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More than just a mood: seasonal affective disorder (SAD)

A depressed woman sits alone in her room with her head in her hands in front of a window on a cloudy dayAs the days grow shorter and sunlight becomes scarce, millions of people worldwide experience more than just a change in weather. Seasonal affective disorder (SAD), often colloquially known as the “winter blues,” is a type of depression that’s related to changes in seasons. Far more than simple moodiness, SAD is a recognized form of clinical depression that can significantly impact daily life, typically beginning in late fall and persisting through winter months. 

Tryon Medical Partners internal medicine specialist Dr. Brownlee is double boarded in psychiatry and shares some key facts about seasonal affective disorder to help keep winter depression at bay. 


When does seasonal affective disorder begin?

Seasonal depression symptoms usually begin mid-late fall (October or November) and last through early spring (March or April). Many seasonal depression sufferers experience the worst of their symptoms in February. 

“By the end of February, it is deep winter,” Dr. Brownlee points out. “It’s cold and dreary and even people without seasonal affective disorder might feel unusually sad. For those who have SAD, the symptoms will peak then.” 

People who are aware they struggle with seasonal depression often pick up on their symptoms earlier, like in October. Those who are less familiar with the diagnosis will often miss many of the symptoms, or the severity of them, until later in the winter, like in February. 

“There is a huge portion of the population who barely see the sunlight in the winter,” Dr. Brownlee says. “They get to work before the sun rises and leave after it sets. In February, they come to me confused, feeling down, and struggling. Those people could very well be experiencing seasonal depression.” 


What are the symptoms of seasonal depression?

The symptoms of seasonal depression are the same as major depressive disorder (MDD), most commonly known as “depression”: 

  • Feelings of sadness, hopelessness, emptiness, or pessimism 
  • Fatigue or lack of energy 
  • Insomnia or other sleep issues, such as waking up early or sleeping too much 
  • Changes in appetite, leading to weight loss or weight gain 
  • Difficulty concentrating, thinking clearly, or making decisions 
  • Thoughts about dying or suicide 
  • Feelings of low self-worth or guilt

The only difference between seasonal depression and general depression is the timing: If you only experience these symptoms seasonally, it’s likely SAD instead of major depressive disorder. 

“It’s important to understand that some of these symptoms are normal to feel now and again,” Dr. Brownlee explains. “In February, it’s common for someone to really want to go to the Bahamas. However, if it’s impacting your life in a negative way, if it’s impacting your ability to work, or interact with your loved ones, it’s time to do something.” 


What causes seasonal affective disorder?

Seasonal affective disorder is much more common among people who live at higher altitudes, because the lack of natural light is a contributing factor. The biggest causes of seasonal affective disorder are: 

  • Circadian rhythms. Seasonal changes in circadian rhythms, or your body’s natural 24-hour cycle, are influenced by daylight length and may contribute to SAD symptoms. 
  • Serotonin levels. People with SAD, especially winter-pattern SAD, have lower levels of serotonin, a brain chemical that regulates mood. Shorter days may prevent molecules from functioning properly, which can lead to lower serotonin levels in the winter. 
  • Melatonin. The hypothalamus, a part of the brain, may not work properly due to a lack of sunlight, which can affect melatonin production. Melatonin is a hormone that makes people feel sleepy, and people with SAD may produce higher than normal levels of it. 

“Because so much of SAD is linked to the amount of daylight, people who get less natural exposure to light are impacted at higher rates,” Dr. Brownlee says. “It’s important to adjust some of your lifestyle habits to soak up as much sunlight as possible if you’re prone to seasonal depression.” 


What are seasonal depression treatments?

If you’re trying to get as much sunlight as possible and still struggling with seasonal affective disorder, Dr. Brownlee recommends the following seasonal depression treatments: 

  • Antidepressants. Medications, such as bupropion hydrochloride (HCL), can offer some relief from SAD symptoms. These antidepressants can provide some more energy and motivation and increase the desire to socialize. It’s not uncommon to only take medication in the seasons you experience the symptoms (for most people, this is the fall and winter). 
  • Psychotherapy. Therapy, also known as talk therapy, can also help you learn coping mechanisms to work through the depressive symptoms and interrupt the thought patterns that make the symptoms worse. 
  • Light therapy. If there is not enough natural light, artificial light can provide many of the same benefits. There are lights uniquely designed to treat seasonal depression. If you sit under them for 20 to 30 minutes a day, this will often alleviate some symptoms. Generally, the light box should provide an exposure to 10,000 lux of light and produce as little UV light as possible. 

“Most of all, it’s important to be proactive about it,” Dr. Brownlee emphasizes. “If you are noticing some troubling symptoms, act on it. There’s no reason to suffer. Visit your clinician as soon as you start to notice symptoms so this winter can be as cheery as possible.” 

If you can already feel the gloominess as the sun begins to set earlier, don’t wait. Use MedChat or call Tryon Medical Partners to discuss seasonal depression today.