Seasonal Affective Disorder

Seasonal Affective Disorder (SAD) is a type of depression that's related to changes in seasons – beginning and ending at about the same times every year and lasting for about 4 to 5 months. Symptoms start in the fall and continue into the winter months, affecting your energy and making you feel moody.

Millions of American adults may suffer from SAD, although many may not know they have the condition. SAD occurs much more often in women than in men, and it is more common in those living farther north, where there are shorter daylight hours in the winter.

Common Signs and Symptoms of SAD:

• Feeling depressed most of the day, nearly every day
• Losing interest in activities you once enjoyed
• Having low energy
• Having problems with sleeping
• Experiencing changes in your appetite or weight
• Feeling sluggish or agitated
• Having difficulty concentrating
• Feeling hopeless, worthless or guilty
• Having frequent thoughts of death or suicide

Symptoms specific to winter-onset SAD, sometimes called winter depression, may include:

• Oversleeping
• Appetite changes, especially a craving for foods high in carbohydrates
• Weight gain
• Tiredness or low energy

Common Causes of SAD:

The specific cause of Seasonal Affective Disorder remains unknown. Some factors that may come into play include:

Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter due to daylight savings may cause winter-onset SAD. This decrease in sunlight may disrupt your body's internal clock and lead to feelings of depression.

Serotonin levels. Reduced sunlight can cause a drop in serotonin (a brain chemical that affects mood) that may trigger depression.

• Deficits in vitamin D may exacerbate these problems because vitamin D is believed to promote serotonin activity.
• The body produces vitamin D when exposed to sunlight on the skin. With less daylight in the winter, people with SAD may have lower vitamin D levels, which may further hinder serotonin activity.

Melatonin levels. The change in season can disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood.

Treatment Options:

Treatment for seasonal affective disorder may include light therapy, medications and psychotherapy

Light therapy. In light therapy, also called phototherapy, you sit a few feet from a special light box so that you're exposed to bright light within the first hour of waking up each day. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood.

Before you purchase a light box, talk with your doctor about the best one for you, and familiarize yourself with the variety of features and options so that you buy a high-quality product that's safe and effective. Also ask your doctor about how and when to use the light box.

Medications. Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe. Your doctor may recommend starting treatment with an antidepressant before your symptoms typically begin each year. They may also recommend that you continue to take the antidepressant beyond the time your symptoms normally go away.

Psychotherapy. Psychotherapy, also called talk therapy, is another option to treat SAD. A type of psychotherapy known as cognitive behavioral therapy can help you:

• Identify and change negative thoughts and behaviors that may be making you feel worse
• Learn healthy ways to cope with SAD, especially with reducing avoidance behavior and scheduling activities
• Learn how to manage stress

Improving the mind-body connection. Examples of mind-body techniques that some people may choose to try to help cope with SAD include:

• Relaxation techniques such as yoga or tai chi. Benefits of yoga and tai chi is that they can decrease stress, anxiety and depression, lowers blood pressure, increases energy and stamina, improves flexibility and improves mood
• Meditation. Benefits of meditation are it can help reduce stress, increase focus, reduce anxiety, increase creativity, increase memory, reduce pain and much more
• Guided imagery. Benefits of guided imagery are it can decrease stress, anxiety and depression, increase relaxation, enhance sleep, decrease pain and enhance quality of life
• Music or art therapy. Benefits of music or art therapy are that it can alleviate pain, manage stress, promote wellness, enhance communication, increase self-esteem, lowers blood pressure, and helps with depression.

Lifestyle and Home Remedies:

Make your environment sunnier and brighter. Open blinds, trim tree branches that block sunlight or add skylights to your home. Sit closer to bright windows while at home or in the office.

Get outside. Take a long walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun (and vitamin D). Even on cold or cloudy days, outdoor light can help — especially if you spend some time outside within two hours of getting up in the morning.

Exercise regularly. Exercise and other types of physical activity help relieve stress and anxiety and can make you feel better and more confident about yourself, which can lift your mood.

Take care of yourself. Get enough sleep to help you feel rested, but be careful not to get too much rest, as SAD symptoms often lead people to feel like hibernating. Participate in an exercise program or engage in another form of regular physical activity. Make healthy choices for meals and snacks. Don't turn to alcohol or recreational drugs for relief.

Practice stress management. Learn techniques to manage your stress better. Unmanaged stress can lead to depression, overeating, or other unhealthy thoughts and behaviors. When you're feeling down, it can be hard to be social. Make an effort to connect with people you enjoy being around. They can offer support, a shoulder to cry on or shared laughter to give you a little boost.

Take a trip. If possible, take winter vacations in sunny, warm locations if you have winter SAD or to cooler locations if you have summer SAD.

Steps to Take

Talk to your health care provider about which treatment, or combination of treatments, is best for you. ECHN has a great Behavioral Health Program that can help you if you suffer from SAD, depression, bipolar depression, anxiety and much more.

Learn more abut our Behavioral Health Program

For more information or if you have any questions, please call us at 860.533.3434

Article Resources: 
Mayo Clinic
National Institute of Mental Health