Seasonal Affective Disorder
What is Seasonal Affective Disorder?
Every year, as the days grow shorter and the weather gets colder, I notice a dip in my energy and mood. A small drop in energy and mood during the fall and winter months, especially in areas far from the equator like Northeast Ohio, is not unusual. Many of my patients have shared similar experiences over the years. While it’s normal to feel a little down during the colder months, for some, these feelings become overwhelming and disruptive. This goes beyond the "winter blues"—seasonal depression is a form of major depression.
Seasonal Affective Disorder (SAD) can also occur alongside bipolar disorder, typically during a depressive episode in bipolar II rather than bipolar I.
SAD, also appropriately called "SAD," is a type of depression that occurs mainly during the fall and winter months when there is less natural sunlight. It’s most common in regions where daylight hours significantly decrease in winter. Although SAD can affect anyone, it is more commonly diagnosed in women, young adults, and individuals with a family history of depression.
Symptoms of SAD
SAD is a form of major depression therefore symptoms mirror the symptoms of major depression but they have a seasonal pattern to them.
Symptoms include:
Persistent sadness or hopelessness: Low mood and energy lasting weeks, occurring most days for most of the day.
Fatigue and low energy: This goes beyond occasional tiredness, persisting for weeks at a time.
Loss of interest in activities once enjoyed.
Difficulty concentrating or making decisions.
Changes in appetite: SAD is often associated with increased cravings for carbohydrates.
Weight gain.
Oversleeping or difficulty waking up.
Feelings of worthlessness or excessive guilt.
These symptoms typically begin in late fall or early winter and subside in spring or summer. However, some individuals experience a less common form, known as "summer depression," which occurs during the warmer months. For teenagers, symptoms can ramp up around the time schoolwork increases and midterms approach.
It’s important to note that while life stressors (like unemployment in winter) can lead to depression or anxiety, these triggers are not the cause of SAD. SAD is specifically linked to seasonal changes, not psychosocial stressors.
What Causes SAD?
The exact cause of SAD isn’t fully understood, but researchers believe it’s linked to reduced exposure to sunlight, which can disrupt the body’s internal clock (circadian rhythm).
Strategies to Manage SAD
Although we can’t all escape to tropical locations for the winter, effective strategies and treatments can help manage SAD:
Light Therapy
Light therapy is a simple and cost-effective treatment for SAD. I use light boxes at home and work, and they’ve improved my mood and energy levels. Light therapy involves sitting near a light box that mimics natural sunlight for 20–30 minutes each morning.Important: If you have bipolar disorder, consult your doctor before starting light therapy, as it can trigger manic episodes. Avoid using light therapy in the evening, as it may interfere with melatonin production and disrupt sleep.
Psychotherapy
Cognitive-behavioral therapy (CBT) can help identify and change negative thought patterns associated with SAD. CBT is particularly effective for managing symptoms, recognizing triggers, and preventing recurrence.Medication
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are often prescribed for SAD. For those already taking medication for depression, providers may adjust the dosage during the winter months. If you think medication might help, schedule an appointment with your primary care provider.
4. Lifestyle Adjustments
Spend Time Outdoors: Natural light, even on cloudy days, is beneficial. Try to take a walk during daylight hours, especially in the morning.
Stay Active: Regular exercise boosts mood and energy levels. Outdoor exercise is even better!
Maintain a Healthy Diet: Often when people are depressed they end up eating more junk food, which isn’t helpful for getting the nutrients you need or giving you long lasting energy. Eating a balanced diet rich in fruits, vegetables, and whole grains can support overall well-being.
Stay Connected: People often isolate themselves when they are depressed. Spending time with friends and family and getting support from them is extra important in the winter months if you have SAD.
Try a Dawn simulator: This is a device that often doubles as an alarm clock and gradually increases light in the morning to mimic a natural sunrise.
When to Seek Help
While occasional low moods during winter are normal, it’s essential to seek professional help if your symptoms:
Last for weeks at a time.
Interfere with daily life.
Include thoughts of self-harm or suicide.
A psychologist or mental health professional can evaluate your symptoms and provide tailored treatment recommendations. If you think I might be a good fit, feel free to call me at (216) 245-2421 for a free 15-minute phone consultation. I’d be happy to hear about what’s happening and, if I’m not the right fit, help point you in the right direction.