Washington (H24N). Ahh – the smell of morning dew, and the chill in the air as children rush off to start the new school year often bring relief to many parents who entertained them through the summer. But, for some Americans, this back-to-school time can mark the start of feelings of depression and loss.

Starting as early as the final days of August to early September and persisting until the beginning of spring, seasonal affective disorder (SAD) or "winter depression" affects 10 million Americans.

According to the American Academy of Family Physicians (AAFP) four to six of every 100 people may have winter depression, and another 10 to 20 percent may have mild SAD. SAD is four times more common in women than in men, and although some children and teen-agers get SAD, it usually doesn’t start in people younger than 20. The risk of SAD decreases as one gets older.

Several symptoms are associated with winter depression: changes in appetite, especially a craving for sweet or starchy foods; weight gain; a heavy feeling in the arms or legs; a drop in energy level; fatigue; a tendency to oversleep; difficulty concentrating; irritability; increased sensitivity to social rejection; and avoidance of social situations.

SAD has also been found to be more common the farther north you go. For example, it’s seven times more common in Washington state than in Florida. This is not surprising since winter depression may be associated with lack of sunlight.

In fact, one of the treatments for SAD is light therapy. This type of therapy uses a specially made desk-type light box or a light visor that patients wear on their head like a cap. For 30 minutes a day, patients sit in front of the box or wear the cap.

Three studies published in the October 1998 issue of Archives of General Psychiatry concluded that such light therapy is most effective when administered immediately upon waking in the morning.

In an accompanying editorial, David H. Avery, M.D., of the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, wrote, "All three studies add to the literature suggesting that morning bright light is superior to evening bright light, a good control condition. Together, the placebo-controlled trials and morning-vs-evening studies strongly support the efficacy of morning bright light in the treatment of SAD and help establish bright light therapy as a first-line treatment for SAD."

According to the AAFP, when used properly, light therapy seems to have very few side effects. Side effects include eye strain, headache, fatigue, irritability and inability to sleep (if light therapy is used too late in the day). Caution is required with light therapy in people with manic depressive disorders, skin that is sensitive to light or medical conditions that make their eyes vulnerable to light damage.

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