According to the World Health Organization, more than 300 million people across the globe have depression, making it the leading cause of disability worldwide. Yet, less than half of those affected around the world receive treatment even though there are known, effective treatments for individuals with depression. In many countries, fewer than 10% of those with depression receive treatment. Although a lack of trained mental health care providers, misdiagnosis, and a lack of resources play a factor, social stigma associated with mental health disabilities plays a large role in the lack of treatment for individuals with depression. Stigma plays a role, not just in the treatments offered to people with depression, but also in how often people with depression avail themselves of treatments available to them.
One form of depression that effects many people but is often misunderstood is Seasonal Affective Disorder (SAD), also sometimes referred to as a major depressive disorder with a seasonal pattern. According to the National Mental Health Association, it is estimated that 10 million Americans have SAD. SAD is usually identified as a form of depression that is recurring when the seasons change. The disability includes symptoms such as depression, anxiety, changes in mood and appetite, problems sleeping and social avoidance typically beginning in the fall and continuing through the winter months. Although it is less common, some people do experience SAD during the summer months. Summertime SAD symptoms include agitation, a feeling of restlessness or being unable to relax, problems sleeping, and unexplained lack of appetite leading to weight loss.
Although Seasonal Affective Disorder is recognized by the National Institute of Mental Health and is diagnosed only when people meet full criteria for major depression coinciding with specific seasons for at least two years, many people treat SAD as if it is a joke or laugh when people share that they are affected by this disability. Individuals who are diagnosed with SAD experience changes in their symptoms based on changes in the seasons and will begin to see a pattern emerge each year that is unconnected to any emotional event. Additionally, research has yielded some biological commonalities for people who are diagnosed with SAD. These include trouble regulating neurotransmitters involved in serotonin during winter months, overproduction of the hormone melatonin, and insufficient levels of Vitamin D.
What does this mean? According to the National Institute of Mental Health:
- People with SAD typically see a 5% increase in serotonin transporters during the winter months, leaving less serotonin available. Serotonin can affect a person’s mood.
- Darkness increases production of the hormone melatonin which regulates sleep and leads to a lethargic feeling.
- Vitamin D is believed to play a role in serotonin activity. The insufficient levels of this vitamin may be linked to symptoms of depression.
Just as with other non-visible disabilities, although SAD may not be something that you can see, it is very real for the person experiencing it. As with other mental health disabilities, this is not something that the people experiencing can just ‘shake off’ or ignore. The symptoms of major depression that people with SAD experience, stay with them almost constantly throughout the season in which they are affected. These symptoms have a very real impact physically, emotionally, and socially and it is not uncommon for people with SAD to have recurring thoughts of suicide. For people who experience SAD, as well as other mental health disabilities, it is important that they receive the support they need to manage their disability. Unfortunately, due to ignorance and stigma associated with mental health disabilities, many people do not receive or stay with treatment.
As we are approaching the winter solstice, or the shortest day of the year (December 21, 2018), you may have employees approach you about accommodations for SAD. Most people with SAD are treated through medication and light therapy. It is important to understand that people with SAD may feel fatigued, have trouble concentrating, or feel additional stress during this time. Accommodations for this disability are typically low cost and will allow for an increased feeling of concentration and productivity, creating a positive impact for both the employee and the company.
According to the Job Accommodation Network (JAN), the following light treatment products are possible accommodations for employees with SAD:
- Light Boxes
- Light Visors
- Desk Lamps (resemble typical office lamps)
- Dawn Stimulators
Some additional accommodations to consider, based on the needs of the individual and what is appropriate for the job role, could include:
- Being placed by a window where sunlight is available
- Being switched to a daylight shift
- Modifying break schedule
- Telework
- Using apps for concentration or task management
- Developing checklists
- Environmental sound or white noise machine
- Noise canceling headsets
- Simulated skylights and windows
- Providing written instruction
- Task rotation
- Stand-lean stools
- Ergonomic assessments and equipment
- Anti-fatigue matting
Supporting employees with disabilities with accommodations provides the foundation for a welcoming environment allowing people with disabilities the opportunity to perform to their potential.