If you find that you cannot manage your SAD symptoms yourself, or they are starting to have a significant impact on your day-to-day life, you might find it helpful to talk to your GP. They will be able to give you further information and discuss treatment options with you.
Your doctor should discuss all your treatment options with you, and your views and preferences should be taken into account when making decisions about your treatment. Treatments include:
You may want to discuss your treatment with your GP regularly, particularly if symptoms worsen or do not improve after trying different options.
Talking treatments, such as counselling, psychotherapy or cognitive behavioural therapy (CBT), can be extremely useful in helping people to cope with SAD symptoms. They can also help you recognise and deal with other factors that may be contributing to your symptoms.
Your GP should be able to give you information about talking treatments and refer you to a local practitioner. Waiting times for talking treatments on the NHS can be long, so you may choose to see a therapist privately. The British Association for Counselling and Psychotherapy (BACP) maintains a list of accredited practitioners. Some offer a reduced fee for people on a limited income.
Antidepressant drugs work by increasing the activity of particular brain chemicals, such as noradrenaline and serotonin, which are thought to be involved with managing your moods. They don’t cure SAD but can help you cope better with some of the symptoms.
If you are offered antidepressants, you will usually be offered SSRI (selective serotonin reuptake inhibitor) antidepressants, such as paroxetine (Seroxat), citalopram, sertraline (Lustral) and fluoxetine (Prozac). SSRIs have been shown to be effective in treating severe cases of SAD but are not recommended as a treatment for mild or moderate SAD. They can be combined with light treatment and taken seasonally, so they have more effect during the winter. SSRI antidepressants have to be taken for around two to six weeks before becoming effective, so you may want to start taking them a few weeks before your symptoms usually begin to get the maximum benefit.
Occasionally you may also be offered older antidepressants, such as amitriptyline, imipramine and dosulepin, but these are not usually prescribed because they can increase symptoms like sleepiness. All antidepressants can cause side effects, so it is important to discuss these and the possible benefits of taking them with your GP before starting treatment.
St John’s wort
St John’s wort is a popular herbal remedy that some people find helpful to deal with mild or moderate symptoms of SAD. However it may not be suitable for severe SAD or if you use a light box because it can make your skin very sensitive to light.
You shouldn’t take St John’s wort if you are taking prescription antidepressants. You should also seek advice from your GP or pharmacist before using it with any other medication, as it can interfere with their effects.
Bright light therapy
Although you can use a light box to increase your light exposure yourself, in some cases, a more structured course of light therapy supervised by a medical professional may be useful.
While light therapy is recommended by the National Institute for Health and Care Excellence (NICE) for SAD, it is not usually available on the NHS. If it’s not available in your area, a private health company may be able to provide it. Your GP should be able to advise you about what you can access in your area.
Specialist SAD services
If you require more intensive support, your GP may refer you to a psychiatrist or service that specialises in treating SAD.
Unfortunately, there are only a few NHS clinics specifically for SAD available, so it can be difficult to get a referral and you may have to wait a long time for an appointment.
This information was published in June 2016. We will revise it in 2019.