Bupropion (Wellbutrin XL) is the first drug approved by the Food and Drug Administration for the prevention of seasonal affective disorder (SAD), or winter depression.
Every year, about 5 percent of Americans, three-quarters of them women, experience SAD, according to Consumer Reports. But do you really need medication to prevent or treat it?
Some of the symptoms of winter depression are similar to those associated with other types of depression: sadness, fatigue, excessive sleepiness, social withdrawal and trouble concentrating. But people with SAD also tend to move slowly, crave carbohydrates and gain weight. They're also less likely than people with conventional depression to have feelings of worthlessness or thoughts of suicide. The nonprofit Center for Environmental Therapeutics has an online questionnaire at www.cet.org that can help you determine whether you have the disorder.
While people who live in a warm and sunny climate can get SAD, it occurs most often in people who live in northern latitudes, where winter days are shorter and darker. For example, about 10 percent of the people living in Alaska experience symptoms of SAD, compared with only 1 percent of people in Florida, where the sun shines for more hours in the winter.
GlaxoSmithKline, the manufacturer of Wellbutrin, and the first to conduct research on preventing SAD, found that 16 percent of people who took bupropion every day through the winter developed the disorder, compared with 28 percent who took a placebo. Although Wellbutrin wasn't any better at treating SAD than other common antidepressants, it might carry less risk of sexual side effects than another type of antidepressants, SSRIs, which includes Zoloft and its generic version.
However, Consumer Reports recommends trying available nondrug treatments before trying medication or other treatments. For mild cases, doing 60 minutes of outdoor aerobic exercise in the morning might bring some relief.
For more persistent cases, there's strong evidence that spending 30 minutes every morning in front of a lamp or a light box that simulates bright white daylight, ideally within 10 minutes of waking, can help. The light box should provide at least 10,000 lux (a measure of light intensity) and give off white, not blue, light. Most light boxes are sold online and cost about $200.
Canadian researchers recently found that light therapy was as effective as the antidepressant fluroxetine (Prozac and its generic version) in reducing symptoms of winter depression. Light therapy was also found to work faster, usually within four to seven days, compared with the four to six weeks it takes for antidepressants to become effective.
Other treatment options include cognitive-behavioral therapy, in which you learn to ward off negative thoughts about the season and engage in enjoyable activities. That kind of therapy might also help prevent a recurrence.
Interestingly, people who have the disorder once do not necessarily get it every year. Those who have experienced winter depression might have a year where the symptoms are less severe or don't show up at all. The best strategy is to watch for early-warning signs, including fatigue, oversleeping, carbohydrate cravings and weight gain. These signs tend to creep up weeks before your mood actually plummets, which gives you time to start medication if you need it.