Seasonal Affective Disorder

Seasonal Affective Disorder

What Is Seasonal Affective Disorder?

Seasonal affective disorder (SAD) is a type of depression that’s affected by seasonal changes in the weather. SAD is also commonly referred to as “seasonal depression” or “winter blues” and is characterized by cyclical depressive episodes that are triggered by seasonal shifts around the same time every year. For most people with this disorder, symptoms begin in the fall and continue through the winter, leaving them with feelings like low energy and moodiness until spring. For a much smaller number of people, symptoms begin in the spring and continue through the summer. 

It’s normal to feel a bit sluggish sometimes during the winter months, and when the days become shorter, colder and darker, people tend to slow down their busy lives and spend more time inside. But for people with seasonal affective disorder, winter brings about depression-like symptoms that are significant and persistent, causing disruption in their everyday lives and impairing their ability to function normally. 

How common is seasonal affective disorder?

Throughout the United States, the prevalence of SAD varies by region. For example, states in the Northeast, where daylight hours are shorter during the winter, have much higher rates of seasonal affective disorder compared to states in the Southeast that are closer to the equator. In New Hampshire, studies have shown that SAD affects almost 10% of the population, whereas in Florida, under 1.5% of people reportedly experience SAD. Overall, seasonal affective disorder is said to impact around 6% of Americans, with women being more likely than men to experience symptoms. 

How does SAD impact mental health?

As with other forms of depression, seasonal affective disorder should be taken seriously, and it has the potential to worsen over time, leading to harmful mental health outcomes if left untreated. Mental health complications that can occur as a result of SAD include:

  • Anxiety disorders
  • Eating disorders
  • Problems at school or work
  • Social withdrawal
  • Substance abuse

If you’re struggling with the symptoms of SAD, you are not alone and you don’t need to just “tough it out” or “brush it off” until the spring. SAD is a mental health disorder with diagnosable symptoms and a variety of treatment options. If SAD is impacting your life, consider reaching out to a mental health professional to help you better manage and cope with your symptoms. 

What Are the Symptoms of Seasonal Affective Disorder?

In most cases, SAD symptoms emerge during late fall, persist and worsen throughout the winter, and go away during the spring. Symptoms of seasonal affective disorder are similar to those of clinical depression, but include some common identifiers that are unique to winter SAD.

Symptoms of winter SAD often include: 

  • Changes in appetite
  • Decreased self-esteem
  • Difficulty concentrating
  • Cravings for foods high in carbohydrates
  • Fatigue
  • Feeling depressed for most of the day, nearly every day
  • Hopelessness
  • Increased irritability 
  • Loss of interest in activities that you once enjoyed
  • Oversleeping
  • Poor mood
  • Relationship problems 
  • Sense of heaviness in arms and legs
  • Sluggishness 
  • Weight gain

What is summer SAD?

Although the majority of people with seasonal affective disorder experience their symptoms in the fall and winter months, there is a small subset of people who struggle with summer SAD. Summer SAD looks a bit different, and symptoms begin in the spring and persist throughout the summer. Aside from the same depression-like symptoms that occur with winter SAD, symptoms of summer SAD tend to manifest as the following:

  • Agitation
  • Anxiety
  • Decreased appetite
  • Insomnia
  • Irritability
  • Feelings of mania

What Causes Seasonal Affective Disorder? 

The exact causes of SAD are still unknown, but researchers are able to point to several factors that likely come into play. These include:

  • Circadian rhythm – Your circadian rhythm is your body’s biological clock and it regulates important functions like sleep, energy, hormone levels, appetite and body temperature. Disruption of this clock is a known trigger of depression. Your brain keeps track of the amount of sunlight you get each day and uses this information to set your internal clock. The reduced level of sunlight in the fall and winter months can throw your body clock out of sync, leading to feelings of depression.
  • Serotonin – Reduced sunlight can also cause a drop in your levels of the neurotransmitter, serotonin. Serotonin is a chemical in your brain that affects mood, behavior, and stress response, and lowered levels of serotonin is a known cause of depression.
  • Melatonin – Melatonin is a chemical that regulates sleep patterns and mood. Reduced sunlight in the winter months can disrupt the balance of your body’s melatonin levels and impact sleep and mood, which both play a large role in depression.
  • Gender – Seasonal affective disorder is diagnosed more often in women than in men.
  • Age – Seasonal affective disorder occurs more frequently in younger adults compared to older adults.
  • Proximity to the equator – SAD is more common among people who live far from the equator due to the decreased sunlight and shorter days during the winter months.
  • Family history – Having a history of depression in your family, especially of seasonal affective disorder specifically, is known to be a risk factor for developing SAD.  

Treatment for Seasonal Affective Disorder

Below are some of the common treatments that work well for seasonal affective disorder. The treatment plan that works best for you may include more than one approach. 

Light Therapy for SAD

Light therapy, or phototherapy, is one of the first line treatments for seasonal affective disorder, and it has proven highly effective in reducing symptoms for those with winter SAD. Light therapy treatment involves exposing oneself to bright light via a special device called a light box. A light box mimics natural outdoor light, which is known to help balance the body’s circadian rhythm and increase chemicals in the brain that directly impact mood. During the fall and winter months, when the days are darker, shorter, and colder, we experience a significant reduction in our exposure to natural sunlight and thus all of its antidepressant benefits. Light therapy sessions generally last about 10-15 minutes at first, and then gradually increase depending on the severity of the symptoms. Light therapy is a popular treatment option because people generally start seeing benefits in just a few days to a few weeks, and it has few known side effects.

Research on light therapy is rather limited, and we don’t recommend purchasing a light box or beginning light therapy sessions without talking to your doctor first and making sure that light therapy is a safe and effective treatment option for you. 

Psychotherapy for SAD

Psychotherapy, or talk therapy, is another popular treatment option for seasonal affective disorder. Psychotherapy is conducted by a licensed mental health professional, like a counselor, therapist or psychologist, and consists of weekly sessions in which the therapist and the patient work together to set individualized goals and reduce the harmful impact that SAD symptoms may be having. Psychotherapy has proven to be very beneficial for people with depression, and a variety of therapeutic approaches and techniques are known to be successful in treating SAD.

Psychotherapy can help SAD patients through…

  • Cognitive Behavioral Therapy (CBT), a form of talk therapy in which patients learn to identify and change negative thought patterns and behaviors that may be making them feel worse
  • Offering healthier, more positive ways to cope with SAD symptoms
  • Reducing harmful coping mechanisms, such as avoidance behavior, through techniques like exposure therapy and setting small, attainable goals
  • Mindfulness and relaxation exercises like deep breathing and meditation that reduce distress 

Self-help tips for coping with SAD

There are some lifestyle changes that you can make on your own to help prevent and improve symptoms of SAD. Some of these include:

  • Stay active and get regular physical exercise
  • Try to spend some time outdoors each day, even on cold or cloudy days
  • Brighten your environment by opening blinds or sitting closer to windows and skylights 
  • Maintain a healthy and regular sleep schedule
  • Do not turn to alcohol or recreational drugs for relief 
  • Keep an active social life and make a conscious effort to connect with friends and loved ones when you’re feeling down 
  • Make healthy, nutritious choices for meals and snacks
  • If you can, plan trips to sunny, warm locations during the winter

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