Seasonal Affective Disorder (SAD) is a sub-type of Depression that is unique for being a condition limited to a seasonal pattern.
Unlike other depression conditions, which typically witness few periods of “normal” mood, SAD usually comes and goes, often with months in between. However, it is still a debilitating condition which causes suffering.
Moreover, SAD isn’t just a case of the “Winter blues” – which is a common feeling to have in the colder, darker winter months. SAD is a serious condition.
Normally the symptoms of depression take place in the winter for those who suffer from SAD. However, this isn’t always the case. With the right treatment and support, recovery is possible.
What are the symptoms of Seasonal Affective Disorder?
The symptoms of Seasonal Affective Disorder, like other depressive conditions, can range slightly from person-to-person. However, there are some general symptoms that tend to be common.
These symptoms include feeling hopeless and sad, and losing interest in formerly-enjoyable activities. These symptoms will generally take place in the winter months, before disappearing a few months later, only to return months on.
This pattern will need to be have been repeated for two or three years for SAD to be diagnosed. Otherwise, an alternative condition called Dysthymia may be diagnosed.
Symptoms are normally either psychological or physical.
Psychological
- Continuous low mood or sadness
- Feelings of hopelessness and helplessness
- Low self-esteem
- Lack of emotion
- Feeling irritable
- Losing interest in formerly enjoyable activities
- Anxiety
- Suicidal ideation
Physical
- Lack of energy
- Loss of libido
- Losing or gaining appetite and weight
- Insomnia or excessive sleep
- Unexplained aches
- Tiredness
- Restlessness
These symptoms will typically lead to a change in the behaviour of an individual. Someone with these symptoms during winter may not want to go outside, and may struggle to enjoy the festive period.
As alluded to above, this is not an exhaustive list of depressive symptoms – everyone experiences depression in different ways.
What are the causes of Seasonal Affective Disorder?
It isn’t known exactly what causes Seasonal Affective Disorder, although it is thought that the reduced sunlight in the winter plays a big role. It may be a case that multiple factors contribute to the onset of SAD.
One very important factor is the reduced sunlight in the winter. The lack of sunlight could potentially stop the hypothalamus – a part of the brain – from working.
This can cause a range of effects, including an increase in melatonin – resulting in feelings of increased sleepiness. Moreover, when the hypothalamus doesn’t work, it is believed this also leads to a deficiency in production of serotonin – which means mood isn’t regulated as normal.
Finally, another possible effect includes the disruption of the body clock. Individuals who have lived in a hotter climate before moving to the United Kingdom may be particularly susceptible to developing SAD.
Certain personality traits appear to play a role too. One study appeared to prove a correlation between some personality traits like adopting avoidance-style coping mechanisms and high levels of neuroticism and the likelihood of developing SAD [1]. Genetics could play a part in SAD.
As with any form of depression, it isn’t entirely known what the cause is. There is often a range of factors that contribute to the onset of depression. These factors could include a traumatic experience, loneliness, substance abuse and childhood experiences among others.
Diagnosis of Seasonal Affective Disorder
It is important to see a doctor or mental health professional if an individual believes they are suffering from Seasonal Affective Disorder. It is of particular importance to seek help if an individual is having suicidal thoughts.
At an appointment, a doctor will ascertain the feelings and condition of a patient by asking several questions. You are encouraged to be as honest as possible.
In terms of the actual symptoms, for Seasonal Affective Disorder to be diagnosed, the following symptoms are generally present:
- Depressed mood for the majority of the day, over the course of a few continuous months.
- The individual goes through periods of remission, usually over the lighter months.
- The time in remission outweighs that of depressive symptoms.
- The same pattern remains the same/similar for more than 2 years.
Sometimes, if the symptoms fit better elsewhere, a different condition can be diagnosed. SAD can be mistaken in some cases for Dysthymia (Persistent Depressive Disorder) or Bipolar Disorder.
Once a diagnosis has been made, treatment can proceed. The treatment will aim to help the individual make a full recovery.
How is Seasonal Affective Disorder treated?
Fortunately, there are many different possible treatments for Seasonal Affective Disorder. The exact treatment plan will be decided by a doctor, based upon symptoms present. Possible treatments include:
Self Help
Sometimes, utilising self-help materials can help. There is plenty of information on the internet, including on our website!
Also, regular exercise can help alleviate some of the symptoms of depression. Conducting exercise in any available daylight hours may be particularly therapeutic in cases of SAD.
At first, trying some low-intensity methods is a useful idea, before trying other approaches.
Therapy
Some form of therapy can be helpful. The main treatment for SAD is Light Therapy. This has proven to be effective for those managing the condition.
Light Therapy: Light therapy is a form of therapy that is best known as a treatment for Seasonal Affective Disorder. It involves an individual sitting in front or near a specially-constructed light box for around 30-60 minutes a day. The light box simulates sunlight, which appears to be crucial in the treatment of SAD. This therapy can help other mental health conditions too.
Additionally, a form of talking therapy could be used if needed. However, due to the short-term nature of SAD, this may not always be appropriate.
Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.
There are a range of other types of talking therapies available. There are many ways that talking therapy can help. We have more information on our Therapy section.
Medication
Occasionally, SAD can be treated with antidepressants. The problem is that as antidepressants can take a few weeks to work to their full capacity, that they might not serve a huge purpose for the few months that SAD’s symptoms are present.
However, for severe cases of SAD, evidence suggests that certain antidepressants may be able to help [2]. It may be necessary to continue taking the tablets throughout the summer too.
Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.
Summary
To maximise the chances of treatment working, it is recommended that anyone suffering from SAD tries to get as much sunlight as possible.
Hopefully, the various treatment options will provide relief from symptoms. For more information on light therapy – see our section here.
See Also
Disclaimer
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Helplines
If you are struggling with your mental health, help is available. With the right support and treatment, you can make a recovery. For information on helplines, or if you are in a state of crisis, please visit our crisis page by clicking on the relevant link for your geographical location (United Kingdom), (United States), (International). You can also see how to get mental health treatment and the process involved by clicking this link.
References
[1] Oginska, H., & Oginska-Bruchal, K. (2013). Chronotype and personality factors of predisposition to seasonal affective disorder. The Journal of Biological and Medical Rhythm Research. 31 (4). DOI: https://doi.org/10.3109/07420528.2013.874355.
[2] Modell, J. G., Rosenthal, N. E., Harriett, A. E., et al. (2005). Seasonal Affective Disorder and Its Prevention by Anticipatory Treatment with Bupropion XL. Biological Psychiatry. 58 (8): p658-667. DOI: https://doi.org/10.1016/j.biopsych.2005.07.021.
