Carl Maronich (Host): Welcome to Expert Insights from Carl Foundation Hospital. I'm Carl Maroni, and joining me today is Dr. Van. Psychiatrist from Carl Foundation Hospital, And we're gonna be talking about seasonal effects on mood and specifically seasonal effective disorder. Doctor, welcome to the podcast.

Bienvenu Nzinga, MD: Thank you so much.

Carl Maronich (Host): Yes. Glad to have you here. And maybe we can start by having you explain just what Seasonal effective disorder is and how it affects people.

Bienvenu Nzinga, MD: season affective disorder can be defined as, Episodes of major depression or mania or hypomania with a season onset and remission. So the essential features is that onset And the remission of the mood episodes occur at a specific time of the years. So since, affective disorder, it's not a separate mood disorder, but a subtype of major DEET, depressive disorder or bipolar disorder.

Major depressive disorder with, uh, seasonal pattern especially, the winter onset seasonal pattern is the most common one that we have.

Carl Maronich (Host): And what are the most common symptoms of seasonal affective disorder?

Bienvenu Nzinga, MD: So, uh, clinical feature, of, seasonal affective disorder depends on the specific mood disorder That is present. As I said, it can be major depressive disorder or bipolar disorder. I would like to focus on, which is most, frequent or most common. As I said, major depressive disorder. with a seasonal pattern is the most concerned, most especially, the one that start, in winter.

So symptoms wise, it's almost the same, with, non-seasonal depression. But, we usually. Observe or notice a typical, features or symptoms, which include increase sleep, increase appetite, car cowboy, hydrate, cravings, And wait. Again, but beside, these, specific symptoms, we have this in general. depressed mood. we can have Adonia, which means loss of interest in the things that, the patient like to do.

We also can have other symptoms that include, disturb, sleep issues, difficulty sleeping, decrease appetite, difficult concentrating. low energy loss of, motivation and, depend on, the severity we can have also, for some patient suicide ideation.

Carl Maronich (Host): Doctor, what are, some of the treatments that are available for those suffering from seasonal effective disorder?

Bienvenu Nzinga, MD: Treatment is influenced by the severity of, illness based on, It can be. One, what we call monotherapy means just one medication or, combination therapy. in general, it's possible to use, medication. So we use, uh, antidepressant. So if it's not medication, it can be, light therapy. I can explain that.

so, if it's not light therapy, we could also, use, psychotherapy. So it's just a talk therapy that a lot of people call counseling. These three, treatment, it's possible. Focus on, a few things like, sleep hygiene. Make sure the patient has, good sleep, daily works outside, exercising. And in terms of medication, um.

As I said, antidepressant can be, SSRI or SNRI, but I would like to mention that for seizure affective disorder, it's possible also to use a specific medication. It's called opion or, because, studies, demonstrated. Efficacy in preventing recurrence and avoid SSRI, side effects such as weight gain or, sexual dysfunction.

But for while virtual bi propal, we need. To Sure the patient doesn't have any history of seizure or, some specific eating disorder like, anorexia or bulimia because while we can lower the, seizure threshold and increase the risk of seizure.

Carl Maronich (Host): Doctor, maybe you could talk a little more about light therapy and talk a little bit about how That is prescribed and how long someone might, sit in a. Light, or maybe you could just elaborate a little more on light therapy.

Bienvenu Nzinga, MD: So light therapy, usually we use, the light bug we like to use the one with 10,000. So, it's possible to get it, it's recommended to use it while the patient, is seated and facing the box, typically 16 to 31 inches. And it's recommended to use it in early morning.

it suggests to do that, 20 to 30 minutes in the morning. usually, after using, that, for, two to four weeks, A lot of patient's, they can, notice some benefit from using that in general by itself. For some patient's it works, but for other patient's, we need, to combine light therapy with other type of treatment.

Carl Maronich (Host): The light box differ from just going outside and getting in the sunlight.

Bienvenu Nzinga, MD: good question. we use it as I said, the most common, season affective disorder. It's, the one, started in winter. So we know that in winter time. sunlight. It's very, very, rare or and frequent. So it's why that, the reason also, when we, talk about, causes. we notice that, patient, because of, the change.

In, daylight. it's also possible that increase the risk of, season affective disorder. So it's, possible to be exposed to sign light, it'll be good. But, we know that, it's more, less frequent to have, sunlight during, the winter time.

Carl Maronich (Host): Doctor, what role does diet and exercise play in man Managing seasonal affective disorder.

Bienvenu Nzinga, MD: It's not just, for season, affective disorder. We know in general, for depression, exercising, diet, sleeping, all, can affect. Positively or negatively, our mood. So for someone who has, difficulty sleeping, it's possible that affect the mood. The same also for someone who's struggling or doesn't have, normal diet, not enough exercise.

It's possible also that affect negatively, the mood. So again, it's not just for seasonal effective disorder, but it's, mood in general. It's why, beside medication beside, Therapy. We also, usually in terms of, treatment, make sure the patient has a good, lifestyle, because we know that it can affect positively or negatively, the patient's mode.

Carl Maronich (Host): Doctor, are there long-term implications of untreated seasonal affective disorder?

Bienvenu Nzinga, MD: So long-term, season affective disorder. It's, A type of mood disorder that can happen every time. we have, uh, mood change, So, It can have for some patient. It can happen, every year. in general, depression, if it's not treated, it's possible that becomes more severe with, suicide ideation some patient can, go from a simple suicide ideation to, suicide attempt or complete.

so that will be a bad outcome. Beside that, each, depression in general, we know that, can affect, life, for someone who. Works, for example, depression. he's not going to be able to work and not working, or not being able to go to work means less income and more, financial issues And, For someone who struggle financially, it's possible also to have other, issues in life.

So it's. Better, it's recommending to take, any depression, or depressive, episode, seriously to make sure the patient is able or is, treated correctly in order to prevent, suicide attempt or any, negative impact in his life in general.

Carl Maronich (Host): Doctor, as we wind up here, let me ask, what advice would you offer to someone who suspects they may be suffering from seasonal affective disorder and hasn't yet gotten professional? Will help.

Bienvenu Nzinga, MD: my advice would be To seek help. Not necessary, to see psychiatrist I'm sure that a lot of, patient's, have, a primary care doctor. So it's, uh, my recommendation, to start with the primary care doctor to make sure that, The diagnosis is made and to make sure, also sure that beside, season affective disorder.

if, the patient doesn't have any other medical condition that also can, cause or make, depression worse. and, Any negative, effect on, his life? My recommendation, it's, at least to see, the primary care doctor and, a lot of time, a lot of primary care doctor are able to manage. Minor or moderate depression, And it's could be enough.

But in terms of when it's more severe, for a lot of primary care doctor, they prefer to refer, the patient to, uh, specialist,

Carl Maronich (Host): Yeah. Very good. So starting with your primary care doctor, always a good idea. Well, doctor Beyond Nu Zinga, you've offered a lot of great information. We appreciate, uh, you being part of the podcast today. For more information and to get connected to one of our providers, please visit carl.org.

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