How to Beat the Winter Blues: Understanding Seasonal Affective Disorder (SAD)

by C. Leonard, MBA, CHC, CHHP

Seasonal depression, also called seasonal affective disorder (SAD), is a type of depression. It’s triggered by the change of seasons and most commonly begins in late fall. Symptoms include feelings of sadness, lack of energy, loss of interest in usual activities, oversleeping and weight gain. Treatments include light therapy, talk therapy and recommended exercise therapies.

What is seasonal affective disorder (SAD)?

Seasonal affective disorder (SAD) is a type of depression triggered by a change in seasons that happens every year, usually when fall starts. This seasonal depression gets worse in the late fall or early winter before ending in the sunnier days of spring.

You can also get a mild version of SAD known as the “winter blues.” It’s normal to feel a little down during colder months. You may be stuck inside, and it gets dark early. .

But full SAD goes beyond this. It’s a form of depression. Unlike the winter blues, SAD affects your daily life, including how you feel and think. Fortunately, proper treatment can help you get through this challenging time.

Your healthcare provider may refer to seasonal affective disorder as seasonal depression.

Can people get seasonal affective disorder (SAD) in the summer?

Some people get a rare form of SAD called “summer depression.” It starts in the late spring or early summer and ends in the fall. It’s less common than the seasonal affective disorder that tends to come during winter.

How common is seasonal affective disorder (SAD)?

About 5% of adults in the U.S. experience SAD. It tends to start in young adulthood (usually between the ages of 18 and 30). SAD affects people assigned female at birth more than people assigned male at birth, though researchers aren’t sure why. About 10% to 20% of people in America may get a milder form of the winter blues.

What are the symptoms of seasonal affective disorder (SAD)?

Seasonal affective disorder (SAD) is a type of depression. The American Psychiatric Association officially classifies SAD as major depressive disorder with seasonal patterns. So if you have seasonal affective disorder, you may experience mood changes and symptoms of depression, including:

Sadness, feeling depressed most of the day, almost every day.
Anxiety
Carbohydrate cravings and weight gain.
Extreme fatigue and lack of energy.
Feelings of hopelessness or worthlessness.
Trouble concentrating.
Feeling irritated or agitated.
Limbs (arms and legs) that feel heavy.
Loss of interest in usually pleasurable activities, including withdrawing from social activities.
Sleeping problems (usually oversleeping).
Thoughts of death or suicide.

People who have summer SAD may experience:

Agitation and restlessness.
Anxiety.
Decreased appetite and weight loss.
Episodes of violent behavior.
Trouble sleeping (insomnia).

What causes seasonal affective disorder (SAD)?

Researchers from the Cleveland Clinic don’t know exactly what causes seasonal depression. Lack of sunlight and Vitamin D may trigger the condition if you’re prone to getting it. The theories suggest:

Biological clock change: When there’s less sunlight, your biological clock shifts. This internal clock regulates your mood, sleep and hormones. When it shifts, you’re out of step with the daily schedule you’ve been used to and can’t adjust to changes in daylight length.
Brain chemical imbalance: Brain chemicals called neurotransmitters send communications between nerves. These chemicals include serotonin, which contributes to feelings of happiness. If you’re at risk of SAD, you may already have less serotonin activity. Since sunlight helps regulate serotonin, a lack of sunlight in the winter can make the situation worse. Serotonin levels can fall further, leading to depression.
Vitamin D deficiency: Your serotonin level also gets a boost from vitamin D. Since sunlight helps produce vitamin D, less sun in the winter can lead to a vitamin D Deficiency. That change can affect your serotonin level and mood.
Melatonin boost: Melatonin is a chemical that affects your sleep patterns and mood. The lack of sunlight may stimulate an overproduction of melatonin in some people. You may feel sluggish and sleepy during the winter.
Negative thoughts: People with SAD often have stress, anxiety and negative thoughts about the winter. Researchers aren’t sure if these negative thoughts are a cause or effect of seasonal depression.

Who is at risk for seasonal affective disorder (SAD)?

Seasonal affective disorder (SAD) is more common in people between 18 and 30 and people assigned female at birth. You’re also at higher risk if you:

Have another mood disorder, such as major depressive disorder or bipolar disorder.
Have relatives with SAD, other forms of depression or mental health conditions, such as major depression or schizophrenia.
Live at latitudes far north or far south from the equator. There’s less sunlight during the winter at these latitudes or, live in cloudy regions.

How is seasonal affective disorder (SAD) diagnosed?

If you have symptoms of seasonal affective disorder (SAD), don’t try to diagnose yourself. See your healthcare provider for a thorough evaluation. You may have another reason for your depression. Many times, seasonal affective disorder is part of a more complex mental health condition.

Your provider may refer you to a psychiatrist or psychologist. These mental health professionals will ask you about your symptoms. They’ll consider your pattern of symptoms and confirm if you have seasonal depression or another mood disorder. You may need to fill out a questionnaire to determine if you have SAD.

There’s no blood test or scan to diagnose seasonal depression. Still, your provider may recommend testing to rule out other conditions that cause similar symptoms, including testing your thyroid to make sure it’s functioning properly.

What are the criteria for a seasonal affective disorder (SAD) diagnosis?

Your provider may diagnose you with SAD if you have:

Symptoms of major depression.
Depressive episodes that occur during specific seasons for at least two consecutive years.
Depressive episodes happening more frequently during a specific season than during the rest of the year.

How is seasonal affective disorder (SAD) treated?

Your provider will talk to you about treatment options. You may need a combination of treatments, including:

Light therapy: Bright light therapy using a special lamp, can help treat SAD or most recent preferred due to outcomes is Red Light Therapy (RLT).
Cognitive behavioral therapy (CBT): CBT is a type of talk therapy. Research has shown it effectively treats SAD, producing the longest-lasting effects of any treatment approach.
Antidepressant medication: Sometimes, providers recommend a medication, either alone or with light therapy.
Spending time outdoors: Getting more sunlight can help improve your symptoms. Try to get out during the day. Also, increase the amount of sunlight that enters your home or office.
Vitamin D: A vitamin D supplement may help improve your symptoms. Talk to the provider before starting this supplement.

How does photo light therapy work?

To use of phototherapy, you purchase special lamps that is affordable. It has white fluorescent light tubes covered with a plastic screen to block ultraviolet rays. The light is about 20 times brighter than regular indoor light. The intensity of light emitted should be 10,000 lux. To use phototherapy, don’t look directly into the light. Your exposure to the light should be indirect. Place the lamp about two to three feet away while you read, eat, work or do other activities.

How long will it take light therapy to work? People who use a lamp for SAD often see results within two to four days. It may take about two weeks to reach its full benefits.

How long should you continue to use light therapy? Healthcare providers often recommend using light therapy throughout the entire winter. SAD symptoms can return quickly after stopping light therapy. Continuing to use the therapy can help you feel your best throughout the season.

Is photo light therapy safe?

Light therapy is typically safe and well-tolerated. But you may need to avoid light therapy if you:

Have diabetes or retinopathies: If you have diabetes or a retina condition, there’s a potential risk of damaging the retina, the back of your eye.
Take some medications: Certain antibiotics and anti-inflammatories can make you more sensitive to sunlight. Light therapy can then cause harm.
Have bipolar disorder: Bright light therapy and antidepressants can trigger hypomania or mania, uncontrolled boosts in mood and energy level. If you have bipolar disorder, let your provider know. This will play a role in your treatment plan.

What are the side effects of photo light therapy?

You may experience:

Eyestrain.
Fatigue.
Headache
Insomnia
Irritability.

How does Red Light Therapy (RLT) work? Red Light therapy (RLT) also known as photobiomodulation (PBM) has shown promise and is most widely used today to treat various medical conditions from skin to whole body for healing, fat loss and overall health. It is a low level laser type therapy using specific wavelengths of light (650-850nm) to produce long lasting health benefits.

Red light therapy has a lot of benefits. Plus, it comes with zero side effects and is completely non-invasive. Red LED light devices work with your body to naturally produce long-lasting benefits. Benefits noted include: 1) Collagen production, reduction of wrinkles 2) Skin health -treat acne, psoriasis, rosacea 3)Hair loss, grow healthier thicker hair 4) Weight loss -reduce cellulite and fat 5) Muscle repair - reduce soreness & improve performance 6) Chronic Pain - pain relief 7) Wound healing - promote healing.

After all, what other things out there can promise all these amazing benefits with just one simple product?

While I’ve only included the top seven benefits, people who use red light therapy also report things like:

Improved brain health
Better Sleep quality
Increased testosterone
Better oral health
Improved mental health, including depression and anxiety

Do not use tanning beds to treat SAD. Tanning beds do generate enough light, but they can cause other harm. They produce a high amount of ultraviolet (UV) rays that can hurt your skin and eyes.

How can you prevent seasonal affective disorder (SAD)?

You may not be able to prevent the first episode of SAD. But once your provider diagnoses you with seasonal depression, you can take steps to better manage it or even prevent it from coming back.

Use your lightbox or red light therapy: Start using light therapy at the beginning of fall, before you feel SAD symptoms.
Get out: Spend time outside every day, even if it’s cloudy. Daylight can help you feel better.
Eat nutritious meals: Even though your body may crave starchy and sweet foods, stick to nutritious choices. Healthy foods with enough vitamins and minerals can give you the proper nutrition and energy you need.
Exercise: Try to get 30 minutes of exercise at least three times a week. Exercise relieves stress and anxiety, which can play a role in your SAD symptoms.
See friends: Stay involved with your social circle and regular activities. They can provide support during the winter months.
Find help: Consider seeing a mental health professional who’s trained in CBT. This treatment can be very effective for seasonal affective disorder.
Consider medications: Talk to your healthcare provider about taking an antidepressant. Medications can help if your symptoms are severe or if they continue after other treatments. In some cases, taking the medication before SAD begins can prevent episodes.

Talk to your healthcare provider to find out if starting treatment early, as a preventive measure, is right for you.

How can you best take care of yourself if you have seasonal affective disorder?

Talk to your healthcare provider Plan ahead, you can manage your symptoms and feel your best.

Do:

Stick to your treatment plan: If you have medications or a lamp for SAD, use them as directed. Follow up with your healthcare provider if you don’t see an improvement in your symptoms.
Care for yourself: Eat well-balanced meals. Get enough sleep. Exercise regularly. Try to manage stress, perhaps by talking to a counselor or therapist.
Plan ahead: Make a plan for what you’ll do if your symptoms get worse. If you notice signs of depression, take action. It might help to plan a lot of activities during these months. Having a busy schedule keeps you from hunkering down at home.
Start treatment early: Talk to your healthcare provider about preventive treatment. If you know your symptoms start in October, consider starting treatment in September.

Don’t:

Isolate yourself: Being alone can make your symptoms worse. Even though you may not feel like going out or being social, try to reach out to friends and loved ones.
Use alcohol or unprescribed drugs: They might make symptoms worse, and they can interact negatively with antidepressants.

You should see your healthcare provider if you think you have symptoms of seasonal depression or another mood disorder, see your healthcare provider. Your provider will want to rule out another condition or illness that may be causing these symptoms.

If you or a loved one has suicidal thoughts, get help. Call your provider, or go to an emergency room, call 911 or call the Suicide and Crisis Lifeline, at 988. This national network of local crisis centers provides free, confidential emotional support to people in suicidal crisis or emotional distress. It’s available 24/7.

What should you ask the healthcare provider?

If you have SAD, ask your provider: