Don't let seasonal affective disorder (SAD) get you down

With the change in seasons, the turning back of the clocks, and our increasingly shorter days, the desire to get cozy at home and hibernate the winter away may sound idyllic to some. For others, though, the fall and winter seasons are intensified by a seasonal depression that makes life more challenging than it needs to be.

What is SAD?

Seasonal affective disorder (SAD) is a type of depression that's related to changes in seasons. It typically occurs during the fall and winter months; although less common, people can also experience the reverse pattern in the spring and summer months. Millions of American adults may suffer from SAD, although many may not know they have the condition. SAD occurs much more often in women than in men, and it is more common in those living farther north, where there are shorter daylight hours in the winter.

For most people with SAD, their symptoms start in the fall and continue into the winter months, sapping away their energy and making them feel moody. However, seasonal affective disorder does not need to be another case of the "winter blues" that one has to get through. Instead, effective treatment options can help you feel revitalized and more energized during the colder months.

Symptoms and causes

Signs and symptoms of SAD may include:

• Feeling depressed most of the day, nearly every day
• Losing interest in activities you once enjoyed
• Having low energy, feeling sluggish or agitated
• Having problems with sleeping (oversleeping)
• Experiencing changes in your appetite or weight (overeating or weight gain)
• Having difficulty concentrating
• Feeling hopeless, worthless or guilty

Take signs and symptoms of seasonal affective disorder seriously. As with other types of depression, SAD can get worse and lead to problems if it's not treated. These can include:

• Social withdrawal
• School or work problems
• Substance abuse
• Other mental health disorders such as anxiety or eating disorders
• Suicidal thoughts or behavior

The specific cause of seasonal affective disorder remains unknown. Some factors that may come into play include:

• Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may cause winter-onset SAD. This decrease in sunlight may disrupt your body's internal clock and lead to feelings of depression.
• Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in SAD. Reduced sunlight can cause a reduction in serotonin that may trigger depression.
• Melatonin levels. The change in season can disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood.

When to see a doctor

It's normal to have some days when you feel down. But if this lasts for days at a time and you can't get motivated to do activities you usually enjoy, see your doctor. This is especially important if your sleep patterns and appetite have changed, you turn to alcohol for comfort or relaxation, or you feel hopeless or think about suicide.

Diagnosis and treatment

If you think you may be experiencing SAD, speak with your doctor or a mental health specialist about your concerns. Your doctor may perform a physical evaluation and run lab tests to rule out any underlying health condition that could be causing symptoms. Even with a thorough evaluation, it can sometimes be difficult to diagnose seasonal affective disorder because other types of depression or other mental health conditions cause similar symptoms.

Treatment for seasonal affective disorder is similar to other depressive disorders and may include light therapy, medications and psychotherapy. Your doctor will work with you to find a combination of treatments and coping mechanisms that work best for your situation.

Light therapy: In light therapy, also called phototherapy, you sit a few feet from a special lightbox so that you're exposed to bright light within the first hour of waking up each day. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood.

Medications: Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe. Selective serotonin reuptake inhibitors (SSRIs) are the type of antidepressant most commonly used to treat SAD.

Talk therapy: Talk therapy, in particular cognitive behavioral therapy, can be effective. It can help by identifying and changing negative thoughts and behaviors that may make you feel worse and by learning healthy ways to cope with SAD, especially by reducing avoidance behavior and scheduling activities.

Coping and support mechanisms

In addition to the treatment plan outlined by your doctor, the following steps can also help you manage seasonal affective disorder:

• Take care of yourself. Get enough sleep to help you feel rested, but be careful not to get too much rest, as SAD symptoms often lead people to feel like hibernating. Make healthy choices for meals and snacks. Don't turn to alcohol or recreational drugs for relief.
• Make your environment sunnier and brighter. Open blinds, trim tree branches that block sunlight, or add skylights to your home. Sit closer to bright windows while at home or in the office.
• Get outside. Take a long walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun. Even on cold or cloudy days, outdoor light can help — especially if you spend some time outside within two hours of getting up in the morning.
• Exercise regularly. Exercise and other types of physical activity help relieve stress and anxiety, both of which can increase SAD symptoms. Being more fit can make you feel better about yourself, too, which can lift your mood.
• Practice stress management. Learn techniques to manage your stress better. Unmanaged stress can lead to depression, overeating, or other unhealthy thoughts and behaviors.
• Socialize. When you're feeling down, it can be hard to be social. Make an effort to connect with people you enjoy being around. They can offer support, a shoulder to cry on, or shared laughter to give you a little boost.
• Take a trip. If possible, take winter vacations in sunny, warm locations if you have winter SAD or cooler locations if you have summer SAD.

If you're experiencing any of the symptoms of seasonal affective disorder, make an appointment with your primary care physician today. They may refer you to a mental health specialist for care.

If you or someone you know is considering suicide, you are not alone. Help is available online and over the phone right now. Please visit suicidepreventionlifeline.org or call 800-273-8255 (available 24/7).

Source: National Institutes of Mental Health, American Psychiatric Association