MEDizzy - A 34-year-old man originally from West Africa is seen in

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Mix Questions VIII

A 34-year-old man originally from West Africa is seen in January with depression. There is no past medical history of note but he is known to smoke cannabis. He has had similar episodes for the past two winters. What is the most likely diagnosis?

ExplanationSeasonal affective disorder (SAD) describes depression which occurs predominately around the winter months. SAD should be treated the same way as depression, therefore as per the NICE guidelines for mild depression, you would begin with psychological therapies and follow up with the patient in 2 weeks to ensure that there has been no deterioration. Following this an SSRI can be given if needed. In seasonal affective disorder, you should not give the patient sleeping tablets as this can make the symptoms worse. Finally, the evidence for light therapy is limited and as such it is not routinely recommended.