What You Should Know
Overview
Seasonal Affective Disorder (SAD) is a type of depression that comes and goes with seasons. SAD typically begins in late fall or early winter and goes away during the spring and summer months.
Symptoms
Symptoms may start out mild and become more severe as the season progresses. Winter pattern SAD symptoms may include, but are not limited to:
• Feeling depressed most of the day, nearly every day
• Low energy
• Hypersomnia (excessive daytime sleepiness or excessive time spent sleeping)
• Difficulty concentrating
• Overeating
• Weight gain
• Craving carbohydrates
• Loss of interest in activities normally enjoyed
• Social withdrawal
SAD episodes may also be linked to the summer months, although less common. Symptoms include:
• Poor appetite; weight loss
• Insomnia
• Agitation
• Anxiety
• Restlessness
Causes
The specific cause of seasonal affective disorder remains unknown. Some factors that may come into play include:
• Your circadian rhythm (decrease in sunlight may disrupt your body’s internal clock)
• Serotonin levels (drop in serotonin due to reduced sunlight)
• Melatonin levels
Risk Factors
SAD is diagnosed more often in women than in men and occurs more frequently in younger adults than in older adults. Factors that may increase your risk of seasonal affective disorder include:
• Family history
• Having major depression or bipolar disorder
• Living far from the equator. (This may be due to decreased sunlight during the winter and longer days during the summer months.)
Diagnosis
Even with a thorough evaluation, it can sometimes be difficult for your doctor or mental health professional to diagnose seasonal affective disorder because other types of depression or other mental health conditions can cause similar symptoms. To help diagnose SAD, your doctor or mental health professional may do a thorough evaluation, which generally includes:
• Physical exam.
• Lab tests. For example, your doctor may do a blood test called a complete blood count (CBC) or test your thyroid to make sure it’s functioning properly.
• Psychological evaluation.
Treatment
Treatment for seasonal affective disorder may include light therapy, medications and psychotherapy.
Light therapy – Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood. This is one of the first lines of treatment and generally starts working in a few days to a few weeks and causes few side effects.
Medications – Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe. An extendedrelease version of the antidepressant bupropion (Wellbutrin XL, Aplenzin) may help prevent depressive episodes in people with a history of SAD. Other antidepressants also may commonly be used to treat SAD. Keep in mind that it may take several weeks to notice the full benefits. In addition, you may have to try different medications before you find one that works well for you.
Psychotherapy – Psychotherapy, also called talk therapy, is another option to treat SAD.
Complications
It’s normal to have some days when you feel down. But if you feel down for days at a time and you can’t get motivated to do activities you normally enjoy, see your doctor. As with other types of depression, SAD can get worse and lead to problems if it’s not treated.
Cope
Learn healthy ways to cope with SAD. Examples of mind-body techniques that some people may choose to try include:
• Yoga or tai chi
• Meditation
• Guided imagery
• Music or art therapy
-ProAct Clinical
