Everything You Need To Know About Seasonal Affective Disorder

Because SAD is a subtype of depression, many of the symptoms are the same, per NIMH. The hallmark symptom of both depression and SAD is feeling down nearly every day, for the majority of the day, for longer than two weeks at a time. You may also feel an overpowering sense of hopelessness or worthlessness. Many people experience overwhelming fatigue and lose interest in the things that used to bring them joy. It's also common to be easily irritated and to have a hard time concentrating or forming thoughts. Thoughts of self-harm or suicide may also accompany depression or SAD. If you start to experience these thoughts, seek professional attention immediately.

A few additional symptoms are common with winter-pattern SAD. Many people find themselves sleeping a lot more than normal but not feeling refreshed by adequate rest. Another common symptom is overeating carbohydrates, which can lead to weight gain. A sense of "hibernation" is also prevalent. You might feel like withdrawing from your friends and family and avoiding social situations.

The symptoms of summer-pattern SAD are essentially the opposite of the symptoms of winter-pattern SAD. Instead of being extremely tired, many people with summer depression have trouble sleeping at all and feel restless, agitated, and anxious much of the time. Instead of gaining weight from carb cravings, they tend to lose weight due to loss of appetite. Sometimes people with summer-pattern depression can struggle with violent outbursts.

If you or someone you know is struggling with mental health or suicidal thoughts, please contact the Crisis Text Line by texting HOME to 741741, call the National Alliance on Mental Illness helpline at 1-800-950-NAMI (6264), visit the National Institute of Mental Health website, or call the National Suicide Prevention Lifeline​ at​ 1-800-273-TALK (8255)​.

According to an article in American Family Physician, experts on seasonal affective disorder generally agree that there is no single cause of the disorder and that it results from a combination of biological factors. One of the biggest contributing factors in both forms of SAD is the change in the amount of daylight. According to the NIMH, research has shown that sunlight helps regulate both serotonin and melatonin. Serotonin plays a major part in mood regulation, and melatonin is one of the hormones responsible for regulating our sleep patterns. Research shows that people with SAD aren't able to produce these chemicals in the proper amounts. So, when the amount of daylight changes and their chemical production is disrupted, they end up with a serotonin deficiency and an overproduction of melatonin, the perfect chemical combination for seasonal depression.

Another study published in Depression Research and Treatment found that people with lower levels of Vitamin D were more likely to exhibit seasonal symptoms of depression, which is consistent with other studies on Vitamin D deficiency and SAD. Since our biggest source of Vitamin D is exposure to sunlight, Vitamin D deficiencies are more likely to develop in the winter because we're not outside as much. Finally, studies have also shown a genetic component to SAD. Research done on families, especially on identical twins, have shown that if one person in the family has SAD, others in the family are more likely to have it as well (via Translational Psychiatry).

Luckily, there are several effective treatment options for seasonal depression, with the most common being antidepressant medications, talk therapy, and light therapy.

There are a few medication options for seasonal affective disorder. The FDA has only approved one medication, Wellbutrin (Bupropion), specifically for SAD, per the NIMH. However, selective serotonin reuptake inhibitors (SSRIs) are also effective. You can work with your doctor to determine which type of medication is best for you. Talking to a therapist, especially one who specializes in cognitive behavioral therapy (CBT), is also helpful for many people. Some people see therapists year-round, while others only work with one when they're experiencing SAD symptoms. Finally, light therapy involves daily exposure to a special kind of very bright light via a light box first thing in the morning. For best results, the exposure should last at least 20 minutes. Many people find that a combination of these therapies works best.

According to Psychology Today, cognitive behavioral therapy (CBT) is a type of talk therapy that focuses on identifying negative thought patterns and behaviors and learning to challenge them. CBT also teaches patients how to overcome these negative thought patterns and behaviors by replacing them with more realistic thought patterns and healthier behaviors.

Clinicians treating people with seasonal affective disorders have developed a specific kind of therapy specifically for SAD called CBT-SAD. This method combines the traditional techniques of CBT with another technique called behavioral activation. This technique focuses on helping patients figure out things that make them happy during the winter and developing a plan for how they'll implement those activities in their lives. One study found that CBT-SAD is just as effective as light therapy after the first year of treatment (via American Journal of Psychiatry). The same study found that after a second year of treatment, patients who underwent CBT-SAD therapy had fewer recurrences of their seasonal depression symptoms. This suggests that the impacts of CBT-SAD therapy may be more long-lasting than the impacts of light therapy. That said, another study found that during an acute depressive event, light therapy and CBT-SAD were equally effective in improving symptoms.

There are also several alternative treatments for SAD including supplements, meditation, and aromatherapy. According to NIMH, many people with SAD have Vitamin D deficiencies, so adding a Vitamin D supplement to their daily routine can help reduce SAD symptoms. The Omega Institute, a holistic medicine education program in the United States, suggests that St. John's wort may help as well. Adding supplements should only be done under the supervision of your medical team.

Additionally, a meta analysis of several studies found that aromatherapy both improved mood and reduced symptoms of SAD. The Omega Institute states that different scents can boost your mood in different ways. If you want to calm anxiety, try frankincense or lavender. If you need some energy, basil, peppermint, or grapefruit can do the trick.

Extensive research has also established that meditation can help reduce the symptoms of depression (via Harvard Health). In fact, new research suggests that meditation may even rewire the brain, improving depression symptoms. Several different forms of meditation have proven helpful, so people with SAD can choose the method that they're most comfortable trying.

Research has long shown a connection between isolation and several mental health issues including depression, per the American Psychological Association. Unfortunately, isolating is one of the symptoms of seasonal affective disorder (via NIMH), which makes it hard to maintain connections with family and friends or participate in social activities. This kicks off a nasty cycle: isolation makes your depression worse but your depression makes you isolate.

The only way to break this cycle is to stay connected with other people, Dr. Arlene Malinowski told Everyday Health. Malinowski, who has SAD herself, recommends preparing for your tough season by lining up a slate of fun activities, particularly ones that are social in nature. Psychologist Kim Burgess seconds this approach, with the reminder that FaceTime is a good way to connect over long distances, when the weather makes it tough to do anything outdoors, or if you aren't able to do a COVID-safe in-person hang (via Everyday Health). So when you know the seasonal blues are coming on, set up a regular walking date with a bestie, join a book club, or put a Zoom call with friends on the calendar — these social connections will help boost your mood.

Making some simple lifestyle changes can also help with SAD. According to Everyday Health, sticking to a consistent daily routine is important. Waking up and going to bed at the same time each day ensures that you're exposed to light for a similar amount of time, and will help regulate your sleep/wake cycle, which is crucial for managing SAD. Make sure that you add things you enjoy into your daily routine as well, or plan a vacation or staycation to get in some fun and relaxation time.

According to WebMD, journaling is another great practice for those with SAD. Writing down how you're feeling on a daily basis can make you more aware of your negative thoughts. It can also help you identify patterns that you've fallen into during your depression. This can give you a sense of control over your SAD. Journaling is also a good release at a time when you might be tempted to push down your thoughts and feelings.

Remember to be gentle with yourself during these times as well. John Hopkins Medicine suggests that adjusting your expectations around productivity and setting goals that are in line with how you're feeling is important for managing seasonal depression as well. If you need to accomplish a big task or project, break it down into smaller pieces to avoid getting overwhelmed by the big picture.