Fall and winter months bring a higher prevalence of Seasonal Affective Disorder, also known as SAD. As time changes and we experience fewer hours of sunlight, symptoms of SAD may begin to surface—and they can look like depression.
What is Seasonal Affective Disorder?
Health care professionals use a resource known as the DSM (Diagnostic and Statistical Manual of Mental Disorders) to research and diagnose disorders. The fifth edition of the DSM does not define SAD as a separate diagnosis, but includes it as a variant of major depressive disorder or bipolar disorder.1 It is a unique disorder and should not be confused with holiday stress or grief related to the holidays.
Typical features of depression include depressed mood, decreased interest in things we once liked, guilt or hopelessness, decreased energy, and impaired mood. Typical features of bipolar disorder include mania, hypomania, depression, irritability, anxiety, mood lability, sleep disturbance, and hyperactivity.
SAD can look like these but the trigger for it is seasonal, and symptoms may diminish at the end of the season. An official diagnosis of SAD requires at least two consecutive years of episodes.
This disorder is most common in the fall and winter, and includes a few unique features, such as increased need for sleep, carbohydrate cravings with increased appetite and weight gain, and extreme fatigue.2 The less common spring/summer type may have the atypical symptoms of increased irritability, poor appetite with weight loss, insomnia, agitation, restlessness, anxiety and increased violence.3
People at higher risk of SAD are those who have a family history of it, were born female, are between the ages 18 to 30, and live in northern latitudes which experience fewer hours of sunlight per day.
Fly South for the Winter
We can’t avoid the seasons in the Texas Panhandle, but the good news is that SAD is treatable. Here are a few ways to be proactive against its effects:
Light up. Light therapy, either using lamps or good old sunshine, can greatly improve symptoms of SAD. Since the 1980s, light therapy has been a mainstay for treating winter-related SAD, using bright light exposure to make up for the diminished natural sunlight of darker months. For some, a clinical form of this treatment involves sitting in front of a very bright light box (10,000 lux) daily from fall to spring. Please consult your optometrist before starting light therapy if you have sensitive eyes.
Another way to treat SAD is a lot more fun than sitting in front of a box; it’s choosing to take that trip to the warmer parts of the world. That’s right: Lying on a beach is a great treatment for SAD! If you aren’t in a position to travel south, try to spend time outside on warm days to soak up a little sunlight. Make sure to wear sunscreen if you go outdoors. (Sunscreen won’t decrease the benefits.)
Sleep. Sleep hygiene is important for everyone—not just those struggling with SAD—but it’s also a worthwhile treatment. Avoid prolonged screen time at night before bed. That means no TVs in the bedroom. (The bedroom should be only for sex and sleep.) Use relaxation techniques like exercise, yoga, meditation, a hot shower or bath, chamomile tea or a good book to wind down at the end of the evening.
Exercise. Physical activity also has benefits against the effects of Seasonal Affective Disorder. It does not have to be scheduled or extreme for those benefits to appear and can be as simple as taking the family dog for a walk around the block, doing a guided yoga session in your living room or shoveling snow, raking leaves or playing outside with your children. Anything that gets you outside on warm days for physical activity releases endorphins that improve mood.
Socialize. Another way you can boost serotonin and endorphins is by socializing with those you love, friends or family. A lot of us are tempted to hibernate indoors when the weather gets chilly, but find ways to spend time with others.
Reach Out. If you feel you are struggling with SAD, don’t hesitate to reach out to a mental health professional. Cognitive-based psychotherapy that concentrates on mindfulness, grounding and meditation, can improve mood, decrease anxiety and manage stress. One can also practice stress management by developing coping skills and healthy distractions.
What About Vitamin D?
I often get asked about the usefulness of vitamin D supplements to treat SAD. Although people with SAD have been known to have a lower level of vitamin D due to diet or lack of sunshine, there is little research supporting supplementation to be helpful in improving symptoms of SAD. Of course, having enough vitamin D is good for a lot of other health-related factors, so it won’t hurt to supplement—but consult your physician beforehand, of course.
Advocate for Yourself
Most importantly, if you struggle with depression or feel like you need an adjustment to your medication, consult with your physician, provider, or psychiatrist. Options are available and can be tailored to your needs while working alongside your current medications, and can include vitamin supplements, sleep aids, anti-anxiety medications and other medications. However, it is essential to discuss any changes with your health care provider first.
1. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2014.
2. Sohn CH, Lam RW. Update on the biology of seasonal affective disorder. CNS Spectr. 2005;10(8):635-646.
3. Melrose S. Seasonal affective disorder: an overview of assessment and treatment approaches [published online November 25, 2015]. Depress Res Treat. https://www.hindawi.com/journals/drt/2015/178564/