Seasonal Affective Disorder (SAD)

Life naturally slows down during the winter. The days grow shorter, and the light becomes scarce. While this can cause a seasonal slump of staying in and watching Netflix under the covers to stay warm, shorter days combined with the stress of the winter holiday season can make the colder months of the year a trying time for many people.

Seasonal affective disorder (SAD) is a specific kind (or subtype) of depression that emerges in particular seasons of the year. Most people notice SAD symptoms starting in the fall and increasing during winter, while a few experience a spring/summer version.

With the changing of seasons, their depression goes into remission.

Those with SAD meet the same criteria you’d need for a diagnosis of major depression. This might include a depressed mood, feelings of hopelessness, a lack of energy, difficulty concentrating, changes in sleep and appetite, a loss of pleasure in activities you once loved, and even thoughts of death or suicide.

Persons with the winter version of SAD might also notice the following unique symptoms:

Heaviness in arms and legs
Frequent oversleeping
Cravings for carbohydrates/weight gain
Relationship problems
A general feeling of wanting to “hibernate”
Reduced sexual interest
Daytime fatigue

A milder version of SAD has been called the “Winter Blues” – with many of the same symptoms applying but to a milder degree.

What causes SAD?

Researchers have yet to uncover the specific cause of SAD, but they do know some of the factors that may come into play, such as:

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

– Serotonin levels: A drop in serotonin (a brain chemical that affects mood) caused by the reduced sunlight, might play a role in SAD.

– 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.

Furthermore, seasonal affective disorder is diagnosed more often in women than in men and occurs more frequently in younger adults than older adults. Other risk factors include:

– Family history: Individuals with SAD may be more likely to have blood relatives with SAD or another form of depression.

– Having major depression or bipolar disorder: Symptoms of depression may worsen seasonally if you have one of these conditions.

– Living far from the equator: SAD appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter and longer days during the summer months.

How to know when to call a doctor

Everyone has days in the winter when they feel sluggish or unmotivated. But if your symptoms are causing disruptions in your life, never hesitate to contact a professional. If symptoms occur for days at a time – and you notice major shifts in sleeping or eating, you’re withdrawing socially, or the activities that usually boost your mood don’t work – then it’s time to pick up your phone.

Seek immediate help if you are using alcohol to manage symptoms or are experiencing suicidal thoughts.

Seasonal affective therapy responds well to treatment. The most commonly used treatments for SAD are:

Light therapy: Phototherapy is considered to be the best form of treatment for SAD at this time. It involves exposing oneself to light via a fluorescent lightbox – a device that gives off bright, white light producing similar effects to natural light, triggering chemicals in your brain that help regulate your mood. The starting “dose” for light therapy is 10,000 lux for 30 minutes a day. It should be started in the early morning, upon awakening, to maximize treatment response. On average, most individuals respond to light therapy within one week, but some patients may require up to four weeks of exposure before feeling results.

Medication: Antidepressants have proven to be effective for people with SAD, especially those with intense symptoms. Wellbutrin XL became the first drug approved specifically for SAD in the U.S. in 2006, due to its uniqueness among antidepressants for not affecting your libido and sexual function. The effectiveness of Wellbutrin XL for the prevention of SAD episodes was established in three double-blind, placebo-controlled trials in adults with a history of major depressive disorder in the fall and winter. Treatment began in September through November, prior to the onset of symptoms, and ended the first week of spring. Results found that 84% of patients were depression-free at the end of the treatment with the use of Wellbutrin, compared to 72% of those on placebo.

Psychotherapy: Talk therapy can be an invaluable option for those with SAD. A psychotherapist can help you identify patterns in negative thinking and behavior that impact depression, learn positive coping methods, and institute relaxation techniques that can help you restore energy.

In addition to seeking help from your doctor, there are lifestyle changes that can improve symptoms and lift your mood. You might try going outside more often, getting plenty of sunlight, exercising, avoiding drugs and alcohol, getting plenty of sleep, and practicing relaxation exercises. But don’t beat yourself up if your symptoms don’t improve right away, and don’t brush them off as winter blues and try to hunker down until spring.

Asking for help is a sign of strength and movement towards a better version of yourself. Consider how you can start managing seasonal affective disorder today and live a healthier life in every season.

Sources:

Seasonal Depression (Seasonal Affective Disorder). https://www.webmd.com/depression/guide/seasonal-affective-disorder#1
Lieber MD, Arnold. Seasonal Affective Disorder. PSYCOM. 2019.
Schimelpfening, Nancy. What to Know About Wellbutrin (Bupropion). Verywell Mind. 2019.
Schimelpfening, Nancy. An Overview of Seasonal Affective Disorder. Verywell Mind. 2019.
Terman, Dr. Michael and Rifkin, Jamie. Seasonal Affective Disorder Symptoms. Verywell Mind. 2019.