How to identify Seasonal Affective Disorder

by Zoey Larsen

As the days get colder and shorter, it’s not uncommon to feel some version of the “winter blues” creeping in. Known as Seasonal Affective Disorder (SAD), the sadness, anxiety, and loneliness that some people experience beginning in fall and lasting until spring can make the winter months feel overwhelming. However, knowing what symptoms to watch for and how to mitigate SAD’s effects can brighten the fall and winter months for those experiencing a seasonal mood shift. 

SAD affects approximately 5% of the country’s population each year, according to Jason Addison, MD, service chief for the young adult unit at Sheppard Pratt in Maryland. Dr. Addison says it is also more common in women than men. The most prevalent form of SAD is marked by recurrent episodes of depression that begin in the fall or winter.

“Most people have some difficulty adjusting to changing patterns of sleep and daily routines with the change in seasons. Unless it affects you for more than a month, it isn’t a true disorder,” says Emily Y. Wu, MD, Staff Psychiatrist, The Menninger Clinic. Although SAD typically ends in the spring, when left untreated, symptoms may continue into the spring or summer months. 

Signs and symptoms of SAD

Beyond a sense of the “winter blues,” the most common signs that you may be experiencing fall-winter onset Seasonal Affective Disorder include: 

• depressive mood including extreme sadness and lethargy that begins or worsens in the fall or winter.

• increased appetite or weight gain during the winter months.

• inability to find joy in activities you normally would enjoy during warmer months.

• increased fatigue or sleepiness in the winter.

• overuse or misuse of drugs and/or alcohol during winter months.

• decreased social activity and overall social connections in the winter.

• depressive symptoms that resolve during travel to a sunnier location or during sunnier months.

Common causes of SAD

Although the exact cause of Seasonal Affective Disorder isn’t known, some conditions can put people particularly at risk:

• Decrease in sunlight: The decrease in sunlight during the winter months may disrupt your body's internal clock and lead to feelings of depression, says Chester Wu, MD, the director of sleep medicine at The Menninger Clinic. Further, reduced sunlight can cause a drop in serotonin, which may trigger depression.

• Being a young adult: Although the cause is not confirmed, SAD is more common in younger adults and teens than older adults.

• Living in northern climates: Because the amount of daylight becomes shorter and darkness can make SAD symptoms more severe, those in northern climates are often at an increased risk of SAD, says Dr. Addison.

• A history of mood disorders: Those who have a history of a mood disorder or a known family history of mood disorders can be more prone to SAD.

Ways to alleviate symptoms of SAD

Most people experiencing Seasonal Affective Disorder use a mix of first-line and second-line tactics to help alleviate symptoms. First-line treatments often include a doctor’s visit, but second-line treatments can be implemented yourself.

“Studies have shown that a combination of regular exercise, healthy diet, and addressing any additional underlying medical conditions can help improve depressive symptoms,” Dr. Addison says. “Don’t be afraid to see a doctor if you are starting to feel down.”

First-line treatments:

• Antidepressants

• Light therapy (phototherapy)

• Psychotherapy

Second-line treatments:

• Daily walks outside, even on cloudy days

• Consistent exercise

• Enhanced indoor lighting

• Eating healthy meals and snacks

• Maintaining regular sleep habits 

COVID-19 and SAD

According to Dr. Wu, the COVID-19 pandemic will likely complicate or exacerbate Seasonal Affective Disorder this year due to the anxiety and isolation that many people have experienced. 

Here are a few reasons why:

• Increased anxiety and psychological distress: Those who experience SAD this winter are likely to have worsening of symptoms due to existing pandemic-related anxiety.

• Disrupted daily routines: Changes in normal patterns and self-care habits may impact the ability to implement normal healthy coping strategies.

• Limited social interaction: Dealing with SAD during a pandemic, which already limits social interaction, can cause many people to experience increased tension and anxiety.

• Job stability: Increased stress from a job loss or changes in schooling for families may cause seasonal depression symptoms to worsen. 

• Disrupted holidays: With the holiday season approaching, it’s unlikely that festivities and gatherings will be the same as in previous years, limiting people’s abilities to see family and loved ones, which is a helpful coping tactic. 

Any increase in stress, including stress related to the pandemic, can contribute to worsening Seasonal Affective Disorder symptoms, but knowing what symptoms to watch for and how to treat the condition—both at home and with the help of a medical professional—can help lessen the severity of SAD and its symptoms.