Seasonal Affective Disorder

What is Seasonal Affective Disorder (SAD)?

Seasonal Affective Disorder is a subtype of Major Depressive Disorder that occurs with a seasonal pattern; this is typically characterized with an onset in fall/winter and symptom remission in spring/summer (although other patterns are possible as well). There are a variety of symptoms that can include feeling sad, not finding pleasure in activities you usually enjoy, sleeping less or more, decreased energy levels, having a hard time concentrating, eating less or more, and any thoughts of death or suicide.

People of all ages and all racial, ethnic and socioeconomic backgrounds experience SAD, and SAD can present with different symptoms, depending on the person.

What causes SAD?

The cause of SAD is believed to be multifactorial, including biochemical (your body and how it functions), genetic (your family medical history), environmental (the things around you both past and present) factors. In the brain, SAD is currently theorized to be due to changes in neural circuits causing differing levels of neurotransmitters, especially glutamate, serotonin, norepinephrine, and dopamine. Common theories correlate the role of serotonin and the circadian rhythm (your biological clock regulating your sleep/wake cycle) in the development of SAD. With changes in sunlight seasonally, the circadian rhythm then functions on an offset schedule, and this dissonance is believed to play a role in SAD.

What’s the difference between SAD and Feeling down in the winter?

It is common to experience “winter blues” with the change in weather and sunlight. SAD is different in that it is a clinical diagnosis made by a healthcare provider. To help avoid confusion, we recommend only using the term “seasonal affective disorder” or “MDD with seasonal pattern” if you have a clinical diagnosis, and instead using terms such as “winter blues” to describe feelings of increased sadness or decreased energy in the winter.

are there treatments for SAD?

A number of treatments exist for SAD and other depressive disorders, such as light therapy (artificial bright light that can reduce the production of melatonin and increase serotonin), talk therapy (including Cognitive Behavioral Therapy, interpersonal therapy, and group therapy), and medications (including antidepressants). There are also a number of coping strategies and habits you can do to help reduce or manage symptoms of SAD, such as getting outside while the sun is up, ecotherapy, regular exercise, sufficient quality sleep, balanced nutrition, avoiding alcohol (a depressant), meditation, and more.

The take-home message here is: there are numerous treatments that exist for SAD, so help exists, and if one method doesn’t work for you there are other approaches that you can try. You should always consult with your mental health professional about your treatment plan.

Here’s what people with SAD want you to know:

“It’s more complex than not liking the dark.”

-Marly R. (University of Virginia)

“One form of treatment might not work, and it can be incredibly discouraging, but know that there are other options and you’re not out of luck.”

-Amelia W. (University of Virginia)

Where to go for help with SAD:

Your primary care physician (these are typically doctors specializing in Family Medicine or Internal Medicine)

A psychiatrist (a doctor specializing in Psychiatry)
A psychologist (a mental health provider with a PhD os PsyD degree), therapist, or counselor (note that these providers cannot prescribe medications but can provide valuable interventions such as therapy)

WHEN Do I go The Doctor?

If you experience one or more of the symptoms of SAD (feeling sad, not finding pleasure in activities you usually enjoy, sleeping less or more, decreased energy levels, having a hard time concentrating, eating less or more, and any thoughts of death or suicide.)

If any of your symptoms cause you distress or impair your day-to-day functioning
Any thoughts of suicide should prompt emergency treatment. Please call/see your physician, call 988, or visit your local emergency department if you have any thoughts of suicide.

When in doubt, see a healthcare provider or mental health professional. They can give you an accurate diagnoses, suggest treatment options, and recommend a different treatment plan if one isn’t working.

HOW Do I find a provider that takes my insurance/form of payment?

Visit your insurance provider’s website and locate the provider finder page. This should assist you in finding care in your area that accepts your insurance.

Call your insurance provider to have them assist you in finding a provider in your area.
Use FindTreatment.gov.
See “Mental Health Providers: Tips on Finding One” for more tips and suggestions.

With all that being said, this is your reminder that you don’t need to be a psychiatrist or psychologist to discuss your mental health or to be an empathetic ear to a friend. All you need is an open mind.

Where Can I Learn More?

American Medical Association, What Doctors Wish Patients Knew About Seasonal Affective Disorder
National Alliance on Mental Illness, About Mental Illness, Seasonal Affective Disorder
American Psychiatric Association, Patients and Families, Seasonal Affective Disorder

what people with SAD have to share with you:

Letters

Marly R.

If you’re reading this, remember that 5% makes a difference.

References:

U.S. Department of Health and Human Services. (n.d.). Seasonal affective disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder
Torres, F. (2020, October). Seasonal affective disorder (SAD). Psychiatry.org - Seasonal Affective Disorder (SAD). https://www.psychiatry.org/patients-families/seasonal-affective-disorder
Munir S, Abbas M. Seasonal Depressive Disorder. [Updated 2023 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568745/