More Than The Winter Blues: What Is Seasonal Affective Disorder?

As the seasons start to change, it's not uncommon for people to experience a mood fluctuation. You may have noticed the way a gray, stormy day makes you feel down or tired, while a sunny day leaves you feeling joyful and energized.

Those longer, sunnier days are scientifically proven to be associated with an uplift in mood. In contrast, the shorter, colder days that start in the late fall are associated with adverse or depressive symptoms, or in some cases, symptoms of seasonal affective disorder.

What is seasonal affective disorder?

Seasonal affective disorder (SAD) is a type of depression that correlates with changes in seasons. In other words, symptoms usually begin and end around the same time every year, when fall and winter come around.

While SAD usually resolves within a few months, it can seriously impact the way you feel and function on a day-to-day basis during the darker and colder months. The good news is, however, that it's highly treatable.

Symptoms of seasonal affective disorder

While seasonal affective disorder symptoms typically appear as the fall season progresses and go away when the sun comes back out in the spring and summer, some people experience the opposite, where symptoms of SAD appear in the spring or summer. Regardless, symptoms can start mild and potentially worsen as the season progresses.

If you believe you may have the seasonal affective disorder, it's essential to consult with your doctor or mental health professional. They can help you rule out any other conditions that may be causing your symptoms.

Note: The DSM-5 doesn't technically consider seasonal affective disorder as its condition. Instead, it's a 'specifier' or a subtype of major depressive disorder, or MDD. The main difference, however, is that symptoms occur seasonally.

A few signs and symptoms of SAD include:

Feeling depressed most of the day, almost every day
Loss of interest in activities you once enjoyed
Feeling sluggish, or having low energy, fatigue
Having difficulty sleeping
Changes in your appetite, diet, or weight
Feeling agitated or irritable
Having trouble concentrating
Feelings of hopelessness, worthlessness, or guilt
Having frequent thoughts of death or suicide

Fall and winter SAD

Depending on the season, symptoms of SAD can differ. Symptoms related to winter-onset SAD, also known as winter depression, can include:

Oversleeping
Appetite changes and cravings, specifically for carbohydrates
Weight gain
Tiredness and low energy

While summer and spring seasonal affective disorder are less common, it still occurs. Symptoms vary slightly and may include a loss of appetite, anxiety, and agitation.

Causes of fall and winter SAD

There are a few factors that come into play for SAD. Some of which may include:

Your biological clock (circadian rhythm). In the winter, many of us get up before the sun and end work when the sun goes down. The lack of sunlight in the fall and winter seasons can disrupt our body's natural internal clock, leading to depressive symptoms and a lower mood overall.
Serotonin levels. Less exposure to sunlight can also drop serotonin production-a brain chemical that can negatively impact our mood. In turn, it can trigger depressive symptoms.
Melatonin levels. Seasonal changes disrupt the body's melatonin production and lead to an overproduction of it. Melatonin plays a role in sleep patterns, mood, and energy. It's the same reason why we start feeling drowsy once it gets dark outside at the end of the day. When the sun rises and the light enters our eyes, melatonin production shuts down in the morning.
Vitamin D deficiency: a general lack of sunshine can lower vitamin D levels, which can contribute to depressive symptoms.

Risk factors

According to experts, seasonal affective disorder is diagnosed more frequently in women than in men. Additionally, younger adults experience symptoms more often than older adults.

Other factors that may enhance your risk of seasonal affective disorder include:

Family history. People with SAD may be more likely to have relatives with the condition or another type of depressive disorder.
Have a previous diagnosis for MDD or bipolar disorder. Symptoms of depression can worsen seasonally if you have one of these conditions.
Living far from the equator. SAD tends to be more common among people who live far north or south from the equator.

Treatment

Seasonal affective therapy responds well to treatment. Treatment can help prevent further complications of SAD, especially if you receive a diagnosis and start taking the proper steps. The most commonly utilized treatments for SAD include light therapy, medication, and psychotherapy.

Light therapy

Light therapy, or phototherapy, has been a standard treatment for SAD. It requires using a lightbox device that gives off an artificial bright, white light, typically in the mornings. The light is supposed to mimic light from the sun and regulates your circadian rhythm and neurotransmitters associated with mood and energy.

While there isn't an evidence-based guideline for light therapy, research suggests:

Using lightboxes with about 10,000 lux for around 30 minutes a day.
early morning treatment, preferably before 8 am every day
Sitting close(about 16 inches) to the lightbox unit
Placing the lightbox at an angle to receive the light indirectly through your eyes
Starting treatment when you notice symptoms arising in the fall or winter and stopping during spring and summertime

Particular timing, the strength of your lightbox, and its placement are essential for achieving the best potential outcome.

Side effects of light therapy can include headaches, agitation, nausea, and eyestrain. While these effects are typically mild and disappear with reducing the light dose, always check with your doctor before starting light therapy.

Medications

Medication is another fairly common option for treating the seasonal affective disorder. Typically, selective serotonin reuptake inhibitors (SSRIs) are prescribed.

Psychotherapy

Cognitive-behavioral therapy (CBT) is also an effective, popular treatment for SAD.

In CBT, you can learn how to identify and replace negative thinking patterns that may be contributing to your symptoms. With behavioral activation, you can also learn how to identify and engage in healthy behaviors that can help you cope, such as going on a walk every morning or maintaining an exercise routine.

Studies have shown that individuals that participated in CBT for SAD experienced fewer recurring symptoms than those who participated in light therapy alone. The results suggest that CBT may be more effective and last longer than light therapy.

Coping

In addition to the listed treatments for SAD, you can also make a few lifestyle changes and habits to promote mental well-being throughout the darker months.

These include:

Regular exercise
Getting quality sleep
Making an effort to get outside every day, even for a few minutes
Eating a well balanced, healthy diet

Finding help for SAD

If your mood changes alongside the seasons, you're not alone. However, if your symptoms start interfering with your ability to function on a day-to-day basis, it may be worth reaching out to a professional.

By knowing the signs of seasonal depression, you can feel more confident in taking the proper steps to manage your mood, help you cope, and feel better overall. At Michigan Psychological Care, our mission is to help you find the care and treatment you need. We work to put your worries about opening up to rest by providing a comfortable location and atmosphere.

Our sessions are provided in a one-on-one setting with one of our experienced therapists. If you're interested in group counseling, we also provide that. We have three convenient facilities to provide you with the compassionate care you deserve. Contact us to schedule an appointment.

References

https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
http://www.suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx
https://www.verywellmind.com/best-light-therapy-lamps-4172537
https://www.healthline.com/health/summer-SAD-is-all-too-real
https://www.psychiatry.org/psychiatrists/practice/dsm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652773/

Keywords: seasonal depression, seasonal affective disorder