Seasonal Affective Disorder – SAD
Seasonal Affective Disorder (or SAD) is a type of cyclical depression that, for most people, tends to return around fall or winter, and tends to get better in the spring. The prevalence of SAD ranges from 1% in the southernmost states, to 10% in the northernmost states.
What causes SAD?
Seasonal Affective Disorder is an interaction between seasonal changes, biological factors and psychological vulnerabilities. Other factors may also have an impact.
Seasonal Changes: The length of the day and the amount of sunlight are key triggers of SAD. SAD is more common the further north you go, and in cloudier climates. People who work in windowless buildings, or get very little sun exposure for other reasons, may experience SAD symptoms as well. In some warm climates, SAD appears to be triggered by rainy seasons.
Biological Factors: Changes in exposure to daylight can throw off your circadian rhythm, or internal body clock, which affects your metabolism and sleep cycle. The lack of sun exposure contributes to vitamin D deficiency, which affects mood. Neurotransmitters such as serotonin are affected by light as well. Additionally, genetics and gender put some individuals at greater risk. Women are more likely than men to experience SAD, just as they are more likely to experience depression in general.
Psychological Vulnerabilities: People who are vulnerable to automatic negative thoughts and attitudes are also more vulnerable to depression, including seasonal depression. Depression can worsen or improve depending on how you think about life’s challenges, how you respond to them, and what coping methods you tend to use.
Other Factors: Other factors may also have an effect on depressive symptoms. For example, people with a good social support network tend to be more resilient. Also, big life stressors can add to the burden of SAD; stressors such as seasonal unemployment, driving in snow, or dealing with difficult family dynamics during holidays. However, these stressors are not enough in and of themselves to warrant a diagnosis of SAD.
Symptoms of Seasonal Affective Disorder
SAD is similar to other types of depression, and can vary somewhat from person to person. Symptoms may include:
- Depressed mood (feeling sad, empty, hopeless)
- Frequent crying
- Losing interest in previous hobbies, or feeling apathetic
- Not enjoying things you would normally enjoy
- Carbohydrate cravings and weight gain
- Feeling tired, fatigued and/or slowed down
- Sleeping too much
- Thinking negatively and self-critically
- Feelings of guilt and worthlessness
- Social withdrawal
- Difficulty thinking clearly, concentrating, or making decisions
- Increased irritability and anger
- Thoughts about suicide
Ideas for coping with SAD
The following list is not exhaustive, but can give you a few pointers. Can you think of more ideas?
1. Brighten your indoor environment.
- Open blinds and curtains.
- Trim tree branches if needed to allow more light through windows.
- Add skylights to your home.
- Routinely sit closer to bright windows.
- Take a cat nap in the sunlight shining through your deck door.
- Spend time in atriums, sun-rooms, or greenhouses.
- Use bright artificial lighting during the daytime, especially in the morning.
2. Spend more time outdoors.
- Get outside daily, especially in the mornings. (Dress warmly enough!)
- Take a walk or hike a nature trail.
- Sit on a park bench.
- Go sledding, skating, skiing, snowboarding, snowmobiling, etc.
- Park further from the building entrance when it’s warm enough to do so.
- Plan trips to warmer places.
- Take off your sunglasses when it’s not too bright out.
- Expose some skin to sunlight when it’s not too cold, but also use precautions to prevent melanoma, such as wearing sunscreen.
3. Try light therapy.
- Use lamps designed especially for SAD, for 30 minutes to two hours per day, according to your doctor’s orders. (Always read warnings before use, and follow manufacturer instructions).
- Use a light box. The standard light box has fluorescent bulbs with10,000-lux of full spectrum or cool white light, set behind an ultraviolet shield. Although a growing variety of portable, head-mounted light visors, smaller desk lamp units, dawn stimulators, and light fixtures with light-emitting diodes (LEDs) have also been developed, more research is needed to determine whether these devices are as effective as the standard light boxes for SAD.
- Visit the Mayo Clinic website, which offers suggestions for choosing the right light.
4. Increase exercise.
- Exercise is one of the best things you can do for depression. It boosts your metabolism, self-esteem, endorphins, and mood. Some studies have found it to be as effective as antidepressants.
- Aerobic exercise has been found to be helpful with depression and with SAD.
- If you haven’t exercised in a long time, start small and increase exercise gradually to improve motivation and to decrease risk of injury. For example, you can start with stretching or beginners yoga.
5. Get balanced sleep.
- In the winter, you may feel tempted to sleep more than usual, but that can depress your metabolism even further. Getting balanced sleep means you get enough (about eight hours on average) but not too much.
- Avoid daytime napping. In many ways SAD is a circadian rhythm disorder, and napping can throw off your sleep cycle even more. But if you do nap, do it consistently at the same time each day, and for no longer than an hour and a half. Also, count that time in with your total number of sleep hours, and sleep less at night, so that you sleep no more than a total of eight hours per 24 hour period.
- Avoid alcohol, especially prior to sleeping.
6. Get proper nutrition.
- Stay hydrated by drinking about a half-gallon of water each day.
- Limit refined carbohydrates such as sugars and refined grains.
- Limit portion sizes, restrict calories to 1800 per day (for the average adult), and eat often enough that your blood sugar doesn’t drop too low.
- Give your brain and body the nutrients they need, including protein, fiber, vitamins, supplements, good fats, probiotics, and whole foods.
- Limit processed foods, artificial additives, and toxins.
- Identify and manage any food sensitivities that you may have.
- Be cautious with nutritional stimulants like caffeine and herbal stimulants.
- Avoid alcohol (a depressant).
7. Engage in life.
- Stay connected with supportive friends and family.
- Create positive and meaningful activities.
- Maintain your routines.
- Develop wintertime interests.
- Do small projects.
- Savor the simple pleasures.
- Spend time interacting with pets.
- Revive your play personality (explorer, collector, artist, storyteller, competitor, joker, director, athlete, dancer, etc.)
8. Practice other stress management strategies.
- Practice relaxation skills.
- Practice effective time management.
- Practice assertiveness to initiate positive activities, and to say no to excessive commitments.
- Practice prioritizing, problem solving, and decision making.
- Talk to supportive others.
9. Sustain a positive attitude.
- Recognize and challenge automatic negative thoughts.
- Count your blessings / keep a gratitude log.
- Recognize excessive worry and redirect your mind toward something more positive.
- Practice encouraging self-talk.
- Get inspired by others.
- Channel uplifting messages automatically to your social media, email, phone, etc.
- Listen to positive music, watch positive shows, and read positive websites or books.
- Let someone know how much you appreciate them and why.
- Do something kind for someone.
- Practice compassion and forgiveness.
- Remember that winter will end.
10. Try psychotherapy.
Talk therapy can offer valuable support to help you overcome depression, seasonal or otherwise. A counselor can help you on your journey of recovery in a variety of ways, depending on their training and theoretical orientation. Having a chance to talk openly about your symptoms and difficulties can be validating and relieving in itself. Being heard and understood can be a healing experience.
11. Try antidepressant medications.
Seasonal Affective Disorder can also be treated with medications, like any depression. Most people get antidepressant medications from their primary doctor, but if you prefer to see a specialist, you could see a psychiatrist.