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Five percent of Americans experience SAD in its “syndromal” form – where symptoms can severely impact a person’s ability to function, according to Dr. Norman Rosenthal, a clinical professor of psychiatry at Georgetown University School of Medicine and author of the book “Winter Blues.”

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“I struggled through until the spring, and then the energy came back. This happened for three straight years.”

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“There is evidence that brain serotonin varies seasonally, decreasing as the day length shortens. There is also evidence that bright light shining on the eyes gets transformed into nerve signals that stimulate serotonin transmission in parts of the brain responsible for regulating mood,” Rosenthal explained.

“One hypothesis is that these serotonin pathways are affected in people with SAD such that they don’t work as efficiently when there is not enough light around,” he added.

“We don’t know how mood is regulated by the brain, despite many decades of research. Consequently, we do not know what causes SAD,” said Dr. Paul Desan, associate professor of psychiatry and director of theWinter Depression Research Clinicat the Yale School of Medicine.

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“I think this is a major public health problem and most people still are very ignorant about treatment opportunities,” he said.

Because feeling crummier during the winter is such a commonplace experience, Desan thinks that can cause people to take SAD less seriously.

“But some people really do have very important changes in how they feel in the winter, and we really would like to get the word out,” he added.

For many SAD patients, bright light therapy is a very effective treatment. As little as 30 minutes of exposure per day makes a significant difference, Desan said.

“We advise people to be in 10,000 lux,” a measure of bright light comparable to being outside on a sunny day in July, he explained.

“It’s clear that the treatment is more powerful in the morning than at any other time of the day, so we recommend people do it as early as possible, and certainly before 8 a.m.,” he said.

“We advise people to do it seven days a week. With a few weeks of that kind of treatment, the vast majority of people with seasonal affective disorder are 100% better,” Desan added.

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In a 2019 study,Desan and colleagues tested 24 devices with three criteria in mind: they should produce at least 7,000 lux at a reasonable distance, they should still provide at least 5,000 lux if the user’s head moved 6 inches (15.2 centimeters) in another direction, and they should obtain an acceptable rating from users in terms of glaring and adequate diffusion.

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“The problem is the FDA doesn’t regulate these light devices,” Desan said. “That means a lot of companies have produced really crappy things that are really just a waste of people’s money,” he added.

If you have a retinal disease, or a medical condition like diabetes that can cause retinal disease, Desan recommends talking to your eye doctor before trying bright light therapy.

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He also emphasized the importance of staying active (exercising, going outside for walks during the daylight hours) and staying social.

“Don’t burrow in like a bear. Keep active and remember that how you behave is going to affect how you feel,” Rosenthal advised.

In any case, and especially if you are treating depression, you should consult with a mental health professional to get an accurate diagnosis and the best approach for you.

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