At this time of year, I am often asked by patients about Seasonal Affective Disorder (SAD). This is a is a type of low mood or depression that is related to changes in the seasons. It typically begins and ends at about the same times every year. Most people with SAD experience symptoms starting in the Autumn that continue into the winter months.
Symptoms of SAD may include: - Feeling depressed most of the day, nearly every day - Losing interest in activities you once enjoyed - Low energy and fatigue - Sleep disturbances (oversleeping or insomnia) - Changes in appetite or weight (often craving for foods high in carbohydrates) - Feeling sluggish or agitated - Difficulty concentrating - Feelings of hopelessness, worthlessness, or guilt In more severe cases there can also be thoughts of self-harm, death or suicide. The causes of SAD are not fully understood but are believed to be related to the reduction in sunlight in Autumn and Winter. This decrease in sunlight may disrupt the body's internal clock and lead to feelings of depression. Reduced sunlight can also cause a drop in serotonin, a brain chemical (neurotransmitter) that affects mood, and affect the balance of melatonin, which plays a role in sleep patterns and mood. Patients also ask how can SAD be treated and the symptoms of SAD improved? - Get regular exercise. Exercise can help to improve your mood and sleep. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. - Eat a healthy diet. Eating healthy foods can help to boost your mood and energy levels. Aim to eat plenty of fruits, vegetables, and whole grains. - Get enough sleep. Most adults need around 7-8 hours of sleep per night. However, people with SAD may need more sleep than this. - Spend time outdoors. Even if it's cold, try to get outside for at least 30 minutes each day. Getting some sunlight can help to improve your mood and sleep. - Talk to a doctor or therapist. If you're struggling to manage your symptoms, talk to your doctor, therapist or local mental health team. They can help you to develop a treatment plan that works for you. - Self- Referral. Many parts of England allow you to refer yourself to local mental health services without requiring a referral from your doctor.
Dear Dr, I am writing to refer a 28-year-old male patient of mine, Mr [Patient's Name], for assessment for the diagnosis and treatment of Attention Deficit Hyperactivity Disorder (ADHD). After a thorough clinical assessment, I believe that Mr. [Patient's Name] meets the criteria for adult ADHD as outlined in NHS guidance for primary care teams in SE London. Mr [Patient's Name] has been under my care for XX years and, during this time, he reports several symptoms (greater than five symptoms in total) consistent with ADHD in adults that have been present for more than six months. These symptoms include difficulties in focusing, following through on tasks, hyperactivity, forgetfulness, impulsiveness, restlessness, and irritability. Mr [Patient's Name] also reports being easily distracted, struggling with time management, organisation, and completing tasks efficiently. Many of Mr [Patient's Name]'s symptoms have been present since he was under 12 years old; and have
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