A Quick Guide to Seasonal Affective Disorder

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What is Seasonal Affective Disorder (SAD)?

Seasonal Affective Disorder (SAD), now referred to as "depression with a seasonal pattern" in the updated DSM-5, is a specific type of recurring depression that people experience during a particular season, typically the fall and winter months of the year. Between 1-10% of the United States population experiences SAD and it is heavily dependent on geographical location--the farther away from the equator you live, the more at risk you are for experiencing seasonal depression.

Some people experience only seasonal depression; that is, they only become depressed during a certain time of year and their depression consistently ends when the season is over. To be diagnosed with SAD, you have to experience at least two consecutive years of seasonal depression without any periods of depression outside of this. 

Seasonal changes in mood and depression are also common for individuals with other mood disorders such as Bipolar Disorder, Major Depressive Disorder, and Dysthymia. Either way, coping with increased depression in the winter is hard, especially if you live someplace cold like Minnesota where it's easy to stay inside, isolate, and engage in behaviors that make your depression worse!

What is SAD caused by?

Shorter days, less sunlight -- Certain neurotransmitters, or chemicals released and produced by your brain to regulate your mood, are influenced by the amount of sunlight you are exposed to. During the winter months when the days are shorter, the neurotransmitter serotonin is impacted by the decrease in sunlight, which can result in increased depression. Some people also produce more melatonin, a hormone that causes sleepiness, in the winter, which can lead you to feel more lethargic and tired than usual. Finally, the lack of sunlight (especially if you are cooped up in a windowless office all day or sleeping because you work nights!) can result in less Vitamin D being produced by the body--deficiencies in this are associated with increased depression.

Symptoms of SAD

Look for the following changes in your behaviors, mood, and self-care:

  • Mood: feeling low, depressed, sad, crying, irritable or impatient with others
  • Social & Leisure: less interest or desire to spend time with others, reduced social activities, isolating yourself, no pleasure from or motivation towards your usual hobbies & interests
  • Sleep: sleeping more than you usually do, feeling tired despite getting enough sleep
  • Eating: Increased appetite, craving for carbohydrates (this is your body's attempt to increase its serotonin! though as you know from the crash experienced after bingeing on sugars, it's a short-lived solution), may experience seasonal weight gain
  • Energy: feeling lethargic, hard to move or get anything done, low energy, feels like your body is moving through a tub of molasses
  • Anxiety & Stress: being stressed out more easily than normal, feeling anxious or worried

You can also take this Seasonal Affective Disorder Questionnaire, which was created by the National Institute for Mental Health and is located inside this article authored by one of its developers, Norman Rosethanl: How Seasonal Are You? 

What to do about being SAD:

First, remind yourself--you are not alone. Many people experience SAD on a yearly basis and it is likely that if you experience seasonal depression, other people living in your city experience it too. 

1. Make A Plan
Whatever strategies or methods your plan includes, it is important to enter winter having a clear plan for how you will cope with increased depression. Becoming aware of a seasonal pattern to your depression is a good first step--you can't address a problem until you know it's happening. Talk to friends, family, or your support system and generate a list of ideas or things to try. Reflect on what's worked for you in the past--and what hasn't. Consider tracking your symptoms and mood each day so you can figure out what strategies, tools, or therapies work best for you. On the bright side? At least you'll have a chance every year to practice getting good at coping with SAD!

2. Traditional & Alternative Therapies
There are many options including both traditional Western medicine and alternative therapies and supplements to address seasonal depression. Of course, always consult with your health professional before trying something new, whether that's your primary care physician, psychiatrist, nurse practictioner, acupuncturist, nutritionist...just have someone with medical knowledge on board :)

  • Lifestyle Changes: This is probably the hardest thing to do in terms of treating SAD, but also one of the most effective, plus it's FREE and requires no external resources. Just like with other kinds of depression, you can change the way you feel and think just by changing your behaviors. This includes things like: getting more exercise, trying to spend time outdoors whenever you can, altering your diet to include more complex carbohydrates, healthy fats and proteins, and reducing refined sugars and other carbohydrates.
     
  • Acupuncture: Some people find acupuncture helpful for treating seasonal depression. I would recommend seeking out someone who specializes in treating individuals with mood disorders or seasonal depression.
     
  • Supplements: Henry Emmons has a great discussion on supplements you can take to help with depression and you can also check out his book The Chemistry of Joy where he talks about these options more in depth. 
     
  • Light Therapy:  You can purchase a light box, which produces bright, artificial light and is used to simulate the sunshine early in the morning. Typically people use this for about 20-30 minutes each day in order to be effective, which means it is a bit of a time commitment--especially if you are not usually a morning person. There are some reasons why you don't want to use this if you are on certain medications so again, consult with your pharmacist or physician.
     
  • Antidepressants: Consult with your physician or med prescriber about the option for using an antidepressant to try and prevent episodes of winter depression by taking them when your symptoms usually begin. As with any medication, there are many side effects that accompany antidepressants so you'll have to weigh the pros and cons with your doctor.

3. Find a Buddy!
If you are experiencing seasonal depression where you live, chances are there is someone else in your life who also struggles with increased depression in the winter. Reach out for support and you may be surprised! Having an accountability buddy can help you stay on track with any goals you set for yourself and can also help you stay motivated--soo improtant when one of the primary symptoms of depression is feeling unmotivated and losing interest in doing anything!

4. Get Professional Help
If your depression becomes so bad that you are struggling to get out of bed every day, missing work or school, thinking about hurting yourself or committing suicide--don't wait to get help. Call the number on the back of your insurance card, ask for a referral from your primary care doc, go to Psychology Today or ask around for suggestions from friends who have been to therapy. If things get really bad, it's unbelievably helpful to have a professional on your side to support you through it. 

5. Other Resources

Winter Blues: Fourth Edition: Everything You Need to Know to Beat Seasonal Affective Disorder by Norman E. Rosenthal

NIMH: Seasonal Affective Disorder
 
Norman Rosenthal's website