Seasonal Affective Disorder (SAD) is a form of depression that follows a seasonal pattern, usually emerging in the fall and winter months when daylight hours decrease. Unlike the occasional “winter blues,” SAD significantly impacts daily life, causing symptoms that can disrupt work, relationships, and overall well-being. Affecting up to 5-10% of individuals in the U.S., SAD is particularly common in northern regions with shorter days, and it disproportionately impacts younger people and women.
Symptoms of SAD
SAD presents with symptoms similar to major depression but tied to the changing seasons, typically presenting in the fall and winter. Common signs include:
- Feeling sad or hopeless
- Loss of interest in activities once enjoyed
- Changes in appetite (increase or loss)
- Excessive sleeping or insomnia
- Feelings of guilt or worthlessness
- Low motivation and difficulty completing daily tasks
- Difficulty concentrating or paying attention
- Physical restlessness or slowed movements
Causes of SAD
SAD’s root causes are still being studied, but certain factors are commonly associated with the condition, including:
- Reduced Daylight: Shorter days disrupt the body’s internal clock (circadian rhythm), which regulates sleep, mood, and energy.
- Excessive Melatonin Production: Reduced exposure to daylight can increase melatonin, a hormone that regulates sleep, causing fatigue and drowsiness.
- Reduced Serotonin Production: Daylight helps regulate serotonin, a neurotransmitter that affects mood. Reduced light can lead to lower serotonin levels, contributing to depressive symptoms.
- Reduced Dopamine Production: Dopamine, another neurotransmitter associated with reward and motivation, may also be affected by changes in light exposure.
- Vitamin D Deficiency: Less sunlight can reduce the body’s ability to produce vitamin D, which plays a role in mood regulation.
Diagnosis of SAD
A trained healthcare professional can diagnose SAD by evaluating your symptoms and understanding their seasonal patterns. Other health conditions, like thyroid disorders or major depression, must also be ruled out.
Treatment Options for Seasonal Affective Disorder
1. Light Therapy
Light therapy is one of the most effective treatments for SAD. It involves sitting in front of a lightbox that emits very bright light (6,000 to 10,000 lux) for 30-60 minutes each day. Ideally, the therapy is done in the morning to align with the body's natural circadian rhythm, but it can be beneficial at any time of day. Incorporating bright lights into your home and taking daily outdoor walks to soak up natural light are also excellent treatment options.
2. Cognitive Behavioral Therapy (CBT)
CBT helps patients identify and modify negative thought patterns that contribute to depression. CBT tailored to SAD can improve coping skills, reduce depressive symptoms, and prevent future episodes by addressing thought patterns associated with the changing seasons.
3. Regular Exercise
Exercise, particularly outdoor activities, can be beneficial. Exercising outside provides natural sunlight exposure while boosting endorphin production, which helps improve mood and energy levels.
4. Whole Foods Diet
A diverse diet high in colorful vegetables and fruits, whole grains, legumes, fatty fish and low in processed foods, refined carbs and saturated fats is a foundation in good mental health. This supports healthy vitamin and mineral levels, is anti-inflammatory and supports a healthy gut and microbiome.
5. Vitamin D
For individuals with a vitamin D deficiency, supplementation can improve mood and alleviate some SAD symptoms. Blood testing can help identify whether you have low levels of vitamin D.
6. B Vitamins
B vitamins, especially when taken with antidepressants, may support improved mood and energy levels. B12 and folate (vitamin B9) are essential for brain function, and individuals with an MTHFR gene mutation may require activated forms of these vitamins for better absorption. While B12 and folate are the two B vitamins most commonly tested, all of the B vitamins likely play a role in good mental health.
7. Antidepressants
When symptoms are severe or other treatments aren’t effective, antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and bupropion may be recommended by healthcare providers. These medications increase serotonin and dopamine levels in the brain and can alleviate symptoms of depression.
8. Herbal Medicines for Depression
Herbal therapies have long been used to support mood disorders, and while not as well-studied as other treatments, they offer additional tools for managing SAD. Choosing the right herb is highly individualized and should be discussed with a healthcare provider, as not all herbs are safe for everyone, despite being considered "natural." As an example, here are three herbs often used for depression that may be considered for SAD:
- St. John’s Wort (Hypericum perforatum): This herb has been traditionally used for mood disorders and mild-to-moderate depression. However, it can interact with many medications, including antidepressants, so it’s crucial to consult a healthcare professional before use.
- Saffron (Crocus sativus): Saffron has shown promise in small studies for reducing depressive symptoms. Its mood-enhancing effects are thought to be linked to its antioxidant properties.
- Rhodiola (Rhodiola rosea): Known for its adaptogenic qualities, Rhodiola may help reduce fatigue and improve mood by regulating cortisol and other stress-related hormones. This herb could be especially useful for those who experience stress or fatigue with their SAD symptoms as it tends to be more stimulating.
While herbal therapies may offer support, it’s essential to discuss these options with a trained professional, as herbs can have side effects and interactions with other medications.
Conclusion
Seasonal Affective Disorder is a serious but treatable condition that affects many individuals during the colder, darker months. Understanding the causes, symptoms, and treatment options—including light therapy, exercise, vitamin D supplementation, and herbal therapies—can make a significant difference in managing and overcoming SAD. By seeking professional guidance and implementing the right strategies, you can find relief and regain control of your mood and daily life, no matter the season.
Disclaimer
The information provided in this blog and throughout the website is intended for educational purposes only and should not be considered, or used as a substitute for, medical advice. The content is not meant to diagnose, treat, or cure any medical condition. This blog does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment. Always consult with a qualified healthcare provider before making any changes to your health regimen or starting new treatments, and never disregard professional medical advice or delay seeking care because of something that you have read on this blog, website or in any linked materials. Your individual needs and circumstances should be evaluated by a medical professional to ensure safe and appropriate care. If you are experiencing a medical emergency, please call 911 or call for emergency medical help on the nearest telephone immediately.
References
Jahan-Mihan, Alireza, Priscilla Stevens, Saily Medero-Alfonso, Georgina Brace, Laurel Kate Overby, Kristin Berg, and Corinne Labyak. “The Role of Water-Soluble Vitamins and Vitamin D in Prevention and Treatment of Depression and Seasonal Affective Disorder in Adults.” Nutrients 16, no. 12 (June 17, 2024): 1902. https://doi.org/10.3390/nu16121902.
“NIMH » Seasonal Affective Disorder.” Accessed November 5, 2021. https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder.
“Psychiatry.Org - Seasonal Affective Disorder (SAD).” Accessed October 16, 2024. https://www.psychiatry.org/patients-families/seasonal-affective-disorder.
“Seasonal Affective Disorder (SAD).” Accessed October 16, 2024. https://www.psychiatry.org:443/patients-families/seasonal-affective-disorder.
Yang, Yongde, Sheng Zhang, Xianping Zhang, Yongjun Xu, Junrui Cheng, and Xue Yang. “The Role of Diet, Eating Behavior, and Nutrition Intervention in Seasonal Affective Disorder: A Systematic Review.” Frontiers in Psychology 11 (August 4, 2020): 1451. https://doi.org/10.3389/fpsyg.2020.01451.