Alazne Díez: "Some people are very affected by the shorter days".

The psychologist Alazne Díez, from Loratu Psicología, talks to us about seasonal affective disorder.

Mood disorders, a group of different psychopathologies that have in common the fact of producing emotional imbalances, have their most famous and popularly known representative in what we usually call "depression".

However, beyond clinical depression (also known as major depression) there are other disorders capable of making us feel sad and down, such as, for example, the seasonal affective disorder.

In this interview to the psychologist Alazne Díez we will know the characteristics of this emotional alteration of the hand of an expert in the topic.

Interview to Alazne Díez: what is and how does the seasonal affective disorder arise?

Alazne Díez Abad is a psychologist and Director of the Loratu Psychology Centerlocated in Bilbao. This professional has been attending adults with emotional problems for many years, and one of the most curious is the one that occurs through the so-called seasonal affective disorder. In this interview we asked her about this psychological disorder.

What is seasonal affective disorder and how does it differ, for example, from the simple sadness of leaving behind a season that we like?

Seasonal affective disorder (SAD) is characterized by the appearance of depressive episodes at a certain time of the year, with these episodes subsiding when the season ends. It usually occurs in late autumn and disappears with spring and, although less frequently, there are people affected in the summer months.

The prevalence is between 1 and 10% of the population, especially in women with family members with a history of depression, including SAD. In addition, people whose origin coincides with northern latitudes are at greater risk of having this disorder, as daylight hours are reduced (as in Finland, for example).

The difference with the sadness of leaving behind a pleasant season lies in the severity of the symptomatology and in the fact that the episode is systematically repeated every year on the same dates for at least two years. Moreover, it is not a nostalgic or sad day, but rather a continuum of months with something more complex to manage than a sadness.

And what differentiates it from major depression, and is its severity considered comparable to that of major depression?

In major depression the symptoms must be present for at least two weeks. The main difference is that in SAD the symptoms remit when the season ends, while in major depressive disorder remission is not frequent without psychological, pharmacological or combined treatment.

SAD can be considered as a specifier within depressive disorders and not so much as a separate or specific mood disorder; although we usually call it so. It is, therefore, a major depressive disorder with a seasonal pattern, where no major depressive episodes occur outside that period.

It is complicated to speak of severity, since in both cases the person has a significant clinical malaise that hinders and has repercussions at a personal, social and/or occupational level. It could be said that the diagnosis may be more difficult to identify in SAD or that the person resorts to psychological help when having later remission.

Likewise, treatment should include elements such as vitamin D, melatonin and adaptation to new light cycles, in addition to psychological issues. SAD can also be associated with other disorders, such as bipolar disorder, so it is important to pay attention to the pattern in order to prevent some hypomanic episodes, for example.

How can this psychological disorder influence the personal relationships of the person who develops it? For example, in family life, in relationships with friends, etc.

People with this type of mood pattern often experience interference in family, social and/or work life. In addition, since it begins in a certain season, we could say abruptly, the environment usually identifies the changes as well.

Each person may have different alterations but, in general, may appear apathy or irritability, increased sensitivity even with a tendency to cry, less interest in social relationships or activities. As with other mood problems, both the person and his or her environment perceive a significant change in personality and functioning from earlier times. In addition to this, the environment may also notice a sadder appearance, such as a duller look.

And how does it usually affect the work environment?

At the work level, concentration and/or memory problems may appear. The depressive state in which he/she finds him/herself can affect work performance or we can identify, for example, failures or absent-mindedness that are not usual in that person. In addition, it may be more difficult to start tasks or finish them, a feeling of guilt or uselessness when noticing failures or not performing adequately or noticing fatigue.

What are some of the most recurrent complaints or thoughts that characterize the mental state of people with seasonal affective disorder, when this disorder is expressing its symptoms?

As it is considered more of a subtype within the affective disorders, the predominant symptomatology or complaint will depend mostly on the underlying depressive disorder. The symptoms resemble those that a person with major depressive disorder might have: sadness for much of the day (crying may occur), lack of energy or vigor and tiredness, changes in weight, appetite and/or sleep, loss of interest and enjoyment in previously satisfying activities, anxiety or restlessness, feelings of hopelessness, worthlessness, emptiness, etc.

Given that seasonal affective disorder is linked to the passing of the seasons and these are characterized by changes in daylight hours and temperature, are these two variables considered to be related to the causes of this psychopathology?

Yes, the fact that the days are shorter and we have fewer moments of light affects some people in a very noticeable way at a physical and psychological level.

One of the explanations, in addition to genetic vulnerabilities, has to do with the ability of circadian cycles to adapt to these new, shorter periods of light. This influences the duration and onset of sleep.

In addition, the efforts of our organism and our psychic apparatus to adapt also happen at the physiological level, altering the functioning of serotonin (related to mood) and melatonin (related to sleep). What for some may last a couple of weeks until the mind-body adapts, for others constitutes the beginning of SAD lasting for the rest of the season.

What can be done in psychotherapy to help people who suffer from having developed seasonal affective disorder?

The first thing is to become aware of it. If we know that at the beginning of the winter months we begin to feel worse, we also have the opportunity to have adequate medical and psychological assistance during that period.

It is possible that in addition to the Biological issues mentioned above, where work on routines and sleep habits, for example, can produce changes, there are also other psychological factors that can influence and can be worked on (such as memories or nostalgia for loved ones during the Christmas season, more accentuated distorted thoughts, pessimism, etc.).