What is SAD?

After the excitement of the holiday season ends and we begin a new year, Winter can begin to feel like a drag.  We find ourselves dreaming of warmer weather and craving breaks from our daily mundane routines. While experiencing bouts of sadness in any season can be completely normal, those who deal with these low-lows around the same time each year may be experiencing Seasonal Affective Disorder (SAD), also referred to as Seasonal Depression. This depression gets triggered when the seasons change, most commonly occurring in the beginning of Fall. This depression worsens as we get into the Winter season and typically gets better in the springtime.

While some people may deal with a mild version of SAD, commonly referred to as ‘Winter Blues’, those who deal with SAD are not simply dealing with the occasional low mood due to being cooped up inside. Rather, they have a steady level of depression present all throughout fall and winter 1. 

Spring/Summer SAD

As mentioned, SAD most commonly occurs in the Fall and Winter months, lessening in the Spring time. However, there are more rare cases of SAD which occur in the Spring and continue throughout the Summer months. The symptoms associated with Spring/Summer SAD vary from those associated with Fall/Winter SAD. It is important to note that while Fall/Winter SAD is often referred to as Winter Blues or Winter Depression, Spring/Summer SAD is sometimes referred to as Summer Depression 2.

Symptoms

Fall/Winter SAD commonly includes symptoms, such as:

  • Overeating behaviors, especially strong cravings for food high in carbohydrates
  • Feeling fatigued, low energy, overly tired
  • Sleeping more than needed
  • Gaining Weight 3
  • Feeling sad or experiencing depressed mood
  • Loss of interest in pleasurable activities
  • Feeling worthless or experiencing feelings of guilt
  • Thoughts of death, self harm, or suicidal ideation

Spring/Summer SAD commonly includes symptoms, such as:

  • Insomnia, which is a sleep disorder, that makes it hard to fall asleep, stay asleep, or both. It can make one feel tired even after getting several hours of rest and can cause fatigue and difficulty functioning throughout the day4
  • Lack of Appetite
  • Losing Weight
  • Agitation, Anxiety, and/or irritability 5

Causes of SAD

First and foremost, there is no known definitive cause of SAD. However, there are some factors that contribute to SAD. Some of these factors include, serotonin levels, melatonin levels, and circadian rhythm.

  • Serotonin Levels: Serotonin is a chemical in the brain, which impacts mood. Reduction in sunlight can then cause a drop in serotonin levels, which can lead to depression. It is hypothesized that this drop in serotonin levels in winter and fall months can play a role in SAD 6.
  • Melatonin Levels: Melatonin, a hormone produced when our brains experience darkness 7, can be impacted by the change of season. This change can cause a disruption in the body’s Melatonin levels in the body, which can lead to difficulty sleep and mood changes 8. 
  • Circadian Rhythm: Our Circadian Rhythm is essentially our bodies internal clock. Circadian Rhythms are running in the background in order to perform necessary functions 9. It is hypothesized that the decrease in sunlight during the fall and winter months can cause a disruption to our internal clock, leading to feelings of depression 10.

Risk Factors

There are multiple factors that contribute to increased risk of SAD in individuals, such as gender, age, family history, presence of certain mental health disorders, distance from equator, and vitamin D levels11.

  • Gender and Age: Women are more often diagnosed with SAD when compared to men. SAD is found more frequently in younger adults when compared to older adults. SAD can begin at any age but is most typically found to start between ages 18 and 30.
  • Family History: Studies have shown that those with SAD are more frequently related to a family member with SAD or some other form of depression.
  • Distance from Equator: Frequency of individuals with SAD appears to be higher in areas far north and south of the equator, as compared to areas closer to the equator. This is likely related to the decrease in sunlight during winter months for those farther from the equator.
  • Vitamin D Levels: Vitamin D is produced through the skin when we are exposed to sunlight. Vitamin D has been found to boost levels of serotonin in the body. Low levels of sunlight, as well as low levels of food that contains Vitamin D, can influence levels in the body, leading to lower serotonin levels.

SAD Complications

There are a variety of complications that can result from SAD. These complications include: withdrawing from loved ones, problems with school or work, suicidal ideations or self-harm behavior, additional mental health concerns, such as anxiety or eating disorders, and substance abuse. In order to combat this condition and the resulting problems, there are treatment options available.

Treatment Options

While SAD symptoms do improve with the changes of season, utilizing treatment options can help improve symptoms quickly. There are three known ways to treat SAD, they include: Phototherapy Light Therapy, Psychotherapy, Medication, or a combination of two or more of these 12.

Light Therapy

Light therapy boxes or lamps can be utilized to emit a very bright light, which also filters the harmful Ultraviolent (UV) rays out. Participating in this type of treatment involves a minimum of 20 minutes of light exposure per day, typically during the morning hours, during the winter months. Those who utilize light therapy typically report an improvement in mood within the first two weeks of treatment. In addition to light therapy boxes and lamps, some individuals with SAD have found increased exposure to sunlight, such as by spending time outside, or placing their offices in direct sunlight, can help with symptoms of SAD.

Psychotherapy and Medication

Talk therapy can help with dealing with symptoms of SAD, oftentimes leading to an improvement in symptoms. Some serotonin reuptake inhibitors (SSRIs) are utilized as antidepressants to treat SAD, which increase serotonin levels in the brain 13. SSRIs are used to increase serotonin levels in the brain, which has potential for helping alleviate symptoms of a variety of mental health conditions.

If you are experiencing SAD and are interested in receiving Cognitive Behavioral Therapy (CBT), we would love to assist you. We have multiple therapists available waiting to support you through the difficult times in your life. When you are ready, head over to www.online-therapy.com, we are looking forward to helping you!

References

  1. Cleveland Clinic. Seasonal Depression (SAD). (https://my.clevelandclinic.org/health/diseases/9293-seasonal-depression). Accessed 02/09/2022.
  2. Mayo Clinic. Seasonal Affective Disorder: SAD. (https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651). Accessed 02/10/2022.
  3. Healthline. Everything you Need to Know about Insomnia. (https://www.healthline.com/health/insomnia). Accessed 02/11/2022.
  4. National Center for Complementary and Integrative Health. Melatonin: What You Need to Know. (https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know). Accessed 02/11/2022.
  5. Sleep Foundation. Circadian Rhythm. (https://www.sleepfoundation.org/circadian-rhythm). Accessed 02/11/2022.
  6. American Psychiatric Association. Seasonal Affective Disorder (SAD). (https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder). Accessed 02/11/2022.
  7. Medical News Today. What are the Differences between SSRIs and SNRIs? (https://www.medicalnewstoday.com/articles/ssri-vs-snri). Accessed 02/11/2022.