Seasonal Affective Disorder: What You Need to Know

If you experience the winter blues, you’re not alone. Many people find their mood falling as days get shorter, but the “winter” blues can occur well into the spring months.

While not every person who feels depressed during this period will be diagnosed with Seasonal Affective Disorder (SAD), it’s helpful to understand what might cause this condition, what you can do about it on your own, and when to seek professional help.

SAD is a clinically defined type of depression that follows a distinctive pattern. Generally, the condition comes on gradually in the fall and goes away in the spring, but it can begin in the winter or even as late as spring. SAD is light-related, and it’s most common in extreme latitudes where seasonal light differences are most profound. Unlike other types of depression that may linger year-round, episodes of SAD are followed by periods of normal or high mood during the summer months.

SAD affects both women and men. The condition usually begins between the ages of 18 and 30 and can continue through middle and older age, although SAD is uncommon in elderly people. And SAD isn’t just a mental health issue: Many people with the condition suffer from a weakened immune system during the winter months.

According to MedlinePlus, the symptoms of SAD may range from mild to severe and can include:

• Loss of energy and the ability to concentrate
• Feelings of restlessness or irritability
• Feelings of helplessness, worthlessness, or guilt
• Lack of interest in activities you typically enjoy
• Changes in weight
• Oversleeping or difficulty sleeping

Symptoms of SAD gradually disappear on their own as spring rolls around. Some people experience an abrupt cessation of their symptoms, followed by feelings of euphoria.

Unfortunately, scientists have yet to discover exactly what causes SAD. This leaves us with several possibilities:

• Genetics: Many people with SAD report having at least one relative with a mental illness.
• Changes to your circadian rhythm: The sleep/wake cycle, an important part of the body’s natural rhythm, is governed by the hormone melatonin. When light gets low in the evening, the brain ramps up melatonin production to make you drowsy and send you off to sleep. Researchers don’t know exactly how melatonin may be linked to SAD, but an alteration in melatonin production that disrupts the circadian rhythm may trigger the condition.
• Serotonin problems: It’s possible that people with SAD have too little serotonin–a neurotransmitter that influences mood–or they may metabolize it differently than other people.
• Geographic location: Generally, people who live farther north seem to be more prone to getting the condition than people who live closer to the equator.

There’s no clinical or lab test for SAD. Your health care provider can diagnose SAD by interviewing you and documenting a thorough history of your mood changes over the course of at least two years. The point of the interview is to discover whether you experience patterns of depression that occur seasonally. If you experience winter depression followed by a summer without depression, you may be diagnosed with SAD. If you believe you may suffer from SAD, you can help your health care provider by keeping a record of your mood changes throughout the year.

If you experience mild to moderate symptoms of SAD, you can try several treatments on your own. These include:

• Get plenty of natural sunlight during the day. Spend at least an hour outdoors, soaking up the sun each day to see if it alleviates your symptoms. Be sure to protect your skin against harmful UV rays.
• Try light therapy. Phototherapy using a light box has proven effective in about 85% of people. You’ll see the best results if you use a 10,000-lux light source and perform phototherapy first thing in the morning. Sit with your eyes open (but don’t stare directly into the light box) for 10 to 15 minutes each day, gradually increasing to 45 minutes daily. You can try twice-daily sessions if your symptoms don’t improve. You can buy phototherapy light boxes can without a prescription.
• Don’t drink. Avoid alcohol, as it can worsen any depression.
• Have fun! Plan social activities that help elevate your mood, such as having lunch with friends.
• Consider supplements. Taking melatonin supplements may help, but the timing for taking the dose is tricky, so ask your health care provider about how to take melatonin to help treat SAD.

If you experience any severe symptoms of depression, such as feelings of suicide, you should seek immediate medical attention. However, even if your symptoms aren’t that extreme, you should seek professional help if SAD begins to affect your everyday life or if you’ve tried light therapy without relief. If you experience any of these symptoms, it’s time for professional help:

• Sudden increase in appetite
• Winter weight gain
• Problems at work due to an inability to focus or concentrate
• Problems in your personal relationships
• Increased sleep or trouble feeling fully awake

If you’re diagnosed with SAD, a medical or mental health professional can discuss treatments beyond home interventions, such as:

• Antidepressant medications
• Psychotherapy, aka “talk therapy”

Because people with SAD may experience a weakened immune system in the winter, it’s essential you take extra precautions to avoid getting sick. These steps won’t prevent SAD, but they can help you stay healthy:

• Get a flu shot every year
• Wash your hands frequently
• Avoid touching your eyes and nose during cold and flu season
• Eat nutritious foods
• Get plenty of sleep
• Exercise regularly, and clean machines at the gym before using them

You can find more information about SAD by visiting these websites:

National Alliance on Mental Illness Newsletter
National Institutes of Health Information Page
National Institute of Mental Health