You may feel like you have had the “winter blues,” “springtime sadness,” or that you haven’t been feeling “right” since the time change when the days get shorter and the nights grow longer. You are not imagining things. You may have seasonal affective disorder (SAD), a depression that occurs with a change in seasons.
According to Mayo Clinic, SAD symptoms, which include fatigue or moodiness, can start in the fall and run during the winter months. Once the weather warms up and the days become longer and sunnier, SAD symptoms usually disappear.
Some people experience SAD symptoms in the spring or early summer, although Mayo Clinic says this happens less often. Symptoms range from mild to severe.
If you do experience SAD, you may have the following signs and symptoms:
- Days of feeling depressed that run almost daily
- Showing little to no interested in hobbies, enjoyable activities
- Low energy, feeling sluggish
- Trouble focusing
- Sleeping problems
- Weight changes, appetite changes
- Feelings of guilt, unworthiness
- Thoughts of suicide, death
Some symptoms of seasonal affective disorder occur specifically in winter as it starts, according to Mayo Clinic. They are:
- Sleeping too long (oversleeping)
- Craving foods that are carbohydrate-heavy
- Weight gain
- Tiredness or low energy
If someone experiences SAD in the spring or summer, they could have insomnia, poor appetite, weight loss, and agitation or anxiety.
Combating SAD is possible, but the approaches used to address it will depend very much on the person experiencing symptoms. Depending on how serious the condition is, a person can take medications and/or participate in light therapy and psychotherapy, which is discussed further down below.
Who Has Seasonal Affective Disorder and What Causes it?
Not everyone will experience SAD, but according to the National Institute of Mental Health (NIMH), millions of people do but may not realize they have the condition. The institute also reports that women experience SAD more often than men and that it is common among people who live in the northern region of the U.S., such as in Alaska or New England, where winter means shorter daylight hours.
It also says SAD begins in young adulthood and that people who have mental health disorders are susceptible to having it. The condition can run in families, as well.
People who have SAD may also have:
- Major depressive disorder
- Bipolar disorder (particularly bipolar II disorder)
- Attention-deficit/hyperactivity disorder
- Anxiety disorder
- Panic disorder
Mayo Clinic and NIMH both report that scientists do not fully understand what causes SAD. Several factors play a role in whether a person has SAD. Some are:
Circadian rhythms (biological clock). Less sunlight in the fall and winter can disrupt a person’s internal clock, which could trigger depression.
Melatonin levels. Melatonin is a hormone that helps maintain a person’s sleep patterns and mood. “The production and release of melatonin in the brain [are] connected to [the] time of day, increasing when it’s dark and decreasing when it’s light,” the Mayo Clinic writes. When the seasons change, it can disrupt the level of melatonin, leading to someone feeling tired and appearing irritable.
Serotonin levels. Serotonin is another hormone in the brain that affects mood. Reduced sunlight means less natural light, which can make serotonin levels dip. Scientists believe lower levels of serotonin can trigger depression.
Changes in melatonin and serotonin levels make it challenging for people to adjust to the changes going on outside. Feeling a lack of control over seasonal changes can make people associate certain times of the year with negative moods and feelings, bringing on stress, coping challenges, and increased inability to manage daily life.
Therese Borchard of Everyday Health writes that several things can bring on seasonal depression and make it especially challenging to deal with, such as change, memories, major events, such as weddings and graduations, and allergies and toxins in the environment.
“All change — even the good and healthy change we need and pursue — brings with it an element of anxiety. That’s especially the case for highly sensitive folks among us who are easily prone to anxiety and depression,” Borchard writes, reminding us that seasons are more than just about the weather.
How SAD is Diagnosed
If you or someone you know is concerned that your SAD symptoms warrant a closer look, you can see your doctor or a mental health professional for an evaluation. During an assessment, your health care provider could perform a physical exam that includes asking your detailed questions about your health and mental health history.
They may ask you to undergo a blood test called a complete blood count or CBC. You may also undergo a lab test to check for thyroid issues. You also may be asked to take a psychological evaluation that would screen for depression. Your health care provider may also check the current edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders to compare your symptoms to see if they align with symptoms of seasonal depression.
Based on the results of your tests and other assessments, a doctor can recommend a treatment approach for you.
Getting Professional Treatment for SAD
Some people may not think seasonal depression is serious because it is seemingly fleeting since it is not permanent, so to speak. However, seasonal affective disorder is a cyclic condition, which means it happens regularly enough that it should be given appropriate attention. Mental health matters are important, especially because they can affect how we live day to day, and seasonal affective disorder will not be mild for everyone. It can be a severe, debilitating condition that requires professional treatment.
Addressing SAD can require several methods. A combination of these may be prescribed for you or perhaps only one.
You can receive light therapy, psychotherapy, medications for depression, or Vitamin D.
Light therapy exposes people with SAD to bright light daily for 30 to 45 minutes to supplement the amount of natural light they receive during the winter months, when the days are shorter. The therapy usually starts early in the morning during the fall to spring months, according to NIMH.
“The light boxes, which are about 20 times brighter than ordinary indoor light, filter out the potentially damaging UV light, making this a safe treatment for most,” it writes.
Mayo Clinic advises speaking with your doctor first before buying a light box. This can help you choose the right one for your needs to make sure you remain safe while using it.
Psychotherapy, also called talk therapy, requires you to sit with a mental health professional who can help you get to the root of your depression and other issues. Cognitive behavioral therapy is a widely employed therapy. It can help you identify negative thoughts that lead to negative behaviors. You can also learn healthy coping strategies and tools that promote addressing seasonal depression in a healthy manner.
A health care provider can prescribe antidepressant medications to help patients who have seasonal depression. These medications include fluoxetine, citalopram, sertraline, paroxetine, and escitalopram.
It can take some time before noticing antidepressants’ effectiveness. You should speak with your doctor about the one that works best for you. If medications work in your favor, your physician might recommend starting antidepressant treatment before the onset of your symptoms for seasonal depression. You also may be prescribed to continue taking medication after the seasons change, and your symptoms disappear.
Vitamin D Supplements
If you have a deficiency in Vitamin D, you may be prescribed a supplement that can increase the amount of it in your system. NIMH reports that studies have shown mixed results of Vitamin D supplements, but you can talk with your doctor to see if they think this approach could help you with your symptoms.
SAD and Substance Use Disorders
If you find that you or someone you know is having trouble going to school or work, handling daily responsibilities, and becoming increasingly withdrawn, you should consider seeing a counselor, therapist, or other mental health professional who can guide you to the right treatment. SAD can also prompt some people to misuse and abuse substances, such as alcohol and drugs, that help them cope with or “escape” their condition.
Using addictive substances to “self-manage” or “self-medicate” oneself to deal with a mental health disorder is very common but extremely dangerous and harmful in the long run. Some people are unaware they have such a disorder because it has not been formally diagnosed, while others know their condition and choose to address it in the way they see fit. Neither is a healthy way to treat the issue.
People who have a mental health disorder and a substance use disorder at the same time have dual diagnosis. Drugs and alcohol may provide temporary relief, but they likely will worsen someone’s existing mental illness and put them at risk of developing an addiction or overdosing on legal or illegal substances.
If you have seasonal affective disorder and abuse substances, consider enrolling in a rehabilitative treatment program to help you with both disorders. A program that treats both conditions at the same time is the best option for recovery.