As the days get shorter and colder, some people experience more than just the typical winter blues. It’s the time of year when clients share difficulties in mood fluctuations, sleep problems and fatigue, and changes in behaviors (social withdrawal, loss of interest in activities, etc). Seasonal Affective Disorder (SAD) is a type of depression that follows a seasonal pattern, often occurring during the fall and winter months in the Northern Hemisphere. According to the American Psychiatric Association, SAD is considered a form of major depressive disorder with a seasonal pattern, primarily impacting individuals in higher latitudes where winter days are shorter and sunlight is limited (American Psychiatric Association, 2017). Understanding SAD can help us recognize its symptoms and find ways to manage it effectively.

What Causes SAD?

The exact cause of SAD isn’t fully understood, but researchers suggest it’s largely linked to reduced sunlight during the fall and winter. Sunlight plays a vital role in regulating our circadian rhythms, or “internal clocks,” and helps maintain proper levels of serotonin, a neurotransmitter associated with mood. When days grow darker, serotonin levels can drop, which may lead to depressive symptoms (Melrose, 2015). Additionally, shorter days can increase melatonin production, making people feel more tired and lethargic, which further affects mood and energy levels (Rosenthal et al., 1984).

Recognizing the Symptoms.

SAD symptoms are similar to those of major depression but are often most intense during specific seasons. They include:

• Persistent low mood

• Loss of interest in previously enjoyable activities

• Low energy and fatigue

• Difficulty sleeping or changes in sleep patterns

• Weight gain and increased appetite, especially for carbohydrates

• Feelings of hopelessness or worthlessness (Rohan et al., 2009)

Who is at Risk?

SAD affects millions of people worldwide, but certain factors can increase the likelihood of experiencing it. Women are more commonly affected than men, though the severity is often greater in men. People living in northern regions are also more susceptible due to the long, dark winters (Kasper, 1993). Those with a family history of depression or other mental health disorders may also be at a higher risk.

Effective Treatments.

Several treatments have been found to help alleviate symptoms of SAD, including:

Light Therapy.

One of the most common treatments, light therapy, involves using a special lightbox that mimics natural sunlight. Studies have shown that daily exposure to bright light can significantly improve mood and energy in people with SAD, especially when used in the early morning (Lam et al., 2006). It’s recommended to consult with a healthcare provider before starting light therapy, as the intensity and duration should be tailored to individual needs. For a 2024 review of best light boxes, visit: https://www.cnn.com/cnn-underscored/reviews/best-sad-light-therapy-lamps

Cognitive Behavioral Therapy (CBT).

CBT has been shown to be highly effective in treating SAD by helping individuals identify and change negative thought patterns and behaviors related to the winter season. Cognitive Behavioral Therapy – Seasonal Affective Disorder (CBT-SAD) is a tailored version of CBT that addresses the specific challenges of winter depression (Rohan et al., 2015). Studies have found that CBT can have lasting effects beyond a single season, helping people build resilience to future episodes.

Medication.

In some cases, antidepressant medications may be prescribed, particularly if other treatments haven’t been effective. Selective serotonin reuptake inhibitors (SSRIs) are commonly used to increase serotonin levels and alleviate depressive symptoms (Thaler et al., 2011). It’s important to discuss the risks and benefits of medication with a healthcare provider.

Lifestyle Changes.

Incorporating lifestyle changes such as regular exercise, a balanced diet, and consistent sleep patterns can help manage SAD symptoms. Physical activity, especially outdoors when possible, can boost endorphins and improve mood. Small steps, like taking a walk during daylight hours, can make a noticeable difference (Miller, 2005).

Coping with SAD.

Aside from treatments, practicing self-care is essential for managing SAD. Staying connected with friends and family, setting realistic goals, and engaging in activities that bring joy can help combat the isolation and low energy that often accompany SAD. Making your home brighter by opening curtains or using additional lamps can also lift your spirits. Remember, seeking support from mental health professionals is a valuable step if you’re feeling overwhelmed.

Final Thoughts.

Seasonal Affective Disorder is a serious condition that affects millions of people, particularly during the winter months. By understanding its causes and symptoms and exploring effective treatment options, those affected by SAD can find relief and enjoy a higher quality of life throughout the year. While winter may be dark, there are many ways to bring light back into your life.

Notes.

• American Psychiatric Association. (2017). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed.

• Kasper, S. (1993). Seasonal affective disorder: light in winter. Guilford Press.

• Lam, R. W., et al. (2006). "Effects of bright light on mood and cortisol in subjects with winter seasonal affective disorder." Biological Psychiatry, 34(4), 210-216.

• Melrose, S. (2015). "Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches." Depression Research and Treatment, 2015.

• Miller, J. (2005). "The importance of exercise for mental health." Psychiatry Journal.

• Rohan, K. J., et al. (2009). "Randomized trial of cognitive-behavioral therapy versus light therapy for seasonal affective disorder: acute outcomes." American Journal of Psychiatry, 166(4), 443-451.

• Rosenthal, N. E., et al. (1984). "Seasonal affective disorder: A description of the syndrome and preliminary findings with light therapy." Archives of General Psychiatry, 41(1), 72-80.

• Thaler, K. J., et al. (2011). "Second-generation antidepressants for seasonal affective disorder: systematic review and meta-analysis." Cochrane Database of Systematic Reviews.