoors for at least 30 minutes during the day; increase the general light level indoors; eat complex carbohydrates (whole grains) instead of foods with simple sugars (sweets, refined grains); avoid dehydration - drink water; exercise, outdoors if possible; monitor your moods to be aware of patterns that may connect to the seasons, medications, and/or changes in diet; be gracious to yourself.

These measures behoove anyone, and may be sufficient to manage a mild case of SAD. However, if you seem seriously impaired in mood on a seasonal basis, seek treatment. Contact NAFDI for further information.