Life naturally slows down in winter. The days grow shorter, light becomes scarce, and we respond by planting ourselves in front of the television or hiding under the covers to stay warm. But how do you know when a seasonal slump is a more serious problem?
Seasonal affective disorder (SAD) is a category of depression that emerges in particular seasons of the year. Most people notice SAD symptoms starting in the fall and increasing during the winter months, but a few people experience a spring/summer version. Let’s take a look at some common questions you might have about this disorder.
What are the most common symptoms of SAD?
SAD symptoms are the same criteria you’d need for a diagnosis of major depression. These might include a depressed mood, feelings of hopelessness, a lack of energy, difficulty concentrating, changes in sleep and appetite, a loss of pleasure in activities you once loved, and even thoughts of death or suicide. Persons with the winter version of SAD might also notice the following unique symptoms:
Heaviness in arms and legs
Cravings for carbohydrates/weight gain
Is SAD a “lighter” version of major depression?
No, even though this is a common misconception. SAD is a “specifier” of major depression, which is just a fancy word for a more specific kind, or subtype. Persons with seasonal affective disorder experience the symptoms at a particular time of year. With the changing of seasons, their depression goes into remission. If you notices this switch happening several times over two years, then you may qualify for this diagnosis.
What causes SAD?
Researchers have yet to uncover the specific cause for SAD. We do know however, that several factors are at play. The reduction in sunlight in winter can throw your biological clock out of whack and reduce levels of serotonin (a brain chemical that regulates your mood) and Melatonin (a chemical which regulates sleep and mood).
If you are young and female, you are also at increased risk for SAD. People who live farther from the equator or have a family history of depression also experience the symptoms more frequently.
How do I know when to call a doctor?
Sure, everyone has days in the winter when they feel sluggish or unmotivated. But if your symptoms are causing disruptions in your life, then never hesitate to reach out to a professional. If symptoms occur for days at a time, you notice major shifts in sleeping or eating, you are withdrawing socially, or the activities that usually boost your mood don’t work, then it’s time to pick up your phone. Seek immediate help if you are using alcohol to manage symptoms or you are experiencing suicidal thoughts.
How do I get the best care for SAD?
It’s never too late if you’re already experiencing symptoms of seasonal affective disorder. Seeking treatment can help prevent them from becoming worse. You can schedule an appointment with your primary care physician or make an appointment with a mental health professional, like a psychiatrist, psychologist, or licensed counselor. Check to see if your workplace has an Employee Assistance Program that offers free counseling or referrals to providers in your community.
To get the best level of care, sit down and engage your brain before your appointment. Play detective, and take some notes about the frequency and nature or your symptoms, other mental and physical health concerns you have, and observations about what helps your depression or makes it worse. You can also jot down specific questions you might have for your doctor. These might include:
What might also be causing my symptoms instead of SAD?
What treatments have your patients found helpful in the past?
Would you recommend a mental health provider in the community?
Are there any behavioral changes I can make today to help my mood?
Are there any written resources you’d recommend?
When you’re at the doctor’s office, he or she may conduct a physical exam or lab tests to rule out other physical causes for your depression. The doctor may also recommend that you see a mental health professional to receive a more thorough assessment.
What treatments might work for me?
With any mental health problem, there is no one-size-fits-all treatment. Here are a few options to explore with your doctor.
Medication – Antidepressants have proven to be effective for people with SAD, especially those with intense symptoms. Medication requires patience, because it can take several weeks before you begin to feel the effects. It’s also important not to stop taking the medication if you feel better. Consult with your doctor before you change your dosage, and let him or her know if you experience any side effects.
Psychotherapy – Talk therapy can be an invaluable option for those with SAD. A psychotherapist can help you identify patterns in negative thinking and behavior that impact depression, learn positive ways of coping with symptoms, and institute relaxation techniques that can help you restore lost energy.
Light therapy – Phototherapy involves exposing oneself to light via a special box or lamp. This device produces similar effects to natural light, triggering chemicals in your brain that help regulate your mood. This treatment has proven effective especially for those who experience the winter version of SAD. Don’t make an impulse buy on the Internet though, as it’s important to consult with your doctor first. You want to make sure you’ve purchased an effective and safe device.
But what can I do today?
In addition to seeking help from your doctor, there are lifestyle changes that can improve symptoms and lift your mood. You might try going outside more often, getting plenty of sunlight, exercising, avoiding drugs and alcohol, getting plenty of sleep, and practicing relaxation exercises.
Planning a healthier lifestyle is never a bad idea. But don’t beat yourself up if your symptoms don’t improve right away. Don’t brush them off as the January blues and simply hunker down until spring. Asking for help is a sign of strength and movement towards a better version of yourself. Consider how you can start managing seasonal affective disorder today and live a healthier life in every season.
Last Updated: Feb 14, 2018
Arnold Lieber, MD