WHEN SEASONS GET YOU DOWN: UNDERSTANDING SEASONAL AFFECTIVE DISORDER

Medically Reviewed by Dr. Sony Sherpa (MBBS) - August 23, 2024

Seasonal depression that strikes at the same time every year, mostly in the fall and winter when the days are shorter and darker, is known as seasonal affective disorder (SAD). This dark, dreary weather often reflects the mood and energy levels of those with SAD, who become depressed and withdrawn. Luckily, there are many ways to tackle winter depression, from light therapy to psychotherapy.

In this blog post, we will explain what SAD is, how common it is, whether it can occur in summer, as well as causes, symptoms, and available treatment options. SAD self-care tips and how to cope with SAD are also discussed in line with optimizing the circadian rhythm for mental well-being.

What is Seasonal Depression, and How Common Is It?

SAD is a specifier that indicates a seasonal pattern of depressive episodes. This means that people with SAD have the same symptoms of depression as people with major depressive disorder (MDD) or bipolar disorder (BD), yet only during certain seasons. ^[1]

SAD is more common in the fall and winter months, when the days are shorter and darker. This is sometimes called winter depression or winter blues. However, some people may experience SAD in the spring and summer months, when the days are longer and brighter. This is known as reverse SAD or summer depression. ^[2]

SAD is a relatively common condition that affects about 4 to 6 percent of the U.S. population and symptoms typically last for up to 40% of the year. However, the prevalence of SAD may vary depending on the latitude, climate, and culture of the region. It is more common in northern countries, where the winter days are short and cold. SAD is also more common in women than in men and in younger adults than in older adults.

What Causes Seasonal Affective Disorder?

The exact causes of SAD are not fully known, but researchers believe that several factors may contribute to the development of this disorder. The seasonal affective disorder is associated with specific genetics, circadian rhythm, and mental health in general^[3]:

Circadian Rhythm Disruption: The circadian rhythm is the natural biological clock that regulates the sleep-wake cycle and other bodily functions. It is influenced by the exposure to natural light, which varies with the seasons. In the fall and winter months, when the days are shorter and darker, the circadian rhythm may be delayed or shifted, resulting in a mismatch between the internal clock and the external environment. This may cause a disruption in the production and regulation of hormones and neurotransmitters, such as melatonin, serotonin, and dopamine, that affect mood, sleep, and appetite.

Genetics: Another factor that may cause SAD is the genetic predisposition. Some people may have a genetic variation that makes them more sensitive to changes in light and more prone to developing depression. Additionally, some people may have a family history of depression or bipolar disorder, which may increase their risk of developing SAD.

Other risk factors that might contribute to disrupting the circadian rhythm and lead to SAD include:

• Pre-existing depression or other related health conditions, such as ADHD
• Daylight saving practices
• Continuous travel or immigration to a different time zone
• Stress and social isolation
• Lack of physical activity
• Poor diet or exposure to allergens
• Excessive blue light exposure just before bedtime

Signs and Symptoms of Seasonal Affective Disorder

The signs and symptoms of SAD may vary from person to person, depending on the severity, duration, and type of the disorder. You might have seasonal affective disorder if you suddenly come down with seasonal depression symptoms in either the summer or winter months of the year.

Some of the common signs of SAD include^[4]:

• Feeling sad, hopeless, or worthless for most of the day, nearly every day
• Losing interest or pleasure in activities that used to be enjoyed
• Having low energy, motivation, or concentration
• Having difficulty sleeping or sleeping too much
• Experiencing changes in appetite or weight, such as craving carbohydrates or gaining weight
• Feeling guilty, irritable, or anxious
• Having consistent thoughts of death or suicide

SAD symptoms can differ depending on whether one has winter depression or summer depression. The changes in light at each of these times of year are responsible for triggering different symptoms.

People with winter SAD may experience symptoms such as:

• Oversleeping or difficulty waking up in the morning
• Feeling sluggish or lethargic
• Having low self-esteem or confidence
• Avoiding social interactions or activities
• Having difficulty coping with stress or daily tasks

Symptoms of people with reverse SAD or summer depression may look more like:

• Insomnia or difficulty falling asleep or staying asleep
• Feeling anxious, restless, or agitated
• Having a loss of appetite or weight
• Experiencing headaches, nausea, or dizziness
• Having increased sensitivity to heat or light

Those who do not realize that their symptoms have a seasonal pattern might be wondering why they feel sad for no reason. If symptoms match the ones above and are new, then it might be worth tending to your circadian rhythm first before approaching them as other types of depression.

Self-Care Tips for How to Deal with SAD

These are simple and healthy habits that can help to improve the overall well-being and quality of life of people with SAD. Some of the self-care practices that can help to cope with SAD include:

Get Sunlight

Getting sunlight and fresh air, especially first thing in the morning, is important for maintaining a stable circadian rhythm. Those with SAD may benefit from more natural lighting in their homes, sitting near sunny window sills, and taking frequent breaks outdoors in natural light, even if cloudy.

Supplementation

Supplementation is considered a complementary treatment approach for SAD that involves taking vitamins, minerals, or herbs that may help to improve the mood and reduce the symptoms of depression. Some of the supplements that may be beneficial for SAD include vitamin D, omega-3 fatty acids, and St. John’s wort. Of these, vitamin D may be particularly beneficial for those with SAD, especially winter SAD:

• Vitamin D3: This is an essential vitamin produced when the body is exposed to sunlight. Vitamin D plays a role in the regulation of the circadian rhythm by enhancing melatonin production and activating the clock genes^[5] (which govern the expression of factors that set the internal clock). Therefore, vitamin D may help to synchronize the circadian rhythm with the external environment and maintain a healthy sleep pattern. Due to their low wintertime sun exposure, people with SAD may have low vitamin D levels, which may lead to symptoms. Despite these observations, there is limited evidence that vitamin D supplementation can help to alleviate SAD symptoms in those affected.

If diagnosed with other health conditions, it is best to consult with a doctor about whether supplements are suitable for you or not. This is especially pertinent for those taking prescription medications or other supplements that may react with supplements for SAD.

Sleep Hygiene

Sleep is essential for the physical and mental health of the body and the brain^[6]. Getting enough sleep can help to regulate the circadian rhythm, boost the immune system, and improve mood and cognition. Getting good quality sleep is just as important as getting enough sleep. The following sleep hygiene tips can be useful for sleeping well at night:

• Aim to get seven to nine hours of sleep per night.
• Maintain a regular sleep schedule that involves getting to bed at a set time every night.
• Avoid eating or drinking in the hour before sleeping.
• Avoid stimulants such as caffeine that can interfere with sleep quality and quantity.
• Avoid using electronics right before bed, such as laptops, TVs, and phones, since their blue light emissions might inhibit melatonin production and interfere with sleep cycles.

Exercising

Physical exercise is one of the best ways to combat depression and anxiety, as it can release endorphins, serotonin, and dopamine, which are natural chemicals that can enhance mood, reduce stress, and increase energy. Physical exercise can also improve cardiovascular, respiratory, and musculoskeletal health and prevent or manage chronic diseases, such as diabetes, obesity, or hypertension. High-intensity exercise may be beneficial for improving mental well-being in those with SAD.^[7]

People with SAD should aim to exercise for at least 30 minutes a day, three to five times a week, preferably outdoors, where they can get some natural sunlight and fresh air. They should also choose activities that they enjoy and that suit their fitness level, such as walking, jogging, cycling, swimming, or dancing.

Eating A Balanced Diet

Another significant element that might impact mood and cognitive performance is nutrition. By eating a balanced diet, the body and the brain can receive the vital nutrients, such as vitamins, minerals, antioxidants, and omega-3 fatty acids^[8] that are needed to support the regulation of mood, cognition, and behavior.

Different food groups, including vegetables, fruits, whole grains, healthy fats, and lean meats should be included in one's diet. Inflammation, oxidative stress, and hormone imbalance, all of which can exacerbate depression and anxiety if left untreated, can be reduced by limiting the consumption of saturated fats and refined carbohydrates.

Practicing Relaxation Techniques

Relaxation techniques can help reduce stress and relax the body. A number of them also reduce cortisol levels, which are linked to stress and depression, blood pressure, and heart rate. Some relaxation techniques that may improve the quality of life for those with SAD include:

• Meditation: Setting aside a few minutes a day to still your mind, breathe deeply, and focus can help you to remain calm and cope with negative emotions that may arise from SAD. Regular meditation helps elevate your serotonin levels, which are in charge of controlling your emotions and bringing about happiness. Increasing serotonin levels can help lessen the symptoms of anxiety and despair because it is a neurotransmitter that is frequently low in individuals with SAD.
• Yoga: Yoga can be seen as a type of physical meditation that also incorporates breathing. It can help you improve your physical and mental health by improving balance, flexibility, core strength, and deep breathing. By doing yoga regularly, you can boost your immune system, lower your blood pressure, and enhance your mood and self-esteem. These benefits extend to stress regulation, a better mood with less negative ideation, improved cognition and a reduced likelihood of picking up infections and illnesses that may worsen your SAD symptoms.
• Taichi: Like yoga, taichi can help you relax your body and mind by coupling slow, graceful movements with deep breathing. By doing taichi regularly, you can promote your blood circulation, reduce inflammation, and improve your mental focus and well-being^[9]. Those with SAD can benefit from taichi since it keeps one relaxed, improves focus and mood, as well as protects one from ailments that may otherwise negatively affect energy levels and mood. Taichi can be performed by people of any age and tends to emphasize practising outdoors in natural light, which may make it more ideal than other relaxation techniques for those with SAD.

Social Support

Social support can help to reduce the feelings of depression, including seasonal depression. Feelings of loneliness, isolation, and alienation can create a dire amount of stress that can lead to hormonal imbalances that affect the body clock and hence intensify symptoms of SAD. Social support is one of the strongest defenses against all forms of stress. Meaningful relationships are a continuous source of positivity, joy, and acceptance.

Seasonal Affective Disorder Treatments

SAD is a treatable condition that can be managed with a combination of different approaches, depending on the individual needs and preferences of the person. Some of the most widely used treatment options for SAD include^[10]:

Chronotherapy: This is a treatment option for SAD that involves adjusting the sleep-wake cycle and exposure to light to align the circadian rhythm with the external environment. Chronotherapy can help to improve the mood, energy, and sleep quality of people with SAD by restoring the balance of melatonin and serotonin in the brain. Chronotherapy can be done in different ways, such as advanced sleep phase therapy or delayed sleep phase therapy, depending on the type of SAD. Each of these involves waking up either earlier or later and exposing oneself to light either in the morning or evening in order to influence the circadian clock and get it back into a healthy alignment.^[11]

Light therapy: This is one of the most effective and widely used treatments for SAD, especially for winter SAD^[12]. Light therapy involves exposing yourself to a bright artificial light source, such as a lightbox, lamp, or visor, for a certain amount of time each day, usually in the morning. The light mimics the natural sunlight and helps to regulate the circadian rhythm and the production of melatonin and serotonin. Light therapy can improve the mood, energy, and sleep quality of people with SAD within a few days or weeks of use.

Psychotherapy: You can better understand and manage your emotions, thoughts, and behavior by speaking with a mental health expert. This is important for learning the skills necessary to cope with SAD symptoms, including stress, as well as prior trauma and cultural adjustment issues that may contribute to SAD. For the treatment of SAD, cognitive-behavioral therapy (CBT) is a form of psychotherapy that may be particularly useful. Your behavior and emotions can be affected by negative ideas and beliefs, which CBT can assist you to recognize and challenge. It might be viewed as a potent tool and a prime example of applied psychotherapy that can help you deal with SAD, improve personal resilience, and promote well-being.

Pharmaceutical medications: These might be prescribed by a psychiatrist that can help balance the brain chemicals that affect your mood. SAD could be treated with selective serotonin reuptake inhibitors (SSRIs). SSRIs can help increase the level of serotonin, a neurotransmitter that regulates mood, sleep, and appetite. They are well-known for reducing symptoms of depression and anxiety that are associated with SAD. However, due to problems of long-term physical dependence, side effects, and diminishing efficacy, they are best for short-term use as part of a wider protocol to help tackle SAD.

In addition to these, other patients might also benefit from electroconvulsive therapy, hormone therapy, or seasonal travel to regions of the world with differing climates.

When to Seek Professional Help

SAD is a serious and debilitating condition that can affect the quality of life and the functioning of people who suffer from it. Therefore, it is important to seek professional help if one experiences any of the following signs or symptoms:

• Feeling depressed, hopeless, or suicidal for most of the day, nearly every day, for more than two weeks.
• Losing interest or pleasure in activities that one used to enjoy or having difficulty performing daily tasks, such as work, school, or household chores.
• Experiencing significant changes in appetite or weight, sleep patterns, energy levels, mood, or physical symptoms that are not explained by any medical condition or medication.
• Having thoughts of harming oneself or others or making plans or attempts to do so.
• Having a history of depression or bipolar disorder or a family history of these conditions.
• A history of substance abuse or addiction or current use of alcohol or drugs, to cope with the symptoms of SAD.
• Having a history of trauma or abuse or a current exposure to stress or violence that may trigger or worsen the symptoms of SAD.

If one experiences any of these signs or symptoms, or if one feels that SAD is interfering with their life and happiness, they should not hesitate to seek professional help as soon as possible.

Professional help can provide a proper diagnosis, a personalized treatment plan, and continuous support and guidance that can help one to overcome SAD and to live a more fulfilling and satisfying life.

Conclusion

Seasonal depression that is related to the seasons is known as seasonal affective disorder (SAD). It is more common in the fall and winter months, when the days are shorter and darker, yet it can also occur in the summer months when there is more light. SAD can affect the mood, energy, sleep, appetite, and behavior of the people who suffer from it. It is thought to be caused by disruption of the circadian rhythm, which is the natural biological clock that regulates the sleep-wake cycle and other bodily functions. SAD is a treatable condition that can be managed with appropriate care and support, and can be prevented or reduced with the adoption of healthy and positive habits that can enhance the well-being of the people who suffer from it.

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