Are SAD and Atypical Depression the Same?

Dr. McLeod,

Are Seasonal Affective Disorder and Atypical Depression the same disorder?  My psychologist tells me I suffer from SAD, but as I was reading your book, it sounds like I have Atypical Depression.  Confused. Help. Thanks.

CR

ANSWER

Dear CR,

Seasonal Affective Disorder (also known as SAD and winter blues) and Atypical Depression (AD) share many of the same symptoms.   These include depression, cravings for carbohydrates, a tendency to gain weight,  loss of energy, oversleeping, heightened sensitivity to rejection, social isolaltion, and difficulty concentrating.  SAD and Atypical Depression are different, however.  In SAD depression usually begins in the the late fall or early winter months, and lifts when spring arrives, whereas AD can occur at any time during the year. People with AD often complain of a heavingess of their arms and legs, referred to as leaden paralysis. AD often starts in the teenage years.

What causes these disorders? An imbalalce of chemical messengers (neurotransmitters) are thought to play a role in causing AD. If you have a biological family member with AD or alcoholism, you may be more suspectible to AD. Childhood physical and/or sexual abuse. and loss of a parent may predispose a person to AD.

The causes of SAD are not known for certain, but SAD is thought to be caused by a reduced amount of light which changes

• your biological clock (circadian rhythm) and lowers mood
•  serotonin levels, and  
• melatonin levels, which play a role in sleep regulation and mood.

What is the treatment for these conditions?

Phototherapy (light therapy) and medications (including melatonin) are often used to treat SAD. Psychotherapy and medications are used to treat AD. 

Based on a small amount of data, I think that chromium, as chromium picolinate, might be helpful in these disorders.  The FDA has not reviewed this claim.

I would be pleased to receive a followup from  you.

Malcolm McLeod, MD