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Psychology & Psychiatry
April 2, 2010

Lawsuits Shed Light on Seasonal Depression

By Jennifer Gibson, PharmD | 1 Comment | 
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Winter Snow

Many people get a little melancholy as the winter months take away sunshine and warm weather. But, for some, the winter blues become a serious case of depression. Recent lawsuits have designated this recurrent seasonal depression, or seasonal affective disorder (SAD), as a disability that requires accommodation by employers. However, these rulings are provoking renewed questions about the validity of the disorder entirely.

Lawsuits complaining that SAD sufferers oblige employers to adjust work schedules, change work locations, or provide access to treatment are an increasing, and controversial, trend. For example, cases have been brought by a teacher who was assigned to teach in a classroom without windows and an office worker who needs a light-therapy lamp at her desk and more time off for doctor’s appointments. The plaintiffs in the SAD cases often claim that their employers did not recognize SAD as a legitimate medical condition or disability that required accommodation in the workplace, sometimes despite notes from physicians explaining otherwise.

SAD symptoms, which most often appear as the hours of daylight get shorter and subside when spring blooms, include oversleeping, fatigue, increased irritability, decreased stress tolerance, and decreased interest in daily activities. These predominantly general symptoms, and the psychometric tools used to diagnose SAD, are vague and apply to a myriad of depressive and psychological disorders. Some researchers argue that singling out one subtype of depression in this way is not a valid concept. A recent study found that the Seasonal Pattern Assessment Questionnaire (SPAQ), a common diagnostic tool, overestimates the prevalence of SAD.

To further compound the controversy, no link has been found between populations living in northern latitudes or climates with a complete lack of sunlight during winter months and an increase in the prevalence of SAD, calling into question whether the whole concept of SAD is an invention of the modern western world. SAD is not a unique diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

So far, no one has been able to define the cause of SAD. Hypotheses suggest that melatonin, with its central role in maintaining circadian rhythms, or serotonin or catecholamine, both neurotransmitters linked to other depressive disorders, may be involved in the development of SAD. Currently, effective treatments are available for SAD, including psychotherapy, antidepressants, and light therapy.

So when does the gloominess of winter become a disability? Even without a diagnosis of SAD, most people would enjoy time off of work to go outside, a workspace with an abundance of natural light, or a physician’s order to take a vacation to a sunny climate. Still, most of the half million people in the United States that suffer from recurrent seasonal depression can survive the winter months without bringing a lawsuit against their employer. But, in this litigious age, employers are wise to accommodate employees who make claims of discrimination, whatever the disability.

References

Brancaleoni G, Nikitenkova E, Grassi L, Hansen V. Seasonal affective disorder and latitude of living. Epidemiol Psichiatr Soc. Oct-Dec 2009;18(4):336-343.

Gagne AM, Bouchard G, Tremblay P, Sasseville A, Hebert M. [When a season means depression.]. Med Sci (Paris). Jan;1(26):79-82.

Hansen V, Skre I, Lund E. What is this thing called “SAD”? A critique of the concept of Seasonal Affective Disorder. Epidemiol Psichiatr Soc. Apr-Jun 2008;17(2):120-127.

Steinhausen, H., Gundelfinger, R., & Winkler Metzke, C. (2009). Prevalence of self-reported seasonal affective disorders and the validity of the seasonal pattern assessment questionnaire in young adultsFindings from a Swiss community study Journal of Affective Disorders, 115 (3), 347-354 DOI: 10.1016/j.jad.2008.09.016

Workplace Accommodations for Seasonal Affective Disorder. AHI’s Employment Law Today.

Jennifer Gibson, PharmD

Dr. Gibson is a practicing clinical pharmacist and freelance medical writer and editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. Her clients include academic research institutions, international authors, pharmaceutical companies, professional organizations, and public advocacy groups.

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1 Response

  1. Dirk Hanson says:
    April 3, 2010 at 8:44 am

    This so clearly involves melatonin that it is hard not to speculate that SAD fits under the umbrella of serotonin-mediated disorders like depression, bulimia, addiction, PMS, pathological shyness, etc. It would be interesting to find out whether those groups (depressives and addicts and bulimics) have a higher rate of SAD. I’m guessing they do.

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