Do you feel down or even depressed during certain months of the year? You could have seasonal affective depression. Seasonal depressive disorder (SAD) is a mood disorder that happens every year at the same time. In most cases, it begins towards the end of fall and ends in spring. However, there are rare cases of summer depression, which starts in late spring and ends in fall.
So, you should not dismiss your depressive state as a simple case of winter blues. SAD is a severe mood disorder that you should not tough out on your own. There are specific steps you can take to improve your mood in the winter. Plus, SAD has clinical treatment options, including medication, psychotherapy, and light therapy.
| Signs and Symptoms of SAD
The reduced warmth, light, and color of the winter season have people feeling tired and melancholic. That is considered normal. However, if these symptoms are persistent and crop up the same time every year, you might have seasonal depression.
The distinct sign of SAD is a low feeling that goes away after the season changes. Other symptoms include:
- Despair, worthlessness, and guilt feelings
- Feeling depressed most of the day and almost every day
- Loss of interest and pleasure in normal everyday activities
- Lack of energy
- Sleeping during the day
- Sleeping for longer than usual and finding it difficult to wake up in the morning
- Weight gain
- Craving carbs
- Difficulty concentrating
- Frequent suicidal thoughts
The winter-specific SAD symptoms include:
- Overeating and weight gain
- Lethargic feeling (lack of energy)
- Craving carbs
- Avoiding people (social withdrawal)
The symptoms of the rare summer SAD include:
- Episodes of violent behavior in an otherwise calm individual
- Poor appetite followed by weight loss
| Causes of Seasonal Affective Disorder
The exact cause of SAD is unclear. However, most theories suggest that the lack of sunlight causes SAD. The reduced sunlight during the winter affects the hypothalamus, the part of the brain responsible for the:
- Circadian rhythm: the body’s internal clock that responds to changes in light and dark to regulate mood, appetite, and sleep. The lack of sunlight and the shorter day during the winter months disrupts the circadian rhythm. As a result, you experience SAD symptoms such as hypersomnia, disorientation, lack of or increased appetite, and feeling groggy at odd times of the day.
- Production of melatonin. Melatonin is a hormone produced in the hypothalamus that influences sleep. The hypothalamus produces melatonin when it is dark. Sunlight, on the other hand, stops the production of melatonin, which explains why you are more alert and awake during the day. Now, during the winter, it is darker during the day. So, your body may continue producing melatonin, making you feel tired and low on energy.
- Production of serotonin. The lack of light lowers the production of serotonin. It is a neurotransmitter responsible for the regulation of mood as well as appetite and sleep. Low levels of serotonin have been linked with the feeling of depression. Also, the deficit of this neurotransmitter can lead to appetite problems, memory issues, sleep irregularities, and low sexual desire.
| SAD Disorder Risk Factors
The following factors increase the risk of SAD:
- Gender. SAD is four times more prevalent in females than in males. That said, males who suffer SAD have more severe symptoms.
- Family history. You are at more risk of SAD if you have family members, siblings, and parents, diagnosed with the condition. Also, a family history of other types of depression is a SAD risk factor.
- Bipolar disorder. If you suffer other types of depression, such as bipolar disorder, your symptoms may worsen during certain seasons. The changes that come with seasons can trigger and exacerbate the symptoms of bipolar disorder. For instance, spring and suffer may trigger mania and hypomania. On the other hand, winter and fall may worsen the depression symptoms of bipolar disorder.
- Age. Younger adults are at a higher risk of SAD than older adults. SAD diagnosis is not necessarily uncommon in teens and kids.
- Living far from the equator: It is rare for people living in tropical regions, where there are no pronounced seasons, to suffer SAD. Similarly, only 1% of people who live in Florida suffer SAD compared to 9% of those who live in the northern states of Alaska and New England.
| How Common Is SAD?
In the US, Seasonal affective disorder is estimated to affect 10 million people. Additionally, between 10 and 20% of the population suffer the mild form of SAD, often referred to as winter blues. Of the people who suffer SAD, 75% are women. Also, most sufferers are young adults. In fact, this form of depression usually begins in early adulthood. And, it is sometimes diagnosed in children and teenagers.
SAD is more prevalent in regions farther north or south of the equator (high latitude locations). It follows that people who relocated from more top latitude locations are more likely to suffer SAD.
SAD symptoms are similar to other types of depression. Therefore, concluding a SAD diagnosis is not a straightforward process.
Remember, SAD is a mood disorder with a recurring seasonal pattern. So, to be diagnosed with the disorder, you have to satisfy the full criteria of major depression that coincides with specific seasons. Additionally, the diagnosis requires recurring seasonal depression for at least two years. And, the seasonal depression has to occur more times than the non-seasonal episodes of depression.
During the diagnosis of SAD, the mental health expert does a thorough evaluation that may include the following procedures:
- Physical examination: The doctor will conduct a physical exam and ask questions about your physical health. Some cases of depression are linked to underlying physical health issues.
- Lab tests: In cases of depression, it is common for doctors to order a complete blood count (CBC). Also, your thyroid may be tested to make sure it is working correctly.
- Psych eval: The doctor will check for signs of depression by conducting a thorough psychological evaluation. They will ask about your symptoms, feeling, behavioral patterns, and thoughts. To help with these questions, you might have to fill a questionnaire.
- DSM-5: When diagnosing mental health issues such as SAD, doctors check your symptoms against those listed in the Diagnostic and Statistical Manual of Mental Disorders. The DSM-5 is a credible diagnostic tool published by the American Psychiatric Association.
| Treatment of SAD
Treatment includes a combination of the following:
- Light therapy
Light therapy is the most used treatment for SAD. The idea behind the treatment is that the diminished sunlight during the winter exaggerates the symptoms of SAD. So, patients are subjected to daily exposure to artificial light.
By simply sitting in front of a lightbox in the morning, daily until winter is over, your symptoms may reduce. Light therapy treatments last between 20 and 60 minutes.
Mental health specialists recommend cognitive behavioral therapy (CBT) for SAD. During the therapy sessions, your doctor will help you identify the negative thoughts. The idea is to replace these negative thoughts with positive ones.
Ultimately, CBT will help you:
- Identify and change your negative way of thinking
- Learn effective methods of managing stress
- Learn healthier ways of coping with SAD, specifically scheduling activities to reduce postponing important activities
When the symptoms of SAD are severe, doctors administer medication, specifically antidepressants. SAD patients can use Selective Serotonin Reuptake inhibitors (SSRIs), which are mostly used to treat clinical depression. Or, you can use FDA approved antidepressants such as bupropion.
Like other drugs, antidepressants have side effects. So, you might have to try different antidepressants before finding the one that improves your symptoms while causing as few side effects as possible.
Seasonal affective disorder is more than just a case of winter blues. Clinically, it is a mood disorder, which left untreated can harm your quality of life. So, if you have a persistently low mood during specific seasons each year, see a doctor. Remember, SAD is a treatable and manageable mental health issue. Though non-fatal, it is not something to tough out on your own.