Learn more about this condition that can affect mood and more.
Feeling a little blue occasionally during the colder months is normal. Winter often ushers in some dark and dreary days. Plus, cold weather can keep us indoors and impact our social life a bit. But sometimes feeling down during the cold season can mean you have seasonal affective disorder.
“Seasonal affective disorder is a general term for a mood disorder where the onset and resolution of symptoms follow a seasonal pattern,” said Dr. Amanda Satterthwaite, an internist and psychiatrist with Vanderbilt Psychiatric Outpatient Clinic. “We most commonly refer to major depressive disorder when we think of seasonal affective disorder.”
What are the symptoms of seasonal affective disorder?
Seasonal affective disorder, also called SAD, often starts in the fall and lasts through winter, before resolving again around spring. “If you notice onset of depressive symptoms during the winter months for at least two consecutive years, then it is possible you could be experiencing major depressive disorder with a seasonal component,” Satterthwaite said.
“If you notice onset of depressive symptoms during the winter months for at least two consecutive years, then it is possible you could be experiencing major depressive disorder with a seasonal component.”
Low energy with depressed mood is the most common symptom of SAD, but you may notice additional changes, such as increased appetite with cravings for starchy carbohydrates. Weight gain can result from the increased appetite, and you may sleep more than you usually would during the daytime, Satterthwaite added.
Why does SAD occur?
The most common pattern of SAD corresponds with a reduction in daylight hours, which can increase production of melatonin. Melatonin is a hormone produced in the pineal gland at nightfall that regulates our circadian rhythm and helps us fall asleep. The change in daylight hours also means a decrease in the activation of your retinal cells that correlate with mood regulation, Satterthwaite explained.
When should you see a doctor?
“I don’t want people to struggle through seasonal affective disorder when there are simple and effective treatments available.”
Everyone has fluctuations in mood. “It is important to recognize when your symptoms are causing functional decline,” Satterthwaite said. For example, are you persistently feeling extreme fatigue, finding getting to work on time difficult, or lacking the motivation to do work-related or everyday tasks? Then it is time to talk to your doctor.
Additionally, you may notice changes in your health. A little weight gain during the winter is common. But if you notice weight gain beyond what is typical for you during this time, that could indicate a more serious underlying cause. “Seek advice from your doctor,” Satterthwaite said. “I don’t want people to struggle through seasonal affective disorder when there are simple and effective treatments available.”
What are the treatments for seasonal affective disorder?
“The best evidence for treatment is with a combination of antidepressants and bright light therapy for severe cases,” Satterthwaite explained. However, you may find relief with bright light therapy alone and not need prescription medications, she added.
“The best evidence for treatment is with a combination of antidepressants and bright light therapy for severe cases.”
If you’re interested in trying bright light therapy, you can buy a light box. However, not just any light will do. Search for a light box with at least 10,000 lux, which is the unit of illuminance, or luminous flux per unit area. Early morning bright light therapy provides better results than midday or at night, Satterthwaite said. She recommends using the light for 30 minutes upon waking.
Outdoor exercise during daylight hours can also be an effective form of seasonal depression therapy, and it doesn’t have to be extreme or intense. “I encourage all of my patients to incorporate a simple daily walking routine during daylight hours,” Satterthwaite said. “It’s been shown to be even more effective than bright light therapy.” Psychotherapy, in addition, can also be beneficial, with a focus on cognitive behavioral therapy.
Can symptoms be prevented?
“I encourage all of my patients to incorporate a simple daily walking routine during daylight hours.”
Start bright light therapy about four weeks before your symptoms tend to start. Boosting your exercise regimen and focusing on eating whole foods as nutrients can help as you head into the winter months. “Set healthy boundaries around the holiday season to decrease your psychosocial stressors,” Satterthwaite added.
Can seasonal affective disorder occur in summer?
The short answer is yes. Seasonal depression is three times more likely to occur in winter than in summer, but some people do experience a summer pattern instead. Depression, like high blood pressure, is a treatable disease. If you are experiencing depressive symptoms that are affecting your overall well-being, discuss your concerns with your doctor. “We should aim for holistic wellness,” Satterthwaite said. “Start with the mind, and the body will follow.”
Personalized Care for Mental Health
Vanderbilt Health’s Adult Outpatient Behavioral Health programs offer comprehensive care to patients age 18 and older with a range of mental health concerns, including psychotic disorders, life transitions, abuse, depression, substance abuse and other conditions. Treatment plans are personalized to each person’s unique needs.
