Alternative Treatments for Seasonal Affective Disorder

Winter brings smiles to the faces of skiers, snowmobilers and ice fishers, but it can be a season of dread for people who get the blues as the days get shorter. They suffer from a type of depression known as Seasonal Affective Disorder or SAD. Although exposure to specially designed lights has been shown to help, University of Maine psychologist Sandra Sigmon and her students are working on new treatments to bring relief.

Previous studies have shown that up to 30 percent of the population may experience symptoms of SAD, but only 10 percent feels them so strongly that they need help. Women are four times more likely to suffer from SAD than men, notes Sigmon.

The symptoms include lack of energy, mood changes, sleep disruption, craving for foods rich in carbohydrates, weight gain and difficulty in making decisions. What distinguishes SAD from other types of depression, she adds, is the seasonal timing, the switch that flips as the leaves change color and clocks are turned back in the fall.

Lights are the first and only recognized line of defense against SAD, but they are effective for only about half to three-quarters of those who experience symptoms, says Sigmon. With non-seasonal forms of depression, psychologists have other techniques to use. They work with their clients to change behaviors involving, for example, exercise and social interaction. They try to modify thinking patterns that are related to moods, such as a common tendency to dwell on negative thoughts. There are also medications. For treatment of people with SAD, however, guidelines in current clinical practice do not recognize cognitive and behavioral treatments.

“There are very successful cognitive and behavioral treatments for non-seasonal depression. If SAD and non-seasonal types of depression are similar in the expression of symptoms, maybe we can extend those treatments to SAD,” says Sigmon.

In order to find out, Sigmon began conducting studies in 1995 with small groups of volunteers in the Bangor area. She divided people into four groups on the basis of whether or not they had experienced depression and, if so, what type and how severe it was. One group had no depression, and the other three groups had minor SAD symptoms, major SAD symptoms or non-seasonal types of depression.

Sigmon found that people with both types of depression benefited from keeping diaries that focused on negative thinking. The groups with minor SAD symptoms benefited less but fell in between the two depressed groups and the group without depression. These results led Sigmon to apply cognitive and behavioral treatments that had been used for people with non-seasonal depression to individuals that had SAD.

Although she cautions that the studies need to be repeated with larger groups of subjects, she says that the results show that cognitive and behavioral treatments do work for people with SAD. Volunteers with minor and major SAD symptoms showed improvements after receiving both the cognitive and behavioral treatments. The extent of the improvements, she adds, was similar to the benefits of conventional light therapy.

In addition, there may be an added benefit in combining these treatments with light therapy. Kelly Rohan, a former student of Sigmon's who is now on the faculty at the Uniform Services University in Maryland, continues to do SAD research. She has found that individuals who received both forms of treatment had a slight advantage over those who received only one type of treatment.

Two of Sigmon's current graduate students, Nina Boulard of New York City and Stacy Whitcomb of Newburgh, Maine, are now doing SAD studies as part of their Ph.D. degree programs. Boulard is focusing on the relationship between SAD and activity levels. Whitcomb is looking at cognitive aspects of SAD. Volunteers in both projects are recording activities and thoughts in a diary at home and providing that information to the researchers. Boulard and Whitcomb hope to complete their studies in 2002.

In addition to the benefits for treatment, UMaine SAD studies are contributing evidence for a broader understanding of depression. The results suggest that SAD may be a disorder that lies between good mental health on one end and other forms of clinical depression on the other, Sigmon suggests. “A lot of individuals experience changes with the seasons, some people very little and some people a little more. There is a seasonal component to all of these groups,” she says,

Sigmon says that the results with SAD sufferers will have to be confirmed in larger studies before psychologists will begin to adopt alternative treatments.

Researchers in the Department of Psychology are working on a wide variety of mental health issues ranging from how the brain works to the effects of aging on cognitive function.

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