Dr. Ralph Parker Fader IV, MD

We don't yet know what causes depression, but it's thought that it is a combination of genetic, biological, environmental, and social influences. Because of this, the most effective treatments for depression combine medication with psychotherapy. Therapy, especially cognitive-behavioral therapy, can be extremely helpful in resolving the negative thoughts and feelings that come with depression. It gives patients new tools that they can use themselves to cope when their depression is making them feel down.

Some of the common medications used to treat depression include antidepressants such as SSRI's (Prozac, Paxil, Zoloft) or atypical antidepressants (Cymbalta, Wellbutrin). It's important to remember that these medications have different effects on everybody, and no one medication works right for everyone. Patients may have to try a couple before finding the one that works just right for them. If the first medication they try doesn't work, they should talk to their doctor about trying something else. In extreme cases where medication is not enough, electro-convulsive therapy and hospitalization may be the answer to keeping a severely depressed person safe.

Depression is a difficult illness to deal with, but it is more common than believed and there are many people who can help. With the right treatment, individuals with depression can get back to fully enjoying life again.

Healthcare providers are working to provide more inclusive care for people of all sexual orientations and identities. Some choose to address LGBT issues through procedures such as chest reconstruction, facial feminization surgery, masculinization surgery, and glottoplasty (surgery to raise the pitch of one's voice). Sensitive OB-GYN care and hormone therapy may also be options for people with LGBT issues.

LGBT therapy can also help people navigate LGBT issues and mental health problems. LGBT affirmative therapy specializes in creating "affirmative" spaces for people who are LGBT. LGBT affirmative therapists use patients' preferred pronouns, address homophobia and social biases, and act as LGBT advocates in their talk therapy sessions.

Young adults ages 18 to 30 are most commonly diagnosed with SAD. For unknown reasons, more women have SAD than men. Those who have a preexisting mood disorder, mental illness, or live in a region with cloudy and dark weather are also more likely to have SAD. People with SAD may experience:

• Feelings of hopelessness
• Fatigue
• Daytime exhaustion
• Loss of interest in activities
• Weight gain
• Social withdrawal
• Oversleeping
• Headaches
• Increased desire for carbohydrates
• Difficulty focusing

The causes of seasonal depression are uncertain. It is suggested that the reduced daylight and sunshine of winter and fall can alter the chemistry of the brain. Sunlight may assist in the production of serotonin, a hormone that regulates mood and happiness. Less exposure to sunlight may result in decreased serotonin, leading to SAD. Other potential causes include disrupted circadian rhythms, vitamin D deficiency, and increased melatonin (sleep hormone).

A variety of treatments are used to alleviate SAD. Patients usually benefit from more than one treatment. Light therapy is a special lamp that lets off intense light. The therapy is performed at home with patients keeping the lamp a few feet away from them as they complete their regular activities. Two types of light therapy include the light box (consistently bright lamp) and the dawn simulator (lamp that gradually becomes brighter and brighter). Light therapy may be partnered with other treatments for SAD, such as:

• Antidepressant medication
• Increased sunlight exposure
• Vitamin D supplements
• Psychotherapy

SAD is more than feeling disappointed by shorter winter nights or rainy days; it is months of depression that can drastically influence mood and behavior. Fortunately, people with SAD typically respond quickly to consistent light therapy and other treatments. Self-care and relaxation are also vital to the SAD recovery process. For those with SAD, treatment can be the first step to making four or five months of the year enjoyable once again.