Cohen Medical Associates is a family medical center and research center located in Delray Beach, FL.
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Feeling SAD? What You Can Do About It

If you’ve been feeling lethargic, sleeping more, or losing interest in activities that used to spark joy, you may be suffering from SAD, or seasonal affective disorder. Our family practice doctors at Cohen Medical Associates frankly don’t like the acronym, because—while memorable—it is somewhat deceptive. It seems to make this major depressive disorder sound as though all you need is a day at the beach or a new hairstyle to perk you up.

SAD is more than just the “winter blues,” according to the American Psychiatric Association (APA). The symptoms can be distressing and overwhelming, and can interfere with daily functioning, the APA reports. Affecting more than five percent of Americans, seasonal affective disorder typically occurs during the winter months, lasts about 40 percent of the year, and seems to affect more women than men.



Even though Florida gets more sunlight than our neighbors farther north, we still receive less this time of year than during the summer months. And except for those brief periods of cold such as we experienced a few weeks ago, we also largely managed to escape the frigid winter weather.

So what could cause people in sunny Delray Beach to experience SAD? Unfortunately, no one is certain of the cause, although as many as 10 million Americans deal with the most severe symptoms every winter. Another 10-20 percent experience less severe symptoms. The APA says that SAD has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and less sunlight in winter.

Psychology Today reports that there is some evidence linking SAD to reductions in the body’s level of melatonin, a hormone secreted by the pineal gland that regulates the sleep cycle. Another theory ties SAD to a reduction in the levels of serotonin, a neurotransmitter that influences mood. This theory is reinforced by the fact that vitamin D helps regulate levels of serotonin, and the diminished sunlight in winter results in decreases in vitamin D, resulting in lower serotonin levels.

The cause of SAD may have an ancient survival connection as well, as humans learned to restrict activity when food sources were scarce. Of course, that’s not a problem today, but the tendency may still be hardwired into our biology, and people can experience symptoms on a sliding scale from barely noticeable to full-blown clinical depression.



The APA lists the following symptoms associated with SAD:

  • fatigue, even with excessive amounts of sleep
  • weight gain associated with overeating and carbohydrate cravings
  • feelings of sadness or depressed mood
  • marked loss of interest or pleasure in activities once enjoyed
  • loss of energy
  • an increase in restless activity (e.g., hand-wringing or pacing)
  • slowed movements and speech
  • feeling worthless or guilty
  • trouble concentrating or making decisions
  • thoughts of death or suicide or attempts at suicide.

SAD may begin at any age, but it typically starts when a person is between the ages of 18 and 30.



If you are experiencing any of the symptoms above, please let us know. It’s normal to feel down from time to time, but if your feelings last for days or weeks at a time and are interfering with your life, you may have SAD, and we can help. It’s also important to screen for other illnesses with similar symptoms, including hypothyroidism, hypoglycemia, infectious mononucleosis, and other viral infections.

SAD can be effectively treated in a number of ways, including through the use of light-box therapy, which employs specially built full-spectrum lamps to alleviate symptoms. Other approaches include antidepressants such as Paxil and Prozac, or cognitive behavioral therapy.


Meanwhile, there are steps you can take to help mitigate milder cases.

  1. Stay active, preferably outdoors

Exposure to early morning light has been shown to be the most effective at reducing symptoms, as has regular exercise. An early morning walk or run might be all you need to boost your spirits.


  1. Let in the light

If you can’t get outside, at least let the sunshine in as much as possible. Open blinds and drapes first thing in the morning, and keep them open all day. If you can, arrange your home or office so you’re exposed to as much sunlight as possible during the day (but remember that the sun’s harmful UV rays can penetrate glass, so use sunscreen if you’re actually sitting in the sun all day).


  1. Eat right

Simple carbs and sugars wreak havoc with your blood sugar, and hence, your mood. Lean meats, fruits, vegetables, nuts, and complex carbohydrates are what your body needs to keep your brain functioning properly.


  1. Stay connected

Studies have shown over and over that connecting with others helps improve mood: volunteering, getting together with friends and family, and participating in group activities, are some possibilities.

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