SAD Test and Diagnosis & treatments and drugs

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Tests and diagnosis
By Mayo Clinic Staff

To help diagnose seasonal affective disorder, your doctor or mental health provider will do a thorough evaluation, which generally includes:
•Detailed questions. Your doctor or mental health provider will ask about your mood and seasonal changes in your thoughts and behavior. He or she may also ask questions about your sleeping and eating patterns, relationships, job, or other questions about your life. You may be asked to answer questions on a psychological questionnaire.
•Physical exam. Your doctor or mental health provider may do a physical examination to check for any underlying physical issues that could be linked to your depression.
•Medical tests. There’s no medical test for seasonal affective disorder, but if your doctor suspects a physical condition may be causing or worsening your depression, you may need blood tests or other tests to rule out an underlying problem.

Seasonal affective disorder is considered a subtype of depression or bipolar disorder. Even with a thorough evaluation, it can sometimes be difficult for your doctor or mental health provider to diagnose seasonal affective disorder because other types of depression or other mental health conditions can cause similar symptoms.

To be diagnosed with seasonal affective disorder, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.

The following criteria must be met for a diagnosis of seasonal affective disorder:
•You’ve experienced depression and other symptoms for at least two consecutive years, during the same season every year.
•The periods of depression have been followed by periods without depression.
•There are no other explanations for the changes in your mood or behavior.

TREATMENTS & DRUGS

Treatments and drugs
By Mayo Clinic Staff

Treatment for seasonal affective disorder may include light therapy, medications and psychotherapy. If you have bipolar disorder, your doctor will be careful when prescribing light therapy or an antidepressant. Both treatments can potentially trigger a manic episode.

Light therapy

In light therapy, also called phototherapy, you sit a few feet from a specialized light therapy box so that you’re exposed to bright light. Light therapy mimics outdoor light and appears to cause a change in brain chemicals linked to mood.

Light therapy is one of the first line treatments for seasonal affective disorder. It generally starts working in two to four days and causes few side effects. Research on light therapy is limited, but it appears to be effective for most people in relieving seasonal affective disorder symptoms.

Before you purchase a light therapy box or consider light therapy, talk to your doctor or mental health provider to make sure it’s a good idea and to make sure you’re getting a high-quality light therapy box.

Medications

Some people with seasonal affective disorder benefit from antidepressant treatment, especially if symptoms are severe.

Antidepressants commonly used to treat seasonal affective disorder include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor).

An extended-release version of the antidepressant bupropion (Wellbutrin XL) may help prevent depressive episodes in people with a history of seasonal affective disorder.

Your doctor may recommend starting treatment with an antidepressant before your symptoms typically begin each year. He or she may also recommend that you continue to take antidepressant medication beyond the time your symptoms normally go away.

Keep in mind that it may take several weeks to notice full benefits from an antidepressant. In addition, you may have to try different medications before you find one that works well for you and has the fewest side effects.

Psychotherapy

Psychotherapy is another option to treat seasonal affective disorder. Although seasonal affective disorder is thought to be related to brain chemistry, your mood and behavior also can add to symptoms. Psychotherapy can help you identify and change negative thoughts and behaviors that may be making you feel worse. You can also learn healthy ways to cope with seasonal affective disorder and manage stress.

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