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Comprehensive, collaborative care is key to treating SAD in Arizona

Seasonal Affective Disorder can occur any time of year

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As primary care physicians, we diagnose and treat depression and anxiety daily. One disorder that isn’t discussed as much and is underdiagnosed is SAD — Seasonal Affective Disorder.

SAD is a type of depression that occurs at specific times of the year, typically during winter months when there is less natural sunlight. It is characterized by symptoms such as low energy, difficulty concentrating, changes in sleep and appetite, feelings of hopelessness and a general lack of interest in activities.

SAD affects a significant portion of the population, particularly in regions farther from the equator, where the reduction in daylight is more pronounced during the colder months. While the exact causes of SAD are not fully understood, it is believed that disruptions in circadian rhythms and imbalances in neurotransmitters such as serotonin may play a role.

Arizona is ranked 47th in the country for seasonal depression. While SAD is more prevalent in the state during the summer — when heat keeps many residents indoors — people can experience it any time of year.  HealthyU Clinics uses a collaborative care model, which involves coordination between a primary care provider and behavioral health specialists. This can be particularly effective in addressing this complex disorder.

A collaborative care model brings together a team of health care providers to deliver comprehensive and coordinated care to patients. This approach is beneficial in treating SAD because it allows for a holistic approach to both the physical and mental health aspects of the disorder.

The role of the PCP in this model is to act as the central point of contact, managing the patient’s overall health while providing initial assessments, diagnosis and medication management.

When a patient exhibits symptoms of depression or SAD, the PCP is often the first point of contact. They can conduct an initial evaluation to rule out other medical conditions, screen for depression, and assess the severity of the symptoms.

For individuals experiencing SAD, the PCP may prescribe antidepressant medications or suggest light therapy, a common treatment for the disorder. However, treating SAD solely through medication may not be sufficient. This is where the behavioral health specialist comes in. Behavioral health specialists, including psychologists or licensed counselors, provide therapies such as cognitive-behavioral therapy, which have been shown to be effective in managing depressive symptoms.

In Healthy U’s collaborative care model, the PCP and the behavioral health provider work together to monitor progress, adjust treatments as necessary, and provide ongoing support to the patient. This collaborative approach is essential for individuals with SAD, as it addresses both the biological and psychological components of the disorder.

An important aspect of the collaborative care model is the emphasis on communication and shared decision-making between the PCP, the patient and the behavioral health specialist. Regular meetings or updates between the two providers ensure that the patient’s care is continuously evaluated and adjusted to meet their evolving needs.

For example, if a patient responds well to antidepressant medication but continues to experience significant symptoms of SAD, the behavioral health specialist may adjust their therapy or suggest additional interventions. Likewise, if a patient struggles with medication side effects or prefers non-pharmaceutical approaches, the PCP can explore alternative treatments such as light therapy or changes in lifestyle.

The collaborative care model has been shown to improve patient outcomes in a variety of mental health conditions, including SAD. By integrating the expertise of both PCPs and behavioral health specialists, patients receive more comprehensive, timely, and personalized care. This approach reduces the likelihood of fragmented care and ensures that all aspects of a patient’s health — physical, mental and emotional — are being addressed.

Seasonal Affective Disorder can significantly impact a person’s quality of life, but a collaborative care model that incorporates both primary care and behavioral health specialists can offer a well-rounded and effective treatment approach.

By coordinating efforts between health care providers, individuals suffering from SAD can receive the support they need to manage their symptoms, improve their mental health and lead healthier, more fulfilling lives during challenging winter and summer months.

Editor’s note: Dr. Talamo is a family medicine physician with HealthyU Clinics, a Valley-based primary and specialty care services provider. Reader reactions, pro or con, are welcomed at AzOpinions@iniusa.org.

Seasonal Affective Disorder, SAD, depression, seasonal depression, collaborative care, behavioral health, cognitive-behavioral therapy, mental health, holistic

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