Seasonal Affective Disorder

What is Seasonal Affective Disorder (SAD)?

Seasonal affective disorder (SAD), also known as seasonal depressive disorder, is a form of depression which typically occurs during changes in the season and starts and ends about the same time each year. SAD generally occurs in the fall and winter months but can occur in the spring or early summer as well, and it is associated with the reduction of sunlight.

How Common is SAD?

Seasonal affective disorder affects anywhere from 1-3% of adults in the general population. It also affects 10-20% of people who already have major depressive disorder, and about 25% of those with bipolar disorder in the United States.

Research shows that it affects more women than men and tends to start when a person is between the ages of 18-30. About 10-20% of Americans are affected by milder forms of “winter blues” as well.1

Is Seasonal Affective Disorder a Mental Illness?

The short answer is no. Seasonal affective disorder is a form of depression, which is a mood disorder, and it is related to changes in the season. It is different from the “winter blues” in that it impacts your mood and behaviors negatively over time. You can feel depressed most of the day every day, lose interest in your normal activities, and have low energy among other symptoms.

It is a form of depression in which people who have normal mental health most of the year experience and exhibit depression symptoms at a particular time of year (generally late fall and winter).

What Are the Symptoms of Seasonal Affective Disorder (SAD)?

The symptoms of seasonal affective disorder are the same as non-seasonal depressive symptoms. The main difference is that these symptoms are associated with seasonal change. For some, these indicators can be severe and have a significant impact on their daily lives.

Symptoms of SAD include:

Sadness: This is a feeling of depression that occurs most of the day, every day.
Anxiety: Symptoms of anxiety include feeling anxious or irritable.
Carbohydrate Cravings and Weight Gain: SAD is associated with overeating and a yearning for more starches and sweets, which can then lead to weight gain.
Extreme Fatigue and Lack of Energy: This includes not being able to get out of bed, putting personal hygiene on the back burner, or just not feeling like caring for yourself.
Feelings of Hopelessness: Having a bleak outlook on life and viewing life as if nothing is ever going to get better is a sign of depression and seasonal affective disorder.
Suicidal Thoughts or Ideations: This can be very dangerous, and it’s necessary to reach out to friends, family, or your doctor if you are having these thoughts.

What Causes Seasonal Affective Disorder (SAD)?

There are many theories about the causes of seasonal affective disorder, including brain chemical imbalances, vitamin D deficiency, and negative thoughts.

Biological Clock Change

Some theories indicate that many people who have SAD become depressed during the winter months because of a delay in circadian rhythms with respect to the sleep and wake cycle. As the days get shorter in winter, we might not be getting enough sunlight. This can disrupt our body’s natural circadian rhythms and lead to feelings of depression.2

Brain Chemical Imbalance

SAD may also be caused by an imbalance in the brain chemicals serotonin and melatonin. Serotonin is responsible for regulating mood, while melatonin helps regulate sleep. An imbalance in these chemicals could lead to symptoms of SAD.

Vitamin D Deficiency

Vitamin D has often been called the “sunshine drug” because our bodies produce this important nutrient when our skin is exposed to sunlight. However, vitamin D deficiency is a growing problem in the United States, particularly during the winter months.

Vitamin D is essential for strong bones and muscles. It helps our bodies absorb calcium and phosphorus, two minerals that are critical for bone health. Vitamin D also plays a role in immune function and cell growth. Although we get some vitamin D from the foods we eat, such as fatty fish and fortified milk, it’s difficult to get enough from diet alone.

Melatonin Boost

Seasonal affective disorder can cause disruptions in sleep. One way to help improve your sleep is by taking a melatonin supplement. Melatonin is a hormone that helps regulate your sleep-wake cycle. Taking a supplement can help you fall asleep faster and stay asleep longer. If you’re looking for a natural way to boost your sleep, consider taking a melatonin supplement.

Negative Thoughts

Negative thoughts can make seasonal affective disorder worse. If you’re already feeling down, anxious, or irritable, negative thinking can make these symptoms even worse. Negative thinking can also fuel a cycle of negative emotions, making it difficult to break out of a funk.

If you’re struggling with seasonal affective disorder, it’s important to find ways to counter negative thinking. One way to do this is to focus on the positive aspects of your life and on things that make you happy. Additionally, therapy, medication, and light therapy can all be effective treatments for SAD. If you’re struggling with negative thoughts, talk to your doctor about treatment options.

How is Seasonal Affective Disorder Diagnosed?

There are a few ways that SAD can be diagnosed, although there is no set physiological test that is conducted.

What Tests Will I Need?

A correct diagnosis can only be achieved when a medical professional finds that a person meets the Diagnostic Manual of Mental Disorders (DSM-5) criteria through screening or interview.

What Are the Criteria for a Diagnosis?

Symptoms will be very similar to depression but will generally occur when the sun is at its lowest point during the seasons. To be diagnosed, you must have symptoms of major depression, and the depressive episodes must occur during specific seasons (i.e., only during the winter months or the summer months) for at least two consecutive years. However, not all people with SAD experience symptoms every year.

The episodes must be much more frequent than other depressive episodes that you may have experienced at other times of the year, and sometimes these episodes may last for weeks or months. They also generally go away once the season changes.

How is Seasonal Affective Disorder (SAD) Treated?

Once diagnosed, there are several treatment options available that can help improve symptoms. These treatment opportunities will be detailed below.

Light Therapy

Light therapy, also known as phototherapy, is one of the most common treatments for SAD. Light therapy involves sitting in front of a special light box that emits bright light. The light is thought to mimic the effect of sunlight on the brain and can help to improve mood and energy levels.

Cognitive Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is another treatment option for SAD. CBT is a type of therapy that focuses on changing negative thought patterns and behaviors. CBT can help people with SAD to identify and change their negative thoughts and beliefs about the winter months.

Antidepressant Medication

Medications, in conjunction with psychotherapy, can be helpful to some people.

Spending Time Outdoors

For some people, increased exposure to the sun can help improve the symptoms of SAD. Spending more time outside or arranging your home so you have more exposure to light during the day can help.

Vitamin D

Many people with SAD often have vitamin D deficiency, and nutritional supplements of vitamin D may help their symptoms. However, studies testing whether vitamin D is effective in SAD treatment have produced mixed findings, with some results indicating that it is as effective as light therapy but others detecting no effect.3

What Type of Antidepressants Can Help?

There are many medications indicated for the use of seasonal affective disorder and include Prozac, Lexapro, Paxil, Zoloft, and Celexa. These will be discussed further below:4

Fluoxetine (Prozac): Prozac is most often used to treat seasonal depressive disorder. It is a selective serotonin reuptake inhibitor (SSRI) that can be used to treat moderate to severe depression.
Escitalopram (Lexapro): Lexapro is an SSRI and is used to treat certain types of depression and anxiety.
Paroxetine (Paxil, Pexeva): Paroxetine is an SSRI and is used to treat depression including major depressive disorder.
Sertraline (Zoloft): Zoloft is an SSRI and is used to treat depression, anxiety, and other mood disorders.
Citalopram (Celexa): Celexa is an SSRI and is approved for use in major depressive disorder (MDD).

Can I Prevent Seasonal Affective Disorder (SAD)?

While you may not be able to prevent seasonal affective disorder, there are actions that you can take to reduce its frequency and severity.

Use Your Lightbox

If you have a lightbox, you should absorb light for at least half an hour per day. You can break this up into increments throughout the day, but you should try and get the first session in prior to 10:00am to help wake you up and get you energized. The lightbox should have a 10,000-lux exposure. People who use the lamp for seasonal depression report a change within two to four days.

Get Outside

Get outside, move, and soak up some vitamin D. Exercise is a great mood booster, and sunshine is necessary for the synthesis of vitamin D to occur in your body.

Eat a Well-Balanced Diet

Look for a variety of whole foods to help keep you healthy and happy over the winter months. Some healthy ideas include vegetables, fruits, nuts, and other healthy fats. Avoid overindulging in sweets and other carbohydrates.

See Friends and Family

Stay involved in your regular activities and make a point to see friends as they can help provide support during the winter months.

Find Help

Seek out a mental health provider who has experience with cognitive behavioral therapy.

Consider Medications

Be sure to talk to your healthcare provider about the adjunct use of medications with other modalities of care. In some cases, taking medications prior to the onset of seasonal affective disorder have been shown to help prevent these episodes.

What’s the Outlook for People with Seasonal Affective Disorder (SAD)?

The outlook for those who experience seasonal affective disorder is positive. SAD in those who are prone to this type of depression can be affected by it every year, but there are steps you can take to reduce or prevent the symptoms.

Get Help for Seasonal Affective Disorder at Pacific Beach Health

Please contact Pacific Beach Health for more information on seasonal affective disorder and how we can help. Reach out today if you or a loved one need help with dealing with SAD’s symptoms or anything else you may need.

Is Seasonal Affective

Disorder (SAD) a Mental Illness?

Many people suffer from seasonal affective disorder (SAD), a form of depression that typically occurs during changes in season.