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Seasonal Affective Disorder: Managing SAD

Seasonal Affective Disorder: Managing SAD

Seasonal Affective Disorder (SAD) is a type of depression that is related to seasonal changes. Most people with SAD have symptoms that begin in the fall and continue into the winter months, causing fatigue and changes in moods. Though rare, SAD can occur during the spring or early summer. 

If you experience Seasonal Affective Disorder, don't brush it off as a simple case of the winter blues that you have to tough out on your own. This is a legitimate condition and there are steps that you can take to keep your mood and motivation steady throughout the year.

Symptoms of Seasonal Affective Disorder

In most cases, SAD symptoms appear during late fall or early winter and disappear during spring and summer. Less commonly, the opposite pattern can cause spring or summer symptoms. In either case, symptoms may start out mild and become more severe as the season progresses.

Signs and symptoms of SAD may include:

  • Depression that persists for an extended period of time.
  • Losing interest in activities you once enjoyed.
  • Fatigue.
  • Difficulty sleeping.
  • Appetite or weight changes.
  • Agitation.
  • Difficulty concentrating.
  • Feeling hopeless, worthless, or guilty.
  • Having frequent thoughts of death or suicide.

Some of these symptoms appear more often in winter SAD or summer SAD. The seasons can also bring changes in those with bipolar disorder, such as hypomania in summer or depression in winter.

Complications

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

Treatment can help prevent complications, especially if SAD is diagnosed and treated before symptoms get worse.

When to See a Doctor

It's normal to have some days when you feel down, but if you feel down for days at a time and you can't get motivated to do activities you normally 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 suicideSee your doctor. 

 

Causes and Risk Factors

Causes

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

Your biological clock, or circadian rhythm: The reduced level of sunlight in fall and winter may cause winter onset SAD. The 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, or neurotransmitter, that affects mood, might play a role in SAD. Reduced sunlight can cause a drop 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. 

Risk Factors

Seasonal Affective Disorder is diagnosed more often in women than in men, and SAD occurs more frequently in younger adults than in older adults. Factors that may increase your risk of SAD include:

Family history: People with SAD may be more likely to have blood relatives with SAD or another form of depression.

Having major depression or bipolar disorder: Symptoms of depression may worsen seasonally if you have one of these conditions.

Living far from the equator: SAD appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter and longer during the summer months.

 

Treating and Managing Seasonal Affective Disorder

Light Therapy Seasonal Affective Disorder

Treating SAD

Treatment for SAD may include light therapy, medications and psychotherapy. If you have Bipolar Disorder, tell your doctor - this is critical to know when prescribing light therapy, or an antidepressant. Both treatments can potentially trigger a manic episode.

Light Therapy

In light therapy, you sit near a special light box so that you're exposed to bright light within the first hour of waking up each day. Light therapy mimics natural light and appears to cause a change in brain chemicals linked to mood.

Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to a few weeks and causes few side effects. Research on light therapy is limited, but it appears to be effective for most people in relieving SAD symptoms.

Before purchasing a light box, talk with your doctor about the best one for you, and familiarize yourself with the variety of features and options so that you buy a high quality product that's safe and effective.

Medications

Some people with SAD benefit from antidepressant treatment, especially in severe cases. An extended release version of the antidepressant bupropion may help prevent depressive episodes in people with a history of SAD. Other antidepressants also may be commonly used to treat SAD.

Psychotherapy

Also called talk therapy, psychotherapy is another treatment option for SAD. A type of psychotherapy known as cognitive behavioral therapy can help you learn healthy ways to cope with SAD, especially by scheduling activities and reducing avoidance behaviors.

Alternative Medicine

Certain herbal remedies or supplements or mind-body techniques are sometimes used to try and relieve depression symptoms, though it's not clear how effective these treatments are for SAD. Talk with your doctor or pharmacist about what vitamins, minerals, or supplements are safe for you, as some do interfere with prescription medication and could cause dangerous interactions. 

Managing Sad

These steps can help you manage SAD, but the most important thing you can do is stick to your treatment plan! Regular management is crucial: 

Practice relaxation and stress management techniques: Yoga, Tai Chi, meditation, guided imagery, and music or art therapy.

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 2 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 active and fit can make you feel better about yourself too, which can lift your mood. 

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, sympathy, or shared laughter. 

Pets: Spending time with animals can have tremendous health benefits and improve your mood dramatically. Studies show that by simply petting a dog can decrease blood pressure, lower stress, and improve overall happiness levels. 

Travel: If possible, take winter vacations in sunny, warm locations to manage winter SAD, or to cooler locations if you have summer SAD.

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