There is sad, and there is SAD, the first being very normal and a feeling that occurs and disappears quickly. SAD is by definition a form of depression that starts in the beginning of fall and winter and is gone by spring and summer, Seasonal Affective Disorder, SAD. Even though the causes of SAD are not totally known, it is thought to be related to the body’s temperature and hormone regulation.

During the night, the pineal gland, located deep in the brain, produces melatonin which makes us sleepy. The production of melatonin stops when the sun rises. Melatonin is also said to have an affect on how other hormones in our body work. In northern Europe the winters are long and very dark, and especially if one stays indoors, one may not receive enough light to start the waking up process.

Many people receive light therapy, sitting in front of special lamps for long periods of the day. This helps, but if they discontinue treatment before the sun is back in the spring, symptoms reappear. The symptoms are much like those of other depressions

• Lack of energy
• Decreased interest in work or significant activities
• Feeling sad and pessimistic, crying
• Feelings that life is not worth living
• Increased appetite with weight gain
• Carbohydrate cravings
• Increased sleep, excessive daytime sleepiness
• Social withdrawal
• Lack of concentration
• Slower movement

As I mentioned in the beginning, feelings of sadness are normal. It can be a reaction to an event that is unhappy, stressful or traumatic. People, who feel sad because of reasons like these, will soon be able to put things in perspective and move on with their lives.

On the other hand, a person who is clinically depressed is unable to get past the grief and sometimes the feeling of sadness is for non-specific or vaguely defined reasons. To find out which is which and maybe the reason, professional help may be needed. Light therapy can help some people suffering from SAD, but it may also help for other depressions.

A certain while light can increase serotonin, which is also produced in the brain, and which is a known reason for depression when it is low.
What other treatments work for depression?

In mild to moderate depression, counselling or psychotherapy may be all that is needed. Included here will be advice on how to cope.

Regular exercise, such as aerobics done on a regular basis, can help ease symptoms of mild to moderate depression.

There are over-the-counter preparations that work for mild to moderate depressions. One of these is St. John’s Wort. Some side effects may occur, including sensitivity to sun, gastrointestinal problems and sometimes allergic reactions. You should therefore never start any medication before consulting your doctor.

If symptoms do not improve in a couple of months, and also in more severe cases of depression, medication may be recommended. Medication may be tablets that increase the serotonin level in the brain. I do not believe in medication without counselling at the same time.

Electroconvulsive therapy (ECT) is still used with good effect.
If the depression is so deep that there is a risk of suicide, medication or hospitalization may be necessary right away.

Treatment may take time, and to be considered recovered, the person should have returned to his or her usual ways of thinking, feeling and behaving for about four to six months.

To end this article with some optimism, I will say that treatment is successful in 80% - 90% of clinically depressed people. With questions, or for advice, please call me at 628 223 445.