Seasonal affective disorder (SAD) is an episode of depression that occurs and tends to reoccur during a certain time of year, usually in winter. SAD entails serious mood changes and possible heightened anxiety. It is not a separate disorder to depression and is added as a description to the pattern of major depression or bipolar, otherwise known as a subtype.
Dr Norman E. Rosenthal reported and named the condition in the early 1980s when he noticed a definite depressive mood in winter months. People who get seasonal affective disorder normally do not have other serious mental health issues during the rest of the year. The onset of seasonal affective disorder is normally around the early twenties and it affects women more than men.
If seasonal affective disorder occurs in summer it is known as reverse seasonal affective disorder. People with SAD can go on to develop bipolar and hypomania in the summer months.
Climate is the main cause of seasonal affective disorder, particularly in places with long and cold winters. There could be a possible evolutionary genetic influence that sends people into a state of hibernation during the winter months in preparation for a lower caloric intake. Symptoms normally appear in late fall or early winter. Light levels are one of the central reasons behind SAD. It is highly prevalent in arctic regions such as Finland; the further away from the equator you live the greater the chance of developing SAD.
A decrease in serotonin and increase in melatonin is thought to underlie this phenomenon. The body clock circadian rhythms are also affected because of the lower amount of light, which can also lead to depression.
The symptoms of seasonal affective disorder include overeating, difficulty getting out of bed, a lack of energy and difficulty concentrating or completing tasks. People who get seasonal affective disorder in non-winter months show symptoms of classic depression: social withdrawal, weight loss, insomnia and suicide. Seasonal affective disroder is simply not feeling a little more tired or lower energy levels in certain seasons.
Fall and winter seasonal affective disorder (winter depression)
Winter-onset seasonal affective disorder symptoms include:
- Loss of energy
- Heavy, “leaden” feeling in the arms or legs
- Social withdrawal
- Loss of interest in activities you once enjoyed
- Appetite changes, especially a craving for foods high in carbohydrates
- Weight gain
- Difficulty concentrating *
It’s important to not just dismiss seasonal affective disorder as some clockwork winter blues that just needs to be worked though and endured. With the right attitude, interventions and planning, your mood and motivation can remain steadfast throughout the year.
What beats seasonal affective disorder?
Light therapy, called phototherapy, has treated SAD for over 20 years. Often treatment is done via a light box although cumbersome delivery makes it difficult for some and this therapy doesn’t work for all. MIND UK lists the main types of light therapy:
- The light boxes range in size from a small TV-sized tabletop box to a wall-mounted window-type fixture. They contain a number of bright light tubes covered by a screen. You sit about half a metre to a metre away from it, and can carry on with normal activities, such as reading, working, eating or even watching TV.
- A portable light visor fits on your head, shining light directly into your eyes and giving you complete freedom of movement.
- A dawn simulator is a bedside light, connected to an alarm clock, which mimics a sunrise and wakes you gradually. *
Examples of light therapy products are found on this website: MM Lights
Antidepressant medications are effective against all forms of depression, including SAD. Discuss this with your health professional for further information.
Cognitive Behaviour Therapy (CBT)
CBT is all about changing cognitive processes that in turn change feelings and behaviours. CBT can be used to pre-empt the shift into SAD before the onset of the season. Unlike other depressions in which episodes cannot be predicted, SAD normally occurs during regular seasons thus allowing the person to mentally prepare and adjust before the onset.
Despite strong feelings of isolation and lethargy, the effort must be made to get outdoors in spite of these feelings. You don’t need to turn into a fitness fanatic, long walks every day can be very beneficial. Treat yourself gently and be easy on yourself. Maximise the time you spend in natural light, as the sun is the best source of Vitamin D you can get.
Connect to a robust and varied support network and keep socialising even when you don’t feel like it.